wapiti Posted September 30, 2012 Share Posted September 30, 2012 My dd3 now has 4 stitches right in the middle of her forehead. It is a vertical laceration, which the ER ped said are generally more prone to scarring than horizontal ones. It was not a complicated procedure (skin split open, about 1.5 cm long, after colliding with a bat). Naturally these things have to happen on a Saturday evening. How much of a difference would the plastic surgeon really make? He used the smallest possible thread and did not need to pull with much tension at all. My other dd had stitches at a similar age, in her chin and lip. Those were done by a plastic surgeon. She does have a scar. The ER ped advised us not to put antibiotic ointment on it to help avoid the scar (considering that face lacerations rarely get infected). Should I (a) take her to a plastic surgeon on Monday to have a look; (b) take her to a plastic surgeon on Friday to remove the stitches and have a look; or © assuming everything looks "normal" with the initial scar, wait however many years to see what happens? What does Dr. Hive think? Quote Link to comment Share on other sites More sharing options...
Firestar Academy Posted September 30, 2012 Share Posted September 30, 2012 my rule is always ALWAYS facial injury=plastic surgeon. ALWAYS robin in nj Quote Link to comment Share on other sites More sharing options...
Firestar Academy Posted September 30, 2012 Share Posted September 30, 2012 it is worth your peace of mind to get it checked out by a plastic surgeon or you will always wonder if they could have done better. i needed to post twice!! robin Quote Link to comment Share on other sites More sharing options...
MotherMayI Posted September 30, 2012 Share Posted September 30, 2012 I agree- I would talk to a plastic surgeon. My 13yo ds had to have stitches on his cheekbone when he was about 8. I asked about a plastic surgeon, but the er doctor poo pooed me and told me it was a very straightforward cut. As the stitches healed I had regrets almost immediatly. My ds has frankenstein stitches on his cheekbone now. Of course he thinks it is cool, but I will always regret not following my instincts and getting a plastic surgeon. Quote Link to comment Share on other sites More sharing options...
QueenCat Posted September 30, 2012 Share Posted September 30, 2012 I'd have a plastic surgeon look at it.... and then make the decision. Quote Link to comment Share on other sites More sharing options...
Catwoman Posted September 30, 2012 Share Posted September 30, 2012 (edited) The ER ped advised us not to put antibiotic ointment on it to help avoid the scar (considering that face lacerations rarely get infected). The ER ped was WRONG. You need to keep the wound from scabbing over, so you absolutely have to keep a thin coating of Bacitracin on it at all times. You can use water to gently clean the area twice a day -- no peroxide or soap should be needed because the Bacitracin will seal the area. You should only have to put a thin coating of Bacitracin (the ointment, not the cream) on it twice a day, then cover it loosely with a bandage (to keep dirt and hair out of it, and so she doesn't accidentally scratch it) -- but if it looks like the area is getting dry or scabby, apply it again. If there is dried blood around the stitches, wet the area carefully, wait a few minutes, and very, very gently remove the softened blood with a Q-Tip. Please don't let the wound get a scab on it -- it will scar for sure! I'm not a doctor, but I learned all this when I had a skin cancer lesion removed from my face -- and I went to the very best plastic surgeon I knew of, so I definitely trust his advice on wound care. I had a pretty decent-sized hole in the side of my face, but ended up with no visible scar. My dad had a lot of skin cancer surgery, and he was always told to use Bacitracin or Polysporin to keep the area moist, as well. my rule is always ALWAYS facial injury=plastic surgeon. ALWAYS :iagree: Definitely see a plastic surgeon on Monday, but take good care of the wound in the meantime. Hopefully, the ER doc did a great job, but I would definitely get a cosmetic surgeon's opinion on it, just to be safe. Edited September 30, 2012 by Catwoman Quote Link to comment Share on other sites More sharing options...
In the Rain Posted September 30, 2012 Share Posted September 30, 2012 I'm pretty sure Cat is right about needing to keep the wound moist with ointment. Mostly I wanted to comment on waiting until Friday to have the stitches removed. When my dd was younger, she had stitches on her forehead. Because dd is fair skinned, and scars easily, the ER doc said to have the stitches removed at the earliest possible date to avoid track marks from the needle holes. I think it was either 48 or 72 hours. We had to go in on a Sunday morning to our ped to have the stitches removed, and replaced with steri-strips. Even then, she had suture marks that lasted for a long time. (You could see each little tiny hole) I would urge you to check in with your pediatrician or a plastic surgeon on Monday. Even if you can't see the plastic surgeon until later, you can ask the ped about replacing the sutures with steri-strips at an earlier date. Quote Link to comment Share on other sites More sharing options...
