Effective Scar Management for Pediatric Trauma: Tips and Techniques

Wound scar care after trauma?

Hello Dr.
Lu,
I would like to ask you about scar prevention.
My little one is 2 years old and recently sustained an injury near the corner of the eye, requiring 2 stitches.
I would like to know how to avoid scarring.
We have Mederma scar gel at home and 3M Steri-Strip (is this a cosmetic strip?).
I found many methods online regarding the use of cosmetic strips, silicone sheets, and scar gels (is Mederma effective?).
Is it better to use Mederma and 3M Steri-Strip together? Should I apply the gel, let it dry, and then apply the cosmetic strip, or should I apply the strip first and then the gel? Alternatively, should I use the cosmetic strip alone for a certain period (how long, 3-6 months, or based on the wound condition?) before applying the gel until the scar fades? How often should the cosmetic strip be changed? If it gets wet, is it okay to dry it without removing it? Should the gel be used morning and night? After applying the cosmetic strip, is it necessary to massage the area regularly? Thank you for your assistance!

Xuan Mami, 20~29 year old female. Ask Date: 2009/08/13

Dr. Lu Daokuan reply Plastic Surgery

If you are using the MedGel and 3M patches, the effects should be similar, and you can alternate their use to avoid skin irritation.
Generally, you should use them for 3 to 6 months before assessing the results.
If you are not satisfied, you can consult a specialist physician.

Reply Date: 2009/08/13

More Info

When it comes to effective scar management for pediatric trauma, particularly for a young child who has sustained a laceration near the eye, there are several strategies and products that can be utilized to minimize scarring. Here’s a comprehensive guide based on current medical knowledge and practices.

Understanding Scarring
Scarring is a natural part of the healing process after an injury. The severity of a scar can depend on various factors, including the depth and location of the injury, the child's age, and how well the wound is cared for during the healing process. In children, the skin is generally more resilient, but it can also be more prone to hypertrophic scars or keloids, especially in areas like the face.

Immediate Care Post-Injury
1. Wound Care: Initially, it’s crucial to keep the wound clean and protected. After the stitches are removed, typically within 5 to 14 days depending on the healing, you can start focusing on scar management.

2. Moisture: Keeping the area moisturized is essential. This can be achieved with silicone gel sheets or silicone gel, which are known to be effective in scar reduction. Products like the Mederma scar gel you mentioned can be beneficial, but it’s important to apply them correctly.

Recommended Scar Management Techniques
1. Silicone Gel Sheets: These are often recommended for scar management. They can be applied once the wound has fully healed and the stitches have been removed. They should be worn for at least 12 hours a day, and some may recommend wearing them continuously for several weeks to months for optimal results.

2. Silicone Gel: The Mederma scar gel can be applied to the scar once the wound is healed. It is typically recommended to apply it twice daily. Ensure that the area is clean and dry before application.
3. 3M Steri-Strip: These strips are used to support the wound edges and can help in reducing tension on the scar. They can be used initially after the stitches are removed. They are not a substitute for silicone gel but can be used in conjunction with it.

Application Sequence
- Initial Phase: After the stitches are removed, you can start with the silicone gel sheets or strips. Apply them directly to the scar for a few weeks.

- Transition to Gel: Once the area is stable, you can start applying the silicone gel. It’s advisable to apply the gel after the silicone sheets have been in place for a while, allowing the skin to adjust.

- Combination Use: You can use both silicone sheets and gel, but it’s generally recommended to use one at a time for a period before transitioning to the other. For example, use the silicone sheets for 4-6 weeks, then switch to the gel for ongoing treatment.

Additional Tips
- Massage: Gentle massage of the scar tissue can help in breaking down the collagen fibers that form the scar. This can be done after applying the silicone gel. Use circular motions and apply gentle pressure.

- Sun Protection: Protect the scar from sun exposure, as UV rays can darken scars. Use sunscreen on the area once it has healed sufficiently.

- Monitoring: Keep an eye on the scar for any signs of infection or abnormal healing. If the scar appears raised, red, or painful, consult a healthcare provider.

Duration of Treatment
Scar management is a long-term process. Typically, it can take several months to see significant improvement in the appearance of a scar. Consistency in using the recommended products is key.

Conclusion
In summary, effective scar management for your child involves a combination of proper wound care, the use of silicone-based products, and gentle massage. Always consult with your healthcare provider before starting any new treatment to ensure it is appropriate for your child's specific situation. With diligent care, you can help minimize the appearance of scars and support your child's healing process.

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