Pediatric Facial Lacerations: First Aid and Suturing Methods

Hello,

This is Dr. J from Cheongdam SNU Plastic Surgery Clinic.

Today, I would like to share effective ways to deal with

pediatric facial lacerations and some tips.

I will introduce useful methods, especially when treating

children around 5 years old who are beginning to understand speech.

1. Characteristics and First Aid for Pediatric Facial Lacerations

Pediatric facial lacerations

are common in boys under 4 years old

and frequently occur on the forehead.

Children have a larger head-to-body ratio than adults

and are more active, leading to frequent

falls and collisions.

When a laceration occurs,

prompt first aid is necessary.

✅ Clean with clean water

If foreign matter remains, the risk of infection increases,

and immediate suturing may be difficult, so

the wound should be cleaned with clean water.

✅ Stop the bleeding

Apply pressure to the wound with clean gauze or a towel

to stop the bleeding.

✅ Maintain protection

Cover the wound with a bandage to prevent it from drying out

and to prevent secondary infection.

2. Suturing Tips for Children Who Understand Speech

Children around 5 years old hear the word ‘suture’

and associate it with needles and thread, causing fear.

Parents do not need to scare them in advance either.

In such cases, it is important to use techniques

to stabilize the child's psyche

for the procedure.

✅ Disguise it as applying medicine

Reassure the child by explaining, ‘We’re just going to apply medicine a few times and then go home.’

✅ Minimize pain induction

After applying disinfectant 1-2 times, if the child

says ‘It hurts,’ quickly administer the anesthetic injection.

At this time, explain in advance, ‘It will sting for a moment,’

to reduce fear.

✅ Distract attention

Since there is virtually no pain due to the injected anesthetic,

continue by saying something like, ‘We’re applying medicine again,’

and ‘If you close your eyes, the medicine won’t go in,’

then carefully proceed with suturing.

Simultaneously, during the procedure, occasionally

provide orientation, such as ‘We’ve applied the medicine this many times,’

to help the child understand the progress.

Using this method,

9 out of 10 children feel almost no pain

and tolerate the suturing process well.

3. When General Anesthesia is Needed

Not all lacerations can be treated with local anesthesia.

In the following cases,

general anesthesia should be considered.

1) For very young children who do not understand speech.
2) For severely contaminated or extensive wounds.
3) For wounds near the airway (nose, mouth, tongue).
4) For complex cases requiring internal exploration of the wound.

Especially,

general anesthesia may be necessary for pediatric patients

where airway management is difficult.

4. Post-Suture Care: Minimizing Scars

Even after suturing, proper care

significantly influences scar formation.

✅ Suture removal

Sutures on the face should be removed

within 5-7 days.

✅ Use of Steri-Strips

For 2 weeks to 2 months after suture removal,

use Steri-Strips (skin closure tapes) to

prevent the wound from reopening.

✅ UV protection

The scar area should not be exposed

to ultraviolet rays.

Using sunscreen and physical barriers

(such as covering with bangs) can

reduce pigmentation.

5. Pediatric Facial Lacerations: Prevention is Key!

As pediatric facial lacerations frequently occur indoors,

home safety management is necessary.

✔️ Install protective covers

on furniture corners.

✔️ Lay safety mats in areas where

children play.

✔️ Parental supervision is required.

When dealing with pediatric facial lacerations,

an approach that considers the child's psychological state

is necessary.

For children who understand speech,

methods utilizing calming techniques are effective, and

in complex cases, suturing should be performed

under general anesthesia.

For the precious future of our children,

prevention is paramount, and

if an accident occurs,

appropriate treatment by a plastic surgeon

can aid in the subsequent scar healing process.

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