Lacerations

What Causes Lacerations in Children?

Falls are by far the most common cause of lacerations in children. Most falls happen when kids run and trip, slip off furniture or playground equipment or tumble down the stairs. 
 
Other common laceration causes include: 

• Using kitchen utensils, especially among older kids helping in the kitchen
• Being bitten by an animal, often from unfamiliar pets or when kids get in the way of food or toys
• Playing sports, including contact sports, bike riding and skateboarding   

What Are the Signs of a Laceration?

A laceration is a cut deep enough to cause bleeding. Lacerations can happen anywhere on the body and are usually minor. Some, however, require medical attention. 

Should I Take My Child to the ER for a Laceration? 

Most of the time, you don’t need to visit the ER for a cut. A bandage — or a virtual consultation with your pediatrician — will be enough. 
 
However, you should consider an emergency room visit if:  

• Bleeding doesn't stop after 10 minutes of applying pressure – with no peeking, so a clot can form.
• It is deep or gaping enough to expose fat, muscle or bone.
• The cut is on the face, ears hands or feet.  
• It is the result of an animal or human bite.
• The cut was made by a dirty or rusty object.
• Your child is under 5 years old.
• It has been more than 5 years since your child’s last tetanus shot. 

Cuts inside the mouth or inner lip usually heal on their own. If you have any worries about injury to the teeth or gums, it's still important to get them checked. Pediatric dentists will often see kids on the day of or day after an injury. 

How Are Lacerations Treated in the ER? 

Here’s what to expect during your child’s emergency room visit: 

• Triage: A nurse will assess the size and depth of the laceration to determine how quickly it needs medical attention.
• Numbing: A nurse will apply a numbing gel called LET (made of lidocaine, epinephrine and tetracaine) and cover the cut with a bandage. LET needs at least 20-30 minutes to take effect. For deep cuts, your child might also receive a lidocaine shot, but only after the numbing gel starts to work.
• Examination: A doctor, nurse practitioner or physician assistant will look at the wound and assess how best to close it. They’ll also check for foreign bodies and injuries to muscles, nerves, tendons, major blood vessels or other deep structures. Sometimes x-rays are needed.  
• Cleaning: Washing out the wound well with saline (sterile salt water), tap water or wound solution (like Vashe) is important for preventing infection.  
• Comfort: If your child is anxious, very young or has a complex laceration they may receive Versed (midazolam), a medication that helps them relax and reduces memory of the procedure. In some cases, deeper sedation is needed. At Lurie Children’s, a child life specialist is often part of your child’s care team. They can explain medical procedures in ways that make sense to your child. They are also trained to make the experience less scary and more manageable with toys, iPads, music, bubbles and lights. 
• Closure: Most lacerations can be repaired by the team in a pediatric ER and do not need a plastic surgeon. If the wound edges come together easily, the provider will likely use skin glue. If not, the provider will stitch the cut closed. They need to use stiches when a cut is in an area with tension or movement. They may use dissolvable stitches. 

Why Go to a Pediatric Emergency Room?  

A pediatric ER, like the one at Lurie Children's, is designed just for kids and offers special advantages: 

• Appropriate closure methods: Pediatric ERs often use skin adhesive (skin glue) for smaller cuts that come together easily. Whenever possible, they use stitches that dissolve and don't require a follow-up appointment for removal.
• Child-friendly environment: Child life specialists and other child-specific resources will help ease your child's worries. Pediatric experts make the experience less scary for everyone.
• Pain management techniques: Pediatric ERs often use techniques like numbing gel instead of shots to ease pain. For younger or anxious children, they may use a medicine called midazolam (Versed) to reduce anxiety.
• Specially trained staff: Pediatric emergency physicians and nurses have experience treating children’s cuts and injuries. Because kids heal quickly, most cuts can be managed without a surgeon.
• Surgical expertise: Pediatric ERs, like Lurie Children’s, can handle more complex cases that might need surgery. This can help prevent the need to transfer your child to another facility. For example, If the laceration involves ligaments, tendons, bones, joints or blood vessels, Lurie Children's can consult their surgical colleagues within the same facility.  

