Consider consultation with local paediatric team when Consider consultation with surgical/plastics team when

DuoDERM Extra Thin dressing is a hydrocolloid dressing indicated for the management of lightly exuding wounds. It combines a unique ConvaTec hydrocolloid formulation that distinguishes it from other hydrocolloid dressings and a vapour permeable outer film to provide an occlusive moist environment. Wound cleansing/irrigation is important for decreasing bacterial load. Cleansing/irrigating with antiseptics may damage tissue defences and impede healing. The exception is contaminated wounds that may benefit from chlorhexidine 0.05% or povidine-iodine 1% irrigationMay require secondary dressing. Not recommended in anaerobic infections. Gel can be confused with slough or pus in wound. Must be removed to monitor wound. Unpleasant odour For emergency advice and paediatric or neonatal ICU transfers, see Retrieval Services Consider discharge when Dressing needs washing with soap and water, pat-dried twice daily. Requires application of oil prior to removal, ideally soaked in oil and wrapped in cling film overnight Use a 20-30 mL syringe with a large bore non bevelled needle filled with 0.9% sodium chloride to slowly irrigate the wound underlying nerve, vessel and tendon damage. This requires assessment of movement while exploring the wound (especially in palmar or hand wounds: see "fight bite")

All wound care including cleaning, irrigation and dressings should be managed with an aseptic technique Allows inspection. Self-adhesive. Some moisture evaporation. Reduces pain. Barrier to external contamination Shepherd, M & Starship hospital et al. Lacerations and Wound Closure. https://starship.org.nz/guidelines/lacerations-and-wound-closure/ (viewed 10 May 2022). Do not absorb exudate or maintain moisture. Requires secondary dressing. May induce allergy or delay healing when impregnated DuoDERM Extra thin protects the wound, support debridement and are easy to use. They can be moulded and cut to shape so you can treat difficult areas. It is designed to reduce the risk of further skin breakdown by preventing friction from clothes and bedlinen.Indications: Duoderm is incated for minor burns, abrasions, lacerations, post-operative wounds, stage 1-2 pressure ulcers and lightly exuding leg ulcers. The Sydney Children’s Hospitals Network. Wound assessment and management: Practice Guideline. https://www.schn.health.nsw.gov.au/_policies/pdf/2014-9040.pdf (viewed 10 May 2022). Can provide or absorb moisture depending on surrounding tissue. Initially lower temperature providing cooling The porous structure of the nonwoven fabric ensures air and water vapour permeability. The fabric is flexible, conforms well to body contours, and allows body movements when in place. The fabric is non-absorbent and provides a barrier for blood and fluid strikethrough. Initial decontamination of the wound with irrigation is of utmost importance and should be performed prior to dressing

Images sourced from SCHN wound assessment and management guideline. Available from: https://www.schn.health.nsw.gov.au/_policies/pdf/2014-9040.pdf Perth Children’s Hospital. Wound care. https://pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Wound-care (viewed 10 May 2022). Provide adequate pain management, anaesthesia (see anaesthesia in lacerations) and procedural sedationMoisturising creams such as vitamin E, aloe vera and sorbelene can be used to soften scar and make massage easier