A wound is a break in the skin caused by a laceration (cut), abrasion (scrape), puncture, blister or incision (opening made during surgery or a medical procedure).

Caring for your child's wound is important to promote healing, avoid infection and minimise scarring. Different types of wounds require different dressing products and care. Your doctor or nurse will provide specific instructions, organise follow-up and discuss a home dressing management plan.

If your child's wound has been closed with stitches, glue or staples, see our fact sheet Stitches and glue care.

If your child needs first aid treatment for a wound, see our fact sheet Cuts, grazes and lacerations.

Wound care at home

The following recommendations will help your child's wounds heal safely.

Keep the dressing dry

If your child has a simple wound, keep a clean, dry dressing on the wound. Dressings keep out germs and protect the wound from injury. A dressing also keeps the wound warm and moist so it can heal. Most dressings can be left on for several days.

• Your child should avoid swimming until the wound has healed.
• Baths should be avoided until otherwise instructed by your doctor (usually about six weeks depending on the wound). It is better to give your child a shower as it is easier to keep the wound dry.
• If your child has had surgery, a dry waterproof dressing is usually applied before you go home. This is normally a clear, sticky dressing which is placed over another dressing. Your child will be able to have a shower if the dressing is waterproof.
• If the dressing is not waterproof and it gets wet, it will need to be removed and replaced with a clean dressing. 
• If your child has had neurosurgery, waterproof dressings are not used and the dressing should be kept dry at all times. Your child can have a bath or shower but must keep their head dry. The dressing will be removed 10 days after surgery.

Protect the wound

Always wash your hands before and after touching your child's wound. This is the most important thing you can do to prevent infection. You can wash your hands with soap and water, or with an alcohol-based hand rub.

• Protect the wound from bumps or pressure on the wound. Try to make sure your child avoids active play or contact sports until the wound has healed.
• Protect your child's wound from the sun. Cover the wound to keep it out of the sun, and after it has healed use sunscreen on the scar for at least a year. This will help to prevent the scar from darkening.
• If your child has had surgery, allow surgical tapes to wear off on their own – don't peel them off. If surgical tapes begin to loosen at edges, trim the curling edge.

Encourage a healthy diet

A balanced diet will give your child the building blocks their bodies need to heal a wound. Make sure your child's diet includes:

• Protein: provides building material for muscle and skin repair (e.g. lean pork and beef, chicken, fish, legumes (beans), lentils, tofu, nuts, dairy products).
• Carbohydrates: supplies the energy needed for healing (e.g. wholegrain breads and cereals, potatoes, rice, pasta, fruit and vegetables).
• Foods with vitamin A : supports skin repair and the immune system (e.g. bright orange fruits and vegetables, dark leafy vegetables like spinach).
• Foods with vitamin C: assists in collagen production and supports the immune system (e.g. citrus fruits).

Dressing removal and changes

Any dressings can be removed one to two weeks after surgery (unless you are told otherwise). You can see your GP for a wound check or, if you feel confident, you can remove the dressing yourself. If the wound appears well healed a new dressing is not needed.

Your child may have unhealed areas that still require dressing changes. If this is likely, you will be instructed on how to change dressings before you leave hospital. If your child's dressing is complicated you will be given a specialist clinic appointment, have nurse visits organised or be asked to visit your GP.

Dressing changes should take place in a clean area of your home. When changing the dressing:

• always wash your hands well before and after changing the dressings
• place the new dressings on a clean area and open before removing the old ones
• try to avoid touching the wound as much as possible
• look for signs of infection (see below)
• be gentle if bathing burned skin.
  

When to see a doctor

To start with, it is normal for your child's wound to appear slightly red or raised in appearance. The edges of the wound should come together neatly and there should be no open areas. See your doctor if you are worried about your child's wound or think that it may be healing too slowly.

All wounds are potentially at risk of developing an infection. To ensure any infection can be treated as soon as possible, it is important to watch for the following signs of wound infection:

• The skin around the wound becomes red and may be hot to touch.
• There are large or increased amounts of discharge from the wound.
• A pimple or yellow crust has formed on the wound.
• Change in discharge colour  – it may change from clear to yellow or green.
• The wound has an unpleasant smell.
• Your child develops a fever and generally feels unwell.
• Your child experiences increased pain.

If any of the above symptoms occur, contact your GP or treating doctor as soon as possible, or take your child to the nearest hospital emergency department.

If your child has had neurosurgery, contact the hospital immediately if there is any sign of infection or fluid coming from the wound.

Key points to remember

• Keep the dressing of the wound dry. Give your child a shower instead of a bath.
• Protect the wound from bumps, pressure and the sun.
• Always wash hands before and after touching the wound, or when changing dressings.
• Watch for the signs of infection and seek medical advice if an infection develops.

For more information

• Kids Health Info fact sheet: Burns – medical treatment
• Kids Health Info fact sheet: Stitches and glue care
• Kids Health Info fact sheet: Cut, grazes and lacerations
• Contact your GP or treating hospital.

Developed by The Royal Children's Hospital Nursing Services, in consultation with the General Medicine, Surgery and Dermatology departments. We acknowledge the input of RCH consumers and carers.

Reviewed June 2018.

This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.

Kids Health Info is supported by The Royal Children’s Hospital Foundation. To donate, visit www.rchfoundation.org.au.