A Momologue by Julie: I never realized until now just how serious a skinned knee could be.
"Last week, my 4-year-old daughter was crossing a street with a friend of mine when she slipped and skinned her knee. Of course, she began crying hysterically, and it was bleeding profusely, but I wasn't worried. After all, as the mother of two, I have survived what feels like hundreds of skinned knees and scraped elbows...so I just washed it off with a wet paper towel and slapped on a few Band-Aids, then sent her back on her way. Because I was at a friend's house, I skipped the peroxide, figuring it wouldn't do any damage. Boy, was I wrong.
A few days later, my daughter began complaining that her leg hurt. A lot. I told her it was probably just her skinned knee, and that it would feel better soon. But she kept complaining...and, that night, when I was putting on her pajamas, I noticed a nasty rash had developed around the skinned knee and was running up her leg. She had hundreds of red, pus-filled sores all over.
Like any Mom would, I freaked out. I ran straight to the computer and Googled "skinned knee rash" and was soon reading about MRSA, impetigo, and other scary-sounding infections. I called the on-call pediatrician and was told to bring my daughter in first thing in the morning. When my pediatrician saw her, she instantly diagnosed a skin infection, and prescribed 10 days of a strong antibiotic.
Thankfully, it looks like the infection is under control, but this got me wondering what I should do about skinned knees in the future. Obviously, my wet-paper-towel-and-Band-Aid remedy wasn't working; in fact, it had nearly sent my daughter to the emergency room! (The guilt I still feel over this is unbearable.) I called friend of Mom•Logic pediatrician Dr. Gwenn for advice, and she gave me the following three strategies for treating a skinned knee."
Boo-Boo Remedies by Dr. Gwenn:
1. Clean the knee well. "Soap and water with peroxide work best. Cleaners that come in squirt bottles are especially good for these purposes and help flush out wounds. The problem with skinned knees is the area often gets very dirty and can be hard to clean. And some areas can be skinned deeper than they appear. If you are not getting in all the folds well and cleaning all the dirt and gunk out, a deeper infection can set in. If a parent is at all uncomfortable cleaning a skinned knee, call the pediatrician. We do this all the time in our office—skinned knees can be tricky to clean and we're always happy to do it for you."
2. Flush it out. "Irrigation is the key to success, in my mind, for skinned knees. You want to really flush out all the dirt. Use lots of water. If, while cleaning, you notice a cut that needs suturing, seek care right away."
3. Be on the lookout for signs of infection. Pain in the knee, redness around the area, pus, fever, swelling, tenderness, and streaking from the wound up the leg are common signs that the knee is infected. If you notice any of these, seek medical attention immediately. An untreated infection in the knee is not good. The infection can spread systemically to any other place in the body, but locally it can cause an infection in the knee which is called a "septic joint" and is a medical emergency. Another big complication of an untreated infection is a bone infection called osteomylelitis—another emergency. Septic joints need to be drained in the operating room, and those kids end up on IV antibiotics for a while. For bone infections, you're looking at weeks of IV antibiotics—initially in the hospital, then at home. So, the bottom line is that this is a situation where a simple skin infection can become something very, very serious."
Julie concludes: "Thankfully, I caught my daughter's infection before it progressed this far, but I guarantee I will take better precautions in the future to make sure this never, ever happens again. I may not be able to prevent skinned knees, but I'll do my darndest to prevent another infection. And that's a promise."