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WOUND INFECTIONS IN CHILDREN

Immuno-suppression from chronic parasitic infections or underlying malnutrition greatly affect wound healing and risk of infection

Preventing infection

  • Cleaning wound: most important factor
  • Antibiotics usually not necessary unless:
    • Wound older than 12 hours
    • Deep penetrating wounds (dirty stick, knife)

Wound closure

  • Less than 24 hours from injury, cleaned properly: primary closure
  • Greater than 24 hours, contaminated or animal bite: do not close
  • Wounds not closed primarily should be packed lightly with damp gauze
  • If clean after 48 hours, delayed primary closure
  • If wound infected, pack lightly, heal by secondary intention
  • Clinical signs:
    • Pain, swelling, redness, warmth, pus drainage
  • Treatment
    • Open wound if pus present or suspected
    • Clean with disinfectant
    • Pack lightly with damp gauze, change daily
    • Antibiotics until cellulitis resolved
      • Staphylococcus: Cloxacillin (25-50mg/kg po qid)
      • Suspected bowel flora : Ampicillin (25-50mg/kg po qid), Gentamycin (7.5 mg/kg IM or IV once a day) and Metronidazole (7.5 mg/kg tid)
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