dirty ethel rackham Posted November 21, 2012 Share Posted November 21, 2012 Dd12 had a little mishap at the climbing gym tonight (another climber tossed a piece of equipment into a locker and missed and it hit dd in the face.) She had an inch long gash on her forehead. Good and bloody like any head wound. One of my climbing friends (and father of dd's teammate) is a doctor and told us that, at the ER, we should ask for a plastic surgeon to work on her. The ER doc, the nurse, and my friend who happened to be working in the ER tonight all thought it wasn't necessary ... that a plastic surgeon would probably do what he did - close the wound with some dermabond and send her on her way. This and the fact that our insurance might not cover the surgeon convinced me to let the ER doc take care of it as he does this stuff every day. So we are home. After washing dd's hair (it was soaked with blood), I changed the bandaid and looked at the wound. It looks much worse than expected. I am so worried that she will end up with a scar. I am hoping that it is just the swelling that is making it look bad. But now I am worried that I should have insisted on having the plastic surgeon come in to treat her. Did I do the right thing? Will it heal up nice and this will all just be an adventure? I am kind of sensitive about these things because I have lived with a scar on my forehead since I was 4 (a much worse injury requiring nearly 30 stitches) and have almost always worn some sort of bangs as a result. Dd's hair just doesn't do bangs - too many funky cowlicks. Quote Link to comment Share on other sites More sharing options...
TexasRachel Posted November 21, 2012 Share Posted November 21, 2012 I've also got a scar on my forehead. I've another one on the back of my head as well. My dad patched me up at home with butterfly stitches, but one of them should've had real stitches. I'm not sure what protocol for calling in a plastic surgeon is, but I expect ER docs and nurses have seen enough that they can make that call. We always seem to get drs that go overboard nowadays. For years I covered up my scar because it's very noticeable, but I've recently decided I no longer care. It's part of me. Hopefully what ever happens your dd will have a positive outlook on it. Quote Link to comment Share on other sites More sharing options...
Mrs Mungo Posted November 21, 2012 Share Posted November 21, 2012 My dd has a tiny scar from when she had (5) stitches at four years old. It isn't very noticeable. I guess I don't have to worry about the guilt since there was no plastic surgeon at our tiny clinic in Germany. In fact, a PA stitched her up because our one doctor wasn't there. Quote Link to comment Share on other sites More sharing options...
Parrothead Posted November 21, 2012 Share Posted November 21, 2012 That is a tough call. If you are really concerned see if you can get an office appointment with the specialist soon. Quote Link to comment Share on other sites More sharing options...
Georgiana Daniels Posted November 21, 2012 Share Posted November 21, 2012 I have no medical knowledge, but you made the best decision you could at the time--so don't second guess yourself. The nice thing is, for women you can change hair and use a bit of cover-up. Might not be perfect with the cowlicks and whatnot, but on the forehead you're dealing with something different than a gash on the cheek. Once the swelling goes down you might find it looks better than what you're thinking now. ((hugs)) Quote Link to comment Share on other sites More sharing options...
Celia Posted November 21, 2012 Share Posted November 21, 2012 I don't know about a plastic surgeon or not, but I've heard that vit. E can help reduce scarring. Quote Link to comment Share on other sites More sharing options...
MollyAnn Posted November 21, 2012 Share Posted November 21, 2012 I don't know about a plastic surgeon or not, but I've heard that vit. E can help reduce scarring. Was going to post the same thing. Quote Link to comment Share on other sites More sharing options...
Lolly Posted November 21, 2012 Share Posted November 21, 2012 Paying out of pocket for a plastic surgeon? You did the right thing. After it has healed, you can check with your doctor about using silicon on it also. I sort of rolled my eyes when dd's surgeon gave her a silicon patch to rub over her scar to help it become less red and raised. (She scars badly with any cut and this one (doctor made) is a doozy-6 inches down the inside of her arm/almost wrist to elbow.)It worked remarkably well. Also keep her out of the sun and keep sunscreen on it when out. (After healed of course!) Quote Link to comment Share on other sites More sharing options...
kroe1 Posted November 21, 2012 Share Posted November 21, 2012 First, there is no way to prevent a scar. What you want to do is minimize the size of the scar. A scar on a forehead is tricky. Results are dependent on whether the scar is vertical or horizontal. Horizontal scars are less noticeable. Plastic surgeons rarely come to ERs anymore. That is because a scar can be modified and changed after the fact. Plus, many times the big, fat everted repairs look much better in the end than those where the edges were just matched neatly back together. This is because as the skin heals and scars, it retracts backwards, away from the wound. Therefore, pushing the edges up and overlapping a little makes for a better scar in the long run because as the skin retracts, the edges fold down neatly together. Wait a couple of months and see what the scar is doing then. If it's big and ugly, take your DD to a plastic surgeon then. There are many ways the scar can then be made to look less noticeable. So, in my opinion, you did the right thing. :thumbup1: Quote Link to comment Share on other sites More sharing options...
