Paediatric Dressings Advice

This leaflet provides information on the aftercare of wounds and is intended for parents, guardians or carers of children who have had wound treatment or have undergone surgery in hospital.

Wound care

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). Some wounds need stitches or glue or a specific dressing to close them. Caring for your child's wound is important to promote healing, avoid infection and minimise scarring.

Your child’s dressing

Dressings keep out germs and protect the wound from injury. They also keep the wound warm and moist so it can heal. Most dressings can be left for several days. Unless you are advised otherwise please keep the dressing intact, clean and dry. You can apply extra tape to secure it if needed. We will advise if the dressing needs to be removed or changed at home.

Plaster casts and K-wires

Your child may have been fitted with a plaster cast on with or without K-wires K-wires are surgical wires used to hold a broken bone in position and usually stick out of the skin so they can be easily removed once the bone is healed. It is important that you try to keep the plaster cast clean and dry. Keep the limb elevated to help reduce swelling and do not put anything inside the cast. K-wires must be kept in place until your surgeon advises that they can be removed. Keep the end of the wire(s) covered and protected at all times.

Changing the dressing at home

• First wash your hands.
• Ideally change the dressing at the same time each day, in a clean, calm environment.
• We recommend soaking the dressing off in the bath and applying a clean, dry dressing immediately afterwards. It will be easier to remove when wet. Ideally use a soap / gel that is pH neutral or un-perfumed.
• Distraction is a very effective tool for worried children; using favourite toys, books, or playing a game or video on a phone/ tablet might help keep your child calm.
• Once you have removed the old dressing, check the wound is clean and dry and look for signs of infection.
• Apply the clean dressings as advised when you attended clinic.
• If needed use extra tape to secure the dressing in place.
• If the wound is almost healed and/ or you feel it needs extra protection then you may use shop bought plasters if needed.

Signs of infection

Wounds often look red and swollen as they are healing, and may ooze slightly, bleed small amounts or be scabby.

You may need to consider that there is an infection if you see the following signs:

• Excessive exudate (oozing) that is green / yellow.
• The wound (not the dressings) smells very bad.
• Increase in pain that does not improve with distraction, paracetamol or ibuprofen.
• Your child complains the wound feels hot and / or itchy.

If you are concerned that there is an infection seek medical advice via your GP or local walk-in centre.

If your child seems very unwell, lethargic and has a fever, suspect SEPSIS and attend your nearest A&E immediately.

Frequently asked questions:

My child seems to be in pain?

Regular paracetamol and ibuprofen should help; give according to the bottle/ packet label. We recommend staggering the doses of each for maximum effect. Also, distraction can be helpful. Do seek further advice if you think your child’s pain is excessive.

Can my child bath / shower as normal?

Unless you are changing the dressing (as advised) please try and keep it clean and dry and intact. We recommend doing a top and tail wash using soapy water and a sponge/ flannel.

Can my child play outside?

Yes, but if they are likely to get ‘grubby’ (in mud / sand etc.) please ensure their wound and/ or dressing is covered.

Can my child play sports?

No, we recommend that until the wound is healed they avoid partaking in activities that may cause further damage or any delay to wound healing. If any tendons or nerves have been damaged please seek advice from the plastic surgeon before your child takes part in any sports.

Can my child go swimming?

No, we advise against this until the wound is healed and your child cannot go swimming while they have a plaster cast on. If they don’t have a cast we still advise no swimming until at least four weeks after the first dressing change.

Will there be a scar?

Yes, all wounds leave a scar but there are things you can do to minimise scarring. Keeping the wound protected from the sun will prevent it from becoming darker. Applying a moisturiser daily once the wound has healed in a massaging motion will also help with healing and improve the appearance.

Name: Date:

Dressings to be changed at home: YES/ NO Leave on until next appointment

Change in . . . . days. And then every day until healed.

Take off dressing in . . . . days and then leave undressed.

Dressings provided for home:

Adaptic Touch (silicone mesh) ☐ Gauze (white cloths) ☐

Cosmopore (white plaster) ☐ Bandages ☐

Leukomed T (clear plaster) ☐ Tape ☐

Tubigrip (can be washed / re-used) ☐

Chloramphenicol Ointment; apply twice a day ☐

Other:

Your next appointment will be:

☐ In the Paediatric Dressings Clinic:

☐ To see the Plastic Surgeon in:

Days Weeks Months

Date / Time:

☐ You are discharged from Clinic.

Please contact the appointment centre via Addenbrooke’s switchboard 01223 245151 if you do not receive notice of an appointment and are expecting one.

Before attending the dressings clinic please give your child paracetamol or ibuprofen to help keep them comfortable during the dressing change.

If you have any further questions please don’t hesitate to contact Clinic 7 at Addenbrooke’s Hospital via 01223 216098, Mon - Fri, 09:00 to 17:00.