Wound Infection

Pediatric HouseCalls Online

DEFINITION

• A break in the skin or a sutured wound shows signs of infection

Symptoms of Wound Infections

• Pus or cloudy fluid is draining from the wound.
• A pimple or yellow crust has formed on the wound.
• The scab has increased in size.
• Increasing redness occurs around the wound.
• A red streak is spreading from the wound toward the heart.
• The wound has become extremely tender.
• Pain or swelling has increased 48 hours after the wound occurred.
• The lymph node draining that area of skin may become large and tender.
• A fever occurs.
• The wound hasn't healed within 10 days after the injury.

Return to School

• For true wound infections, your child can return to day care or school after the fever is gone and your child has received antibiotics for 24 hours.

See More Appropriate Topic (instead of this one) If

• Stitches and not infected, see SUTURE QUESTIONS.

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WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

• Not moving or too weak to stand

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick.
• Fever occurs.
• Red streak runs from the wound. 
• Increasing redness around the wound.
• Severe pain in the wound. 
• Any face wound with signs of infection.

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think your child needs to be seen.
• Pus or cloudy drainage from the wound. 
• Pimple where a stitch comes through the skin.
• Wound becomes more painful or tender after the 2nd day.

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns

Parent Care at Home If

• Mild redness of wound and you don't think your child needs to be seen.

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HOME CARE ADVICE FOR MILD REDNESS OF WOUND

1. Warm Soaks or Local Heat:
   • For open cuts or scrapes, soak it in warm water or put a warm wet cloth on the wound for 20 minutes 3 times per day. Use a warm saltwater solution containing 2 teaspoons of table salt per quart of water.
   • For closed or sutured cuts, apply a heating pad or warm, moist washcloth to the reddened area for 20 minutes 3 times per day.
   • Cautions for sutured wounds: Avoid any moisture to wound for first 24 hours. Never soak the wound before all sutures are removed.
2. Antibiotic Ointment: Apply an antibiotic ointment 3 times a day. If the area could become dirty, cover with a Band-Aid.
3. Pain Medicine: For pain relief, give acetaminophen (e.g., Tylenol) or ibuprofen.
4. Fever Medicine:
   • Fevers only need to be treated with medicine if they cause discomfort. That usually means fevers above 102° F (39° C).
   • Give acetaminophen (e.g., Tylenol) (See Dosage Chart) or ibuprofen (e.g., Advil). (See Dosage Chart)
5. Expected Course:
   • Pain and swelling normally peak on day 2.
   • Any redness should go away by day 3 or 4.
   • Complete healing should occur by day 10.
6. Contagiousness: For true wound infections, your child can return to day care or school after the fever is gone and your child has received antibiotics for 24 hours.
7. Call Your Doctor If:
   • Wound becomes more painful
   • Redness starts to spread
   • Pus, drainage or fever occurs
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 1/19/2009

Last Revised: 6/24/2008

Content Set: Pediatric HouseCalls Online

Copyright 1994-2009 Barton D. Schmitt, M.D.