Wound care – The Alex

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Wound closure with skin glue

Skin glue is as strong as stitches and has the added benefit of not leaving stitch marks either side of the wound. It may help to think of the glue as a ‘pretend scab’. As the wound heals the glue will naturally fall off. This usually takes 5 to 10 days. You should never pick the glue off. Wounds on the scalp that have been glued should be kept dry for 4 to 7 days and hair should not be washed during this time. Sometimes, Steri-Strips are used with skin glue; then, treat the wound as if it was glue only.

Wound closure with Steri-Strips

Steri-Strips are narrow strong sticky strips that help to close the edges of a small wound and should be left in place for a minimum of 7 days. After this you can soak them off in the bath or shower, but it is perfectly safe to leave Steri-Strips on the wound until they fall off naturally. If the Steri-Strips begin to peel off before the 7 days, you can carefully trim them down (on older children) otherwise put a normal plaster over the top.

Wound closure with sutures (stitches)

Sutures, or stitches, hold the edges of a wound together until it heals. They are made from different materials. Some sutures are absorbable and will dissolve without needing to be removed. Most sutures used in ourChildren’s Emergency Department are nylon and need removing at a later date. The choice is based on which is most suitable for your child’s wound.

When will the sutures be removed?

The length of time that sutures stay in the skin will depend on where the wound is. It is important that you do not leave them in for longer than advised as sutures may begin to irritate the skin or become buried and difficult to remove if left in too long. Your GP or practice nurse can remove the stitches at the right time.

Will my child have a scar?

Yes, your child will have a scar. Scarring is a result of the body’s natural healing process and will vary from person to person. When there is a cut to the skin, the body produces more protein called collagen and this builds up where the tissue has been damaged, helping to heal and strengthen the wound.

For a period of about three months or longer, new collagen continues to form and blood supply increases. The scar becomes raised, lumpy and red. Gradually the scar will become smoother, softer and paler.

Scar tissue is delicate and burns easily in the sun. You should apply a high factor sun screen to the scar for up to a year whenever your child is out in the sun. Although scars are permanent, they can fade over a period of up to two years. It is unlikely they will fade any more after this time.

What are the signs of infection?

These may be signs that your child’s wound is infected and they may need antibiotics. Your GP or local walk-in centre will be able to assess this for you.

Useful numbers

NHS 111 – 24hr advice line