Antonious Kerolos
Dermatology, Rutgers Robert Wood Johnson Medical School, Piscataway, USA.
Cureus. 2025 Jun 13;17(6):e85909. doi: 10.7759/cureus.85909. eCollection 2025 Jun.
Pediatric facial lacerations are common injuries that carry important cosmetic and psychosocial implications. Prompt, evidence-based management focusing on optimal wound closure, early wound care, and scar prevention is essential to achieving favorable long-term outcomes. This review summarizes findings from a comprehensive literature review conducted from 2010 to 2025, drawing from randomized controlled trials (RCTs), meta-analyses, systematic reviews, and clinical guidelines addressing pediatric facial laceration repair, wound care practices, scar prevention, and caregiver involvement. Practical interventions accessible over the counter (OTC) were emphasized. Evidence supports the use of topical anesthetics such as lidocaine-epinephrine-tetracaine (LET) gel to reduce procedural pain, copious irrigation with potable water, and wound closure methods tailored to the injury's characteristics, including tissue adhesives and absorbable sutures. Routine systemic antibiotics are not indicated for clean facial wounds. Early moist wound care with petrolatum promotes faster healing, while scar prevention measures such as silicone therapy, sun protection, scar massage, and tension offloading techniques significantly improve cosmetic outcomes. Over-the-counter products such as onion extract and vitamin E offer minimal benefit compared to silicone-based therapies. Parental education on wound care, emotional reassurance, and scar management plays a pivotal role in optimizing healing and minimizing the psychosocial impact of facial scars in children. Through collaboration between clinicians and caregivers, excellent functional and aesthetic outcomes can be achieved, helping children heal both physically and emotionally.
小儿面部裂伤是常见的损伤，具有重要的美容和心理社会影响。迅速采取基于证据的管理措施，重点是实现最佳伤口闭合、早期伤口护理和预防疤痕，这对于取得良好的长期效果至关重要。本综述总结了2010年至2025年进行的全面文献综述的结果，这些结果来自随机对照试验（RCT）、荟萃分析、系统评价以及针对小儿面部裂伤修复、伤口护理实践、疤痕预防和护理人员参与的临床指南。强调了非处方（OTC）可用的实用干预措施。有证据支持使用局部麻醉剂，如利多卡因-肾上腺素-丁卡因（LET）凝胶以减轻手术疼痛，用饮用水大量冲洗，以及根据损伤特征定制的伤口闭合方法，包括组织粘合剂和可吸收缝线。清洁的面部伤口无需常规使用全身抗生素。早期用凡士林进行湿性伤口护理可促进更快愈合，而诸如硅酮疗法、防晒、疤痕按摩和减轻张力技术等疤痕预防措施可显著改善美容效果。与基于硅酮的疗法相比，非处方产品如洋葱提取物和维生素E的益处极小。对家长进行伤口护理、情感安抚和疤痕管理教育，对于优化愈合和最小化儿童面部疤痕的心理社会影响起着关键作用。通过临床医生和护理人员之间的合作，可以实现出色的功能和美学效果，帮助儿童在身体和情感上都得到康复。
