A wound is an injury that damages the skin or tissues of the body. Wounds may be located on the surface of the skin, under the skin, or both.
Good wound care helps prevent infection, speeds up healing, and reduces other problems, such as scarring, tissue damage, pain, and difficulty moving.
Check your child’s skin regularly and report any changes or problems to your care team.
There are several types of wounds with different causes. These include:
- Abrasions (scrapes): When the top layer of skin is scraped off
- Cuts: Breaks in the skin caused by sharp objects or surgery
- Lacerations: Jagged wounds caused by blunt objects or tearing of the skin
- Burns: Injuries caused by heat, chemicals, or radiation
- Puncture: Wound caused by a pointed object that makes a small, deep hole
- Pressure injuries (bedsores or pressure sores): Sores or tissue damage caused by prolonged pressure and decreased blood flow, which can happen from being in one position too long or having medical devices that press on the skin.
Wounds in children with cancer or other serious illness
Certain medical conditions and treatments can make your child more likely to get wounds. Or their wounds might be slow to heal or be more severe. Factors that might increase your child’s risk include:
- Medical conditions, such as cancer, diabetes, immune system disorders, or other chronic illness
- Chemotherapy, radiation therapy, steroid medicines, and other treatments
- Neutropenia or weakened immune system
- Having a medical device, such as a feeding tube, central line, orthotics, or other equipment
- Bedrest or limited mobility
- Repeated surgeries or procedures
Talk to your care team about ways to help protect your child’s skin and how to prevent infections.
Some wounds can take days to develop. Others can develop quickly. Be sure to let your care team know about any changes in your child’s skin.
Signs and symptoms of wounds include:
- Scaly, flaky, cracked, or broken skin
- Scabs or sores
- Blisters or raised skin
- Bleeding, including bleeding in skin creases of the knuckles, elbows, or other joints
- Drainage of fluid or pus
- Rash or itching
- Swelling or warmth
- Pain, tenderness, burning, numbness, or tingling
- Changes in skin color, such as redness, purplish bruising, or discoloration
On darker skin tones, bruises or wounds may look different. For example, they can appear as areas that are darker or lighter than the surrounding skin.
Wound healing occurs through a series of steps or phases. In general, these include:
- Bleeding and clotting: The flow of blood is slowed through the tightening of blood vessels and blood clotting. Platelets in blood are activated and stick together to slow and stop bleeding.
- Inflammation: White blood cells travel to the wound to get rid of dead cells, germs, and debris. Immune cells also release substances to signal the growth of new tissues to help heal the wound and prevent infection.
- Skin repair and tissue growth: New blood vessels, collagen, and skin cells begin to grow. The edges of the wound pull together to close the wound.
- Strengthening: As the wound heals, the tissue becomes stronger. A scar may form. Scarring depends on how deep the wound is. Scars may appear smaller or fade over time as your child grows.
The time it takes for a wound to heal depends on the kind of wound, how big and deep it is, and where it is located on your child’s body. Healing also depends on your child's medical condition, treatments, and how well their immune system works.
Some medical conditions and treatments can lead to delayed wound healing or slow or incomplete healing of wounds. Talk to your health care team about what to expect during the healing process.
Most wounds heal over time with proper care. But each wound is different. Your health care provider will select the best treatment based on the wound type and your child’s health needs.
To treat your child’s wound, your care team will usually follow these steps:
- Examine the wound: Your care team will assess the type of wound and its severity. They may ask questions about your child’s health and medical history, how long the wound has been there, and how you have treated it.
- Clean the wound: Your care team will clean the area with soap and water, sterile saline, or antiseptic solution. In some cases, debridement may be done to remove dead tissue, dirt, or debris in the wound.
- Close the wound: If needed, the wound will be closed using stitches, staples, skin glue, or adhesive strips. Some wounds may be left open to heal.
- Give medicines: Your care team may give medications for pain or to prevent or treat infections. They may apply an ointment or other medicine to the wound to promote healing.
- Apply a dressing: Your care team may use a bandage or sterile dressing over the wound to protect it from germs and help it heal.
- Give wound care instructions: Your care team will let you know how to care for your child’s wound and what follow-up care is needed.
Your care team may use other treatments, such as negative pressure wound therapy (wound vac).
How to care for wounds at home
Your care team will teach you how to care for your child’s wounds. Always wash your hands with soap and water or use hand sanitizer before and after doing any patient care task.
Do not apply any ointment, powder, or other product to the wound without consulting your care team.
Here are some simple tips for taking care of wounds at home:
- Keep the wound clean and dry: Clean the area as instructed by your care team. Minor wounds can usually be cleaned with mild soap and water. Do not use hydrogen peroxide or rubbing alcohol on wounds. Only use products recommended by your care team.
- Protect the wound: Keep the wound covered with a bandage or dressing if recommended.
- Change dressings as directed: Your care team will tell you how often to change bandages or dressings. Change dressings if they become wet, dirty, or loose.
- Follow instructions for medicines: Give antibiotic medicines if the care team prescribes them. Be sure your child takes all doses, even if the wound has improved. Apply ointments or creams to the wound as instructed. Only use products approved by the care team.
- Avoid irritating the area: Help your child avoid picking or scratching, as it can slow healing and increase the risk of infection.
- Follow activity restrictions: Ask your care team about any activities your child should avoid while the wound heals, such as swimming or sports.
- Pain management: Give pain medicine as prescribed or recommended by your child’s doctor to keep your child comfortable. Let your care team know if your child’s pain gets worse or does not get better as the wound heals.
- Watch for signs of infection: Call your care team if you notice redness, swelling, warmth, pus, a bad smell, or if your child develops a fever or chills.
If you are unsure how to care for your child’s wound, contact a health care provider.
When to call your care team
Contact your care team if you notice any of the following:
- A new wound or skin change
- Increased pain, redness, warmth, or swelling around the wound
- Discharge, pus, or bad smell from the wound (yellow or green)
- Fever, chills, or nausea
- Dirt or debris in the wound
- Pain, redness, swelling, warmth, or discharge around a medical device (catheter, feeding tube)
Questions to ask your care team