Urgent care centers often will need to refer young children with lacerations to a pediatric ER because they usually are not equipped to handle the situation.  

Tetanus Check 

When there is a cut, it is important to check if your child needs a tetanus shot. Tetanus is a concern if dirt, rust or saliva from an animal bite contaminates the wound. If the wound is dirty and your child hasn't had a tetanus shot in the last 5 years, they may need one. 

How to Care for Lacerations at Home 

Parents often have questions about what to expect after treatment. Here are some common concerns: 

• Can my child take a bath right after getting stitches or skin glue? No. Keep the wound dry for the first 24 hours. Sponge baths are fine, though. Generally, after the initial 24 hours, your child can take brief showers. Be sure to pat the cut dry to promote healing. Avoid submerging the wound until your doctor removes stitches, the stitches dissolve or skin glue naturally falls off with 5 days.
• How do I protect the skin glue? Think of skin adhesive as a liquid bandage. Keep the area dry and untouched. The adhesive will naturally flake off in five to seven days. Avoid applying ointments or oils to skin glue, because these will dissolve it and can cause a cut to open back up.
• What if my child develops a fever? If your child has a fever, redness, swelling or pus drainage from the wound, seek medical attention to check for infection.
• What if there is blood or fluid on the bandage? A few small blood spots or a clear yellow fluid on the bandage are normal. However, if the bleeding is heavy or doesn’t stop, contact a doctor immediately.  

What Are the Long-Term Consequences of a Laceration? 

Any time the skin is cut, there will be some scarring. Most lacerations heal well with proper care. Scars stay smallest when wounds are cared for properly and infection is prevented. 

Infection 

Infection is the biggest problem after a laceration, especially if treatment is delayed. Parts of the body your child uses frequently, like the hands, get infected more easily because they’re exposed to more germs. In some cases — particularly with animal bites or deep wounds — doctors may leave the wound partially open to prevent an infection from forming beneath the skin. 

Scarring  

Abrasions will not scar but because lacerations go through all layers of the skin, they will leave a scar. However, the right treatment and aftercare can minimize scarring. Here are some tips: 

• Keep wound closed with stitches moist: Apply bacitracin ointment (or Vaseline) three times a day for the first five days.
• Massage the scar: After stitches are removed or dissolve (after 5 to 14 days, depending on the body region that was cut), gently massage the area in small circles using petroleum jelly, Vaseline or Aquaphor.
• Protect from the sun: Sun exposure can cause scars to darken and thicken. Apply sunscreen to the area for at least six to 12 months after healing. 

Why Choose Lurie Children’s? 

Lurie Children’s Pediatric Emergency Care takes a child-centered approach to laceration care, giving you and your child the best possible experience. Our specialists are highly skilled in treating children while keeping them calm and comfortable.
 
For more complex injuries, our team works with in-house pediatric surgeons and specialists, so your child gets expert care all in one place. We design every step of the process with children in mind, from washing to wound closure to minimizing pain, anxiety and long-term scarring. 

For non-emergencies and illnesses that are not life-threatening, we offer in-person and virtual Immediate Care services. Learn more about Lurie Children's Immediate Care. 

About Lurie Children’s Emergency Services

The Kenneth & Anne Griffin Emergency Care Center at Lurie Children’s Hospital is a trusted resource for families across the Chicago area, providing care for more than 60,000 children each year. With a team of board-certified pediatric emergency medicine specialists and fellows, the center offers expert support for a variety of illnesses and injuries, including lacerations. Backed by an extensive range of pediatric medical and surgical subspecialties and advanced diagnostic services, it ensures every child receives thoughtful, thorough, child-centered care. Learn more about our pediatric emergency services.

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