Wounds

• Soft-tissue wounds, including abrasions, punctures, and lacerations, are common pediatric injuries. • The cosmetic outcome of wounds depends on multiple factors, including static tension on the wound, the proximity of wound edges, innate healing characteristics of the wound, and underlying medical conditions of the patient. • A physical examination should determine the extent of the wound and any underlying or associated injuries. • Patients should have adequate analgesia or procedural sedation for wound exploration and repair. • The method of wound closure depends on the type, location, and size of the wound. • Complications of wound healing can be minimized through irrigation, removal of foreign body, and the splinting of wounds under high tension. • There are a few indications for prophylactic antibiotics, including some mammalian bites and open fractures. Tetanus immunization status should be elicited and updated when appropriate. • Subspecialty consultation may be necessary for severe multisite trauma, open fractures, cosmetically sensitive body regions, or extensive wounds.