First Wounds.

Do you remember the first time you drew blood from a wound in childhood?

I do.

I was about 4 or 5, I think.  I have a vivid memory of my mother carrying me through the doors of an emergency department because I stepped on something sharp.  It was a piece of glass, though I can’t remember where we were exactly.  I have some memory of a doctor holding my foot down and me screaming.  I got a stitch or two and if I look really, really closely, I can still see the scar.

The second time I was older – about 10.  We had just come back from a summer vacation as a family.  It was dusk and my older brother and I were playing in the street with our neighbourhood friends.  I ran up onto the grass to get a ball and tripped and fell.  I didn’t know it at the time, but I had sliced my left index finger on a broken Coca Cola bottle.  It was my brother who noticed the blood pouring down my hand.  I screamed and ran to the front door only to be even more horrified by the sight of my own blood.  My mom wrapped my hand in a towel and whisked me in the car to my Godfather’s house (he was a doctor, see previous post).  He examined my finger and I recall seeing muscle. (ewww!)  He said I needed stitches, so off we went back to the same emergency department.

Scars are a part of childhood, a rite of passage if you will.  My daughter has a scar on her right cheek from scratching herself.  I didn’t expect it to scar but it was slightly deeper scratch with jagged edges, so it’s no wonder it scarred.  She was 2.5 when it happened.

But 13 months?  Yep – my son who just turned 1 in April suffered his first wound of childhood – well, toddlerhood more accurately.  Being bathed by his grandmother (my mother), he stood up in the bath and slipped, making contact between the bathtub tap and his left eyebrow.  When I got home from daughter’s Kindergarten orientation, I immediately noticed his bloody eyebrow. On closer inspection, a 1 cm fine, horizontal laceration.  Not bleeding anymore, so unlikely to need stitches.  Husband applied some crazy glue.  My first instinct was, “Oh no, he’s going to have a scar and his eyebrow hair won’t grow properly.”  (His father has a vertical scar of the right eyebrow.)  But then I recalled something from medical school.

A scar is “the fibrous tissue that replaces normal tissue destroyed by injury of disease”.  It is the end product of wound repair.  Scars can range from being almost invisible to keloid in appearance.  If hair was growing in the skin where the scar develops, it might not grow back properly.  Take for example, Mr. Al Pacino – famous actor, who has a scar on his left eyebrow.  Image

This is what I immediately thought would be the end result of my son’s first wound.  A scarred eyebrow.  I know it’s not the end of the world, and if it does scar like this, it’ll make for a good story when he’s older, not to mention making him quite the stud!

Direction of force is along each line. Cuts perpendicular to these lines are thus under greatest tension and most likely to widen.

But then, the doctor in me calmed the mother down and thought it through.  Our skin has lines of tension inherent in the elasticity of the skin itself.   From the Merck Manual: “There are static forces on the skin because of its natural elasticity and the underlying muscles.  Because scar tissue is not as strong as adjacent undamaged skin, these forces tend to widen scars, sometimes resulting in a cosmetically unacceptable appearance after apparently adequate wound closure.     Scar widening is particularly likely when the forces are perpendicular to the wound edge. This tendency (and resultant wound stress) is readily observed in the fresh wound; gaping edges indicate perpendicular tension, and relatively well approximated edges indicate parallel forces.

So, all this to say, that given my son’s cut had about a 1 mm gap, parallel to the lines of tension of the skin, it’s my gut feeling the scarring will be minimal, and his eyebrow hair will grow normally.

And if it doesn’t, he’ll just be more handsome than he already is.  😉

2 thoughts on “First Wounds.

  1. So hard to see our own kids hurt. BTW, am totally impressed with how often you blog, and by the visual aids/ photos. Between clinic nd being mom to 2 kids under 2y/o, I am barely blogging weekly.

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