Fear of needles in children – not a problem at all with suture-free wound closure methods
Possible wounds are then treated individually depending on their size and type. For superficial wounds such as abrasions, a plaster is often sufficient to support optimal wound healing. Should there be larger wounds, a plaster does not provide appropriate protection. Therefore, lacerations and cuts are often treated with stitches. Post-operative wounds often require this type of wound closure as well.
In any case, the suture material must be sterile. Depending on place and size of the wound, different thread strengths are available. Once the suitable suture material has been chosen, the wound can be sutured under local anesthesia. A post-operative wound is often painful and therefore requires local anesthesia. For children, this is a particularly unpleasant experience. A fear of needles or injection phobia is quite common and makes the wound management experience extremely stressful.
After several days of healing, the stitches can be removed. This procedure, again, can be quite painful and thus takes place under local anesthesia, too. Having a fear of needles anyway, the child is once again confronted with the placement of an injection. In order to prevent the need of removing the stitches, absorbable sutures can be used. The suture material dissolves on its own – however; absorbable sutures are not suitable for all types of wounds.
Alternatives to wound closure with sutures
If a wound cannot sufficiently be protected by a plaster, there is a number of different options aside from stitching to close the wound adequately. Post-operative wounds from surgery can easily be treated with a strip. The so-called wound closure strip holds the edges of a wound together so that the potential scarring is very mild. The application of these strips is quick and does not involve any pain for the child. The wound closure strips join the wound margins via strain resulting from the taping technique. It is of particular importance to ensure that the strips remain on the wound until the healing process is complete. Should they be removed from the wound too early, e.g. through moisture, the wound healing process may be affected negatively. For proper protection, a film dressing is often applied on top of the wound closure strip. This way, both wound and wound closure strip are protected from moisture and other external factors. Proper use of wound closure strips allows for wound management without the need of needles or threads.
Another, well-approved wound closure method is the use of tissue adhesive. The advantage for larger wounds is that no big wound dressing is necessary. Tissue adhesive applies easily onto the joined wound margins – and it dries after only a few seconds. Then, the tissue adhesive is applied to the surrounding skin in several layers forming a strong bond which holds the wound margins together. This way, it is possible to close wounds without using threads – and the wound healing process can begin. As soon as the wound is closed and the margins of the wound have grown back together, the tissue adhesive peels off the skin on its own. Tissue adhesive is also suitable for wounds that are haired, exposed to bodily fluids, or located near mucous membranes. However, before applying tissue adhesive to hairy places, it is advised to shave them to achieve better adhesion. Relaxation therapy such as hypnosis or moxibustion can help reduce the fear of needles. If a post-operative wound is foreseeable in the future, the child can be prepared for it using one of the above-mentioned techniques.
In general, sutures cannot always be avoided. In the event of a very large wound, only stitches can support wound healing optimally. If, however, avoiding stitches is a possible option, wound closure strips or tissue adhesive are great alternatives to treat wounds in children.
It is of major importance to treat each wound or injury professionally to support wound healing and to avoid scarring.