Healthy and normally developed 5- year old fell down the stairs – approximately 4 steps – and landed on her face. Acute pain and bleeding from her left upper eyelid but no problems with her vision. She did not pass out. She is up to date on all immunizations. No abuse/neglect concerns.
7 mm horizontal laceration down to supraorbital rim in left lateral upper eyelid.
Fracture and Concussion which have been ruled out.
The wound was cleaned with saline and closed with steri strips without local anesthesia.
Emergency Room MD, PA, NP or RN.
Unpredictability of scar development and risk of reinjury in a 5-year old during healing are main concerns.
Wound gently cleaned with saline on sterile gauze and then dried by gentle dabbing with dry sterile gauze. Wound closed with ¼” flesh colored steri strips cut down to 10mm in length. Pick ups are used to apply the steri strips perpendicular to the laceration, first on one side, and the wound edges are then approximated by pulling on the steri strips before laying them down on the opposite side of the laceration. No need for prophylactic antibiotics.
With Pediatrician in 7 days. Parents are given two sterile packs (sheets) of flesh colored steri strips and advised to replace them as they fall off for a total of 1 month. The replacement procedure is clean and not sterile.