dirty ethel rackham Posted November 21, 2012 Author Share Posted November 21, 2012 Thanks everyone. After a good night's sleep (well not so good since ds16 was up late with his final paper for his college English class), I feel less worried. I will look into options to minimize scarring. I would have been less concerned if bangs were an option for her, but she is a soon-to-be curly girl and pony-tails are her friend. Quote Link to comment Share on other sites More sharing options...
dirty ethel rackham Posted November 21, 2012 Author Share Posted November 21, 2012 Well, this morning, my climbing friend who is a doctor and helped bandage up dd before we went to the ER last night, called to check on Meg and expressed dismay that we didn't wait for a consult with a plastic surgeon. He had discussed the situation with his wife (a dermatologist) and she had been very concerned about the Dermabond treatment. At my friend's insistence, I called his wife and she consulted several plastic surgeons that she works with. They all were of the opinion that the Dermabond was an appropriate treatment for her type of laceration, and should provide similar results long-term to stitches. I am greatly relieved that I didn't "scar her for life" :D . So, it will look pretty bad for a couple of months, but, if we follow instructions like keep it covered from the sun and use Mederma daily, it should be barely noticeable. I am so thankful she took time out of her day caring for skin cancer patients to look into this for me. Quote Link to comment Share on other sites More sharing options...
LMV Posted November 21, 2012 Share Posted November 21, 2012 Well, this morning, my climbing friend who is a doctor and helped bandage up dd before we went to the ER last night, called to check on Meg and expressed dismay that we didn't wait for a consult with a plastic surgeon. He had discussed the situation with his wife (a dermatologist) and she had been very concerned about the Dermabond treatment. At my friend's insistence, I called his wife and she consulted several plastic surgeons that she works with. They all were of the opinion that the Dermabond was an appropriate treatment for her type of laceration, and should provide similar results long-term to stitches. I am greatly relieved that I didn't "scar her for life" :D . So, it will look pretty bad for a couple of months, but, if we follow instructions like keep it covered from the sun and use Mederma daily, it should be barely noticeable. I am so thankful she took time out of her day caring for skin cancer patients to look into this for me. Honestly, if Dermabond is appropriate (and from what you have described it sounds like an appropriate use) then often the cosmetic results are even better than sutures whether those sutures are placed by a plastic surgeon or not. I'm an EM physician and in a similar scenario I would have let one of my colleagues do the same thing with one of my daughters. Quote Link to comment Share on other sites More sharing options...
Parrothead Posted November 21, 2012 Share Posted November 21, 2012 Glad to hear the good news. Quote Link to comment Share on other sites More sharing options...
gardenmom5 Posted November 21, 2012 Share Posted November 21, 2012 the reason they rec'd the plastic surgeon was the wound was on her face. an ER doc may do that stuff frequently, but not with as much skill at reducing scarring as someone who spent more years training to learn the techniques. Quote Link to comment Share on other sites More sharing options...
TranquilMind Posted November 21, 2012 Share Posted November 21, 2012 Dd12 had a little mishap at the climbing gym tonight (another climber tossed a piece of equipment into a locker and missed and it hit dd in the face.) She had an inch long gash on her forehead. Good and bloody like any head wound. One of my climbing friends (and father of dd's teammate) is a doctor and told us that, at the ER, we should ask for a plastic surgeon to work on her. The ER doc, the nurse, and my friend who happened to be working in the ER tonight all thought it wasn't necessary ... that a plastic surgeon would probably do what he did - close the wound with some dermabond and send her on her way. This and the fact that our insurance might not cover the surgeon convinced me to let the ER doc take care of it as he does this stuff every day. So we are home. After washing dd's hair (it was soaked with blood), I changed the bandaid and looked at the wound. It looks much worse than expected. I am so worried that she will end up with a scar. I am hoping that it is just the swelling that is making it look bad. But now I am worried that I should have insisted on having the plastic surgeon come in to treat her. Did I do the right thing? Will it heal up nice and this will all just be an adventure? I am kind of sensitive about these things because I have lived with a scar on my forehead since I was 4 (a much worse injury requiring nearly 30 stitches) and have almost always worn some sort of bangs as a result. Dd's hair just doesn't do bangs - too many funky cowlicks. I don't know. My daughter had a facial scar once, from where her toddler brother accidentally whacked her in the face with a large book. It's gone. But I got a facial scar in my 20's, and I can still see it faintly decades later. Kids heal faster and better. I pray she does. Quote Link to comment Share on other sites More sharing options...
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