Desert Rat Posted September 30, 2012 Share Posted September 30, 2012 I would see a plastic surgeon. Ds9 split his forehead open at 18 months. We were told later that if he had been a girl we would have seen a plastic surgeon.:confused: No one told me to have the sutures removed quickly. It was a holiday weekend. I made an appointment for that Monday. The nurse told me I should have had them removed on Saturday and now he was was going to have a "Frankenstein scar". I cried. He does. He wears his hair long to cover his scar. He is very self conscious of it. And won't grow his hair out because I insist on pulling back for sports and he doesn't want his scar to show. The entire thing was handled terribly. He's had it so long that I'm used to it, but it is a significant scar of about 2 1/2 inches. At some point maybe we can do a scar revision. If he continues to have esteem issues over it, we will. The thing that makes me mad though is that if he had been a girl, they would have automatically called for a plastic consult. I guess boys don't have to be pretty. Scabs heal and chicks dig scars, right?:confused: Quote Link to comment Share on other sites More sharing options...
kitten18 Posted September 30, 2012 Share Posted September 30, 2012 my rule is always ALWAYS facial injury=plastic surgeon. ALWAYS robin in nj it is worth your peace of mind to get it checked out by a plastic surgeon or you will always wonder if they could have done better. i needed to post twice!! robin :iagree::iagree::iagree: Quote Link to comment Share on other sites More sharing options...
Juniper Posted September 30, 2012 Share Posted September 30, 2012 Honestly, with my boys, I didn't see a plastic surgeon. If my daughter needed facial stitches I would. Even if it is to just rehash the best methods for healing and diminishing the scar, and if there are better scripts out there. I will say that the stitches done to ds's lip by a plastic surgeon(in the ER) have left no visible scar (lip area and they had to align the lip to cheek perfectly), but the one on his forehead has. Quote Link to comment Share on other sites More sharing options...
weddell Posted September 30, 2012 Share Posted September 30, 2012 The replies here are making me feel better. DS ran, fell, and hit his head on a chair leg. It split his forehead about 1.5 cm starting about an inch above his eye. The ER recommended a plastic surgeon. He straightened the edges, did stitches underneath and glue on top. Then we are supposed to keep it covered with a prescription called kelo-cote which is a thin layer of silicone that helps minimize the scar. It only happened last month so I don't know how it will look long term. But so many people we told couldn't believe we paid the extra for a plastic surgeon so it is making me feel better that so many people agree. Quote Link to comment Share on other sites More sharing options...
Laura Corin Posted September 30, 2012 Share Posted September 30, 2012 I would definitely see a plastic surgeon. Calvin has a facial scar. We took him to a plastic surgeon at the time and the surgeon did the work, but the cut went straight through his (now heavy, dark) eyebrow, destroying the hair follicles. So scarring was inevitable. If we hadn't seen the surgeon, however, I'd be beating myself up with the what-ifs. Laura Quote Link to comment Share on other sites More sharing options...
Cinder Posted September 30, 2012 Share Posted September 30, 2012 Interesting discussion. My college roommate had an inch-long scar on her cheek. Her dad was a plastic surgeon. They never got it fixed. She was asked a few times, after people found out her dad was a plastic surgeon, why she didn't have the scar fixed. She said it wasn't necessary. I suppose it made a difference in her perspecitive that her dad was one of those surgeons that fixed people up after accidents; he did not do elective surgery. I think a consult would be good; at least then you'd know what to expect and can decide from there whether to pursue surgery. Quote Link to comment Share on other sites More sharing options...
lexi Posted September 30, 2012 Share Posted September 30, 2012 my rule is always ALWAYS facial injury=plastic surgeon. ALWAYS robin in nj :iagree::iagree::iagree: I had a facial injury as a child and my parents took me straight to the surgeon. My scar is not even noticeable and it was a big laceration. Cut my knee as a child and went to ER-one HUGE scar still! I vote surgeon!!! Quote Link to comment Share on other sites More sharing options...
LMA Posted September 30, 2012 Share Posted September 30, 2012 See a surgeon. I had to have surgery in the palm of a hand and I made sure the hand surgeon was also a plastic surgeon. My scar is not visible. Quote Link to comment Share on other sites More sharing options...
Renee in NC Posted September 30, 2012 Share Posted September 30, 2012 I wish we had for my dd who had a very noticeable scar on her forehead. Quote Link to comment Share on other sites More sharing options...
wapiti Posted September 30, 2012 Author Share Posted September 30, 2012 Ok thanks everyone! I'm planning to take her to a pediatric plastic surgeon tomorrow, if I can get in. I was up all night worrying about this - it's going to be a long day... Quote Link to comment Share on other sites More sharing options...
melissad2 Posted September 30, 2012 Share Posted September 30, 2012 I don't know what a plastic surgeon is going to about it after the fact :confused:. The wound has already started to heal so I doubt he would take out the stitches and redo them as that would possibly make any scaring worse. I would probably wait til the stitches come out and see what it looks like. FWIW I've used mederma on scars and they have faded quite nicely. Quote Link to comment Share on other sites More sharing options...
