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Wound Infection

Definition

  • Signs of wound infection include pus, spreading redness, increased pain or swelling, and fever
  • A break in the skin (a wound) shows signs of infection
  • Includes infected cuts, scrapes, sutured wounds, puncture wounds and animal bites
  • Most dirty wounds become infected 24 to 72 hours later

Symptoms of Wound Infections

  • Pus or cloudy fluid is draining from the wound.
  • Pimple or yellow crust has formed on the wound.
  • Soft Scab that has increased in size.
  • Red Area increasing around the wound.
  • Red Streak is spreading from the wound toward the heart.
  • More Pain. The wound has become very tender.
  • More Swelling. Pain or swelling is increasing 48 hours after the wound occurred.
  • Swollen Node. The lymph node draining that area of skin may become large and tender.
  • Fever occurs.
  • The wound hasn't healed within 10 days after the injury.

When To Call

Call 911 Now

  • Not moving or too weak to stand
  • You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

  • Fever occurs
  • Red streak runs from the wound
  • Spreading redness around the wound
  • Severe pain in the wound
  • Any face wound with signs of infection
  • No past tetanus shots. Note: tetanus is the "T" in DTaP, TdaP, or Td vaccines.
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Pus or cloudy drainage from the wound
  • Wound gets more painful or tender after 2 days
  • Last tetanus shot was more than 5 years ago
  • You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Pimple where a stitch (or staple) comes through the skin
  • You have other questions or concerns

Self Care at Home

  • Mild redness of wound

Care Advice

What You Should Know About Normal Healing:

  • Some pink or red skin on the edge of the wound is normal.
  • It's more common if the wound is sutured.
  • It's also normal for it to be swollen for a few days.
  • Your child's wound is not infected unless the redness spreads or pain increases.
  • Here is some care advice that should help.

Warm Soaks or Warm Wet Cloth:

  • For any redness or other signs of early infection, use heat.
  • Open Cuts or Scrapes. Soak it in warm water. You can also put a warm wet cloth on the wound. Do this for 10 minutes 3 times per day. Use a warm saltwater solution. You can make your own. Put 2 teaspoons (10 mL) of table salt in a quart (liter) of warm water.
  • Closed or Sutured Cuts. Put a heating pad on the wound. You can also use a warm, moist washcloth. Do this for 10 minutes 3 times per day.
  • Cautions for Sutured Wounds. Do not put anything wet on the wound for first 24 hours. After 24 hours, can take brief showers. Never soak the wound before all sutures are removed.

Antibiotic Ointment:

  • Use an antibiotic ointment (such as Polysporin).
  • No prescription is needed.
  • Put it on the wound 3 times a day.
  • If the area could become dirty, cover with a bandage.

Pain Medicine:

  • To help with the pain, give an acetaminophen product (such as Tylenol).
  • Another choice is an ibuprofen product (such as Advil).
  • Use as needed.

Fever Medicine:

  • For fevers higher than 102° F (39° C), give an acetaminophen product (such as Tylenol).
  • Another choice is an ibuprofen product (such as Advil).
  • Note: fevers less than 102° F (39° C) are important for fighting infections.
  • For all fevers: keep your child well hydrated. Give lots of cold fluids.

What to Expect:

  • Pain and swelling normally peak on day 2.
  • Any redness should go away by day 4.
  • Complete healing should occur by day 10.

Return to School:

  • For true wound infections, your child can return after the fever is gone. Your child should also be taking an antibiotic by mouth for 24 hours.
  • For minor redness around the wound, your child does not need to stay home.

Call Your Doctor If:

  • Wound becomes more painful
  • Redness starts to spread
  • Pus or fever occurs
  • You think your child needs to be seen
  • Your child becomes worse

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Photos

Impetigo of Elbow

This shows impetigo on the elbow. Impetigo is a skin infection caused by bacteria. The infection causes a red sore which leaks fluid. This area will then dry and become crusty as it heals.

Source: Wikimedia Commons
Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License. This is a public domain image file from Wikimedia Commons. Wikimedia is a freely licensed media repository.

Wound Infection - Suture Site

There is a pimple where a stitch comes through the skin. The pimple suggests a low-grade infection.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.

Lymphangitis of Left Forearm

If you look closely at this photo, you should be able to see a red streak (lymphangitis) spreading from the hand wound up into the arm.

The presence of lymphangitis means that there is an infection that needs urgent antibiotic treatment. It may require a hospital stay for treatment.

Source: Self Care Decisions, LLC
Used with Permission from Schmitt Pediatric Guidelines LLC.

Barton Schmitt MD, FAAP
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.
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