Rate of Wound Infection After Repair The rate of wound infection is reported between 2% and 10% Decreasing the likelihood of infection can help prevent additional morbidity and optimize cosmesis, as wounds that are infected during the healing process are more likely to scar Efforts to reduce the risk of infection can be achieved by proper techniques discussed throughout the chapter Current Evidence Lacerations account for 30% to 40% of all injuries in a pediatric ED Blunt trauma with sufficient force or contact with sharp objects causes the majority of lacerations Animal bites account for the remainder More than 40% of the wounds involve a fall Boys are injured twice as often as girls The mechanism of injury varies with the patient’s age In younger children, falls and accidents are classic mechanisms; violent encounters are more likely in older children Two-thirds of the injuries occur during warm weather months, although half of injuries in urban environments occur indoors Serious morbidity or mortality from minor lacerations is rare; however, complications occur in nearly 10% Children are less likely to get wound infections compared with adults In children, the infection rate is about 2% for all sutured wounds The risk of infection increases if there is a delay in primary closure Absorbable sutures for the repair of facial lacerations in children can be used to avoid the need for suture removal Data support that these sutures have equally acceptable cosmetic outcomes in facial lacerations In pediatrics, it is important to consider painless alternatives to sutures in some cases These include tape strips and tissue adhesives (i.e., skin glue) Tape strips have the advantage of not leading to marks in the skin, minimal tissue reaction, and fewer wound infections than sutures Skin glue has been demonstrated in multiple studies to have cosmetic results that are comparable to those of sutures for low-tension wounds There are no proven benefits to the use of routine oral antibiotics to prevent wound infection and their use is controversial The risk of antibiotic use from allergic reaction to growth of resistant organisms may outweigh the benefits Antibiotics should be routinely considered for wounds with high risk of infection such as bites, devitalized tissue, and heavily contaminated wounds The immunization and tetanus status of a patient with a wound should always be obtained and guidelines for tetanus prophylaxis followed, which is discussed later in the chapter ( Table 110.1 ) Clinical Considerations