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)