Catwoman Posted October 1, 2012 Share Posted October 1, 2012 Ok thanks everyone! I'm planning to take her to a pediatric plastic surgeon tomorrow, if I can get in. I was up all night worrying about this - it's going to be a long day... Let us know how it goes! :grouphug: Quote Link to comment Share on other sites More sharing options...
1GirlTwinBoys Posted October 1, 2012 Share Posted October 1, 2012 My DH is in business with a plastic surgeon and you should definitely see one any time it's a facial matter. You have to INSIST when you go to the ER that it be done by a plastic surgeon or it won't be. It's MUCH harder for a PS to revise an incision made by another Dr. Quote Link to comment Share on other sites More sharing options...
airforcefamily Posted October 1, 2012 Share Posted October 1, 2012 (edited) FWIW, my daughter split her skin right below her eyebrow. We lived in a rural area (we live in another one now) and when I asked for a plastic surgeon to be called I was told there were none in town. We would have had to drive her over 100 miles away and she was already so stressed. They closed it with glue rather than stitches to minimize scaring. Now it's hardly noticeable, you really have to look closely to see the little fine line. Another one of our kids cut her toe. It was stitched up in the er and the scar is barely visible. I've had a scar on my face since I was a kid. It was stitched up by a plastic surgeon and still turned into a noticeable scar. I don't even notice it anymore and I've never been self conscience about it. Sometimes what an er doc does turns out great and other times what a plastic surgeon does isn't so great. Sometimes there aren't other reasonable options. Edited October 1, 2012 by airforcefamily Quote Link to comment Share on other sites More sharing options...
Tammi K Posted October 1, 2012 Share Posted October 1, 2012 I hate to be the voice of dissent here, and I'm not a doctor so I may be wrong, but if the injury was Saturday, I'm pretty sure that Monday will be too late for a plastic surgeon to do anything about it because the wound will have already begun to heal. He may have some ideas on how to keep scarring to a minimum. Quote Link to comment Share on other sites More sharing options...
kroe1 Posted October 1, 2012 Share Posted October 1, 2012 Good luck getting a plastic surgeon to come to an ER. Most don't even take call anymore. And if they do, they would request the ER staff sew or glue the child with a small laceration. Now with laser therapy, peels, z-plasty, etc., there are other ways to treat a scar after-the-fact. The plastic surgeon isn't needed as much at the time of injury as they used to be. :) Quote Link to comment Share on other sites More sharing options...
---- Posted October 1, 2012 Share Posted October 1, 2012 . Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted October 1, 2012 Share Posted October 1, 2012 Dd had a big cut stitched up by a plastic surgeon. The ER called him in. Lots of internal and external stitches, and cutting of ragged flesh. She still has a scar but it could have been much worse. She was put on oral antibiotics and there was a special tape put on to cover the wound so that the area wouldn't be exposed to the sun. They were insistent that sun exposure would increase the risk of scarring. Quote Link to comment Share on other sites More sharing options...
1GirlTwinBoys Posted October 2, 2012 Share Posted October 2, 2012 They were insistent that sun exposure would increase the risk of scarring. :iagree:For at least a year you need to keep it out of the sun. Quote Link to comment Share on other sites More sharing options...
Excelsior! Academy Posted October 2, 2012 Share Posted October 2, 2012 my rule is always ALWAYS facial injury=plastic surgeon. ALWAYS robin in nj :iagree: Quote Link to comment Share on other sites More sharing options...
pfamilygal Posted October 2, 2012 Share Posted October 2, 2012 As an ER nurse, I can tell you that the best things you can do at this point are: take the sutures out within 5 days and be SUPER ANAL RETENTIVE about sun screen for the next year (at least - or have your child wear a hat). We suture within 12 hrs or not at all, as the risk of infection goes up. The reason we scar so badly on our face and hands is sun exposure. So avoid it. Quote Link to comment Share on other sites More sharing options...
Guest boxerluvr Posted March 23, 2013 Share Posted March 23, 2013 I am a 40 yr old female, who had a head laceration due to missing a hard hit softball. When I went to the ER, my head was badly swollen. They opted to used the adhesive ( super glue). 10 days later, it was ooozing still, I went to the dr, they opened it up, and were shocked to see a hole in my head. ( dead tissue) laceration did not heal. They sent me to the ER, where they did stitches. I went back to my regular dr, he did not feel comfortable taking out the stitches. He wanted me to go see a plastic surgeon. The Plastic surgeon could not see me till Monday, so my stitches will have been in for 10 days! now I am nervous that they should have come out sooner, after reading what everyone has said about taking them out as soon as possible. I just wonder why my dr did not feel comfortable taking them out? There is a gash ( dent) on my head, maybe that's why he wants me to go see the PS? I dunno. Maybe I should just pull them out myself, like everyone keeps telling me to? Quote Link to comment Share on other sites More sharing options...
Guest boxerluvr Posted March 23, 2013 Share Posted March 23, 2013 also, I'm still having headaches 18 days after my head injury.... could it be from the injury? or is it all in my head, lol Quote Link to comment Share on other sites More sharing options...
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