Red, Hot, Puffy, Painful: Signs of a Wound Infection

It's not just your imagination: Kids really are accident prone. Not only do they fall all the time — resulting in nearly 3 million visits to the emergency department (ED) in 2010 — but their skin tears more easily. The younger the child, the less strongly the outer skin is bound to the layers of soft tissue beneath it. This means cuts are longer, scrapes are wider, and punctures are deeper than they might be for older kids. Also, because children often aren't vigilant about keeping clean, infections are common. Here are some signs of a wound infection that indicate you should visit a medical professional.

What to Look For

Four words describe a common wound infection: red, hot, puffy, and painful. Pus is another indicator, but a wound can be infected without any leaking fluid in sight. All these signs come from the action of bacteria invading the area. Whether your child wiped out during a ball game, cut themselves doing a class project, or played too roughly with the family dog, signs that the wound is now infected include color changes, warmth, swelling, and pain.

What else can be problematic? According to Dr. Anthony Thomas, pediatric hospitalist at Lauren Small Children's Medical Center at Bakersfield Memorial Hospital, "If the wound has active bleeding or the edges of the wound are gaping, bring the child in for evaluation." Active bleeding is the kind that won't stop after 15 minutes of pressure or that restarts again after stopping. A wound with gaping edges cannot be closed easy and may need stitches to heal. Because they don't close on their own, these wounds are more prone to infection, as are skin breaks on the hands, face, abdomen, and genital areas.

Infection Prevention

To prevent infections, all wounds should be cleaned immediately with soap and warm water. While products such as hydrogen peroxide and alcohol are popular cleaning agents, a National Institutes of Health study suggests that these products kill off the cells that help wounds heal. Soap and normal saline, if available, have been shown to be the best cleaning agents outside the hospital. If wounds are in the lower portion of the body, sitz baths can be used to soak them clean of debris.

Once clean, a wound should be covered. Dr. Thomas recommends protecting the wound with heavy padding to prevent re-injury. "Sometimes, splinting the area will help, as well," he said.

Next Steps

If a wound is not healing well and the aforementioned common signs of an infection are present, Dr. Thomas recommends that parents bring their child to an urgent-care office or ED. Especially if the injury has just occurred and "the edges of the wound are widely spaced or the bleeding is uncontrollable," Dr. Thomas calls for taking your kid in for immediate care and suggests calling 911 rather than driving urgently.

If the wound is stable but still showing infection signs, take your child to the treatment facility best equipped to handle the injury. "Most pediatricians can evaluate and treat minor wounds, but more severe wounds are better treated in an urgent care or ED where supplies are readily available," Dr. Thomas says.

Your kid is going to have an accident and get scraped or cut at some point — there's no avoiding it. The best you can do is evaluate the injury and determine if emergency or urgent care is required. Once the wound has been treated, rely on your knowledge of infection signs to figure out where to go from there. As long as you're keeping a close eye on any cuts, you'll be able to get the right treatment for your child before things get serious.