to ignore hospital's advice re my DS(38 Posts)
My DS2, who is 3, fell over today and split his lip It's a small cut, just short of 1cm.
We took him to A&E to be checked out expecting to be told he was fine and it would heal on its own. However, the paedeatric nurse advised us because the cut is on his "lip border" he would need stitches. We've been referred to our city hospital tomorrow morning for him to be "put under" and stitched.
Now the impression the nurse gave was that this would happen, not that he'd be checked by the plastic surgeon and they would make the decision. This made me think it was a necessity. Looking at the cut, it looks fine. Not necessary to put such a small child through starvation for the anaesthetic and the overall ordeal for what amounts to a small scar.
But I'm worried about what if we don't go? Whats the worst that can happen?
I'm really asking AIBU not to take him to this appointment in the morning? I really don't want to put him through more than is necessary but will absolutely take him if there is something I'm just not seeing.
TIA and sorry its so long
The worst that could happen is the cut will take a long time to heal, will be prone to infection and could cause him a lot more pain in the long term.
They dont operate on a child for the fun of it, and as they are the experts, you would be negligent towards your son if you ignore their advice.
I'm assuming they'll want to stitch it to make sure it heals straight? If it's a cut between lip and the normal skin the swelling could cause the flesh not to knit neatly? Just a thought.
Yep, thats what I thought.
I've had so many people telling me today that it doesn't need any further intervention and will heal on its own and I just wanted outside perspective.
If the wound doesn't heal properly you're risking infection and eventual scarring.
My ds1 fell against the doorframe when he was about 3 and badly cut an area just over his eyebrow. It bled like crazy and they didn't stitch it, but just applied steristrips instead. They came off the next day and we put a hydrocolloid dressing over it, which did help it heal, but he's been left with a noticeable scar. I honestly wish they'd just stitched it and it would have been far neater.
Go to the appointment and discuss the options. You're not obligated to have it stitched, but at least find out what would happen if you didn't have it done.
When I worked in A&E it was standard protocol to suture lip lacerations that went through the vermillion border, especially in growing children. A scar at 3 may look worse when he is 13 after he has grown some more - scar tissue doesn't really 'grow' along with healthy skin so he could end up with a deformed lip.
But when it boils down to it they need your consent to do the procedure so if you're not happy then don't consent. However I would recommend you attend the appointment, speak to the surgeon as to the necessity for the op and associated anaesthesia, and then make your decision.
However if you don't have the op soon, it heals and heals poorly leaving him with a bad scar it will be harder to tidy up than a fresh wound.
Take him to the appointment and make the descision then.
Oh and others now agree too.
Fantastic, thats given me total resolve now.
I would presume that because of all their training and experience that they'd know better than me.
But of course that doesn't apply to all situations, nor does it devalue your opinion as his mum.
But you asked them, and they gave you their advice.
DD just had to have her lip stitched from a fall 2 weeks ago. It's healed so well. She had a local in her lip and then it was stitched. I wouldn't hesitate to do it again, even though it was bloody traumatic.
The mouth (outside) of it, is also very prone to infections, dirty hands touching the wound etc.. which is something a 3yo would be very like to do without thinking.
My husband got bitten by a dog on his lip a few years ago, and the scar tissue from that is still there, and visible. For some reason lip tissue does heal in a different way to normal skin.
I would think they also want to check that the wound is absolutely clean, and that would be a difficult thing to check on anyone with a split lip, and painful too, so imagine how scary it would be for a toddler. Hence the need to anaesthetise briefly while they do the job.
Glad you've made a decision. FWIW I think it's the right one.
Also FWIW I had to make a similar decision when DS was 25 months. I spoke to the SHO of maxillo who said it would be cosmetic mainly and it wouldn't affect him. (not his lip it was internal). I decided against it because it wouldn't leave any visable scarring and if problems occured he could have surgery when older.
He ended up having a tooth removed 3 years ago and they still do not know if the adult one will ever grow - not what the op was for. The thing they would have operated on has healed perfectly.
Best of luck.
My daughter did the same thing at the same age. She has a tiny scar, and I am thankful to the surgeons for that - it could have been much bigger, and right in the centre of her face. No hiding that. The scar is more noticeable if she is cold or unwell, but some days you can barely see it.
They have to put them under GA because children that young can't be relied upon to stay still. My young son recently had stitches without GA (outside UK) and it was a truly awful experience - he screamed and fought throughout and has ended up with a bigger scar than if we had done nothing.
My daughter was sewn up by the maxillo-facial team, I believe because they are the best or most practised at tiny stitching.
I'm not saying that day was a highlight of my parenting career, but tbh it wasn't all that bad. Definitely far worse for dh and me than for her! And I am so pleased we did it.
I think you need to take him, but it is reasonable for you to want to be absolutely sure he needs the GA and to expect the surgeon to explain to you why this is the case.
When DS1 was the same age as your DS, he got a very nasty cut on his head, which clearly needed stitching. However, the doctor was very reluctant to give him GA and asked us to hold him down while the stitches went it. It was horrible to do it, but the doctor and the nurse were fantastic. Once the decision was made, the nurse was quick as a flash wrapping him in a sheet so he couldn't move his arms or legs, then I held his shoulders down while DH has his feet.
It sounds awful, but it was over very quickly and I was glad he didn't have to have the GA with it's associated risks. I don't think the hospital will want to give your DS GA unless it's really necessary, but do ask them why it is.
I split my lip at tht age and it healed with a larged lump that made me self conccious when a teeneager - dont think about it now
I think I would rather take the (very very low) risk of a GA rather than subject my child to a very traumatic painful experience that he will remember for life, and quite possibly give him a severe phobia of hospitals or anything medical.
My daughter got her finger trapped in a door and her nail bed was fractured.
I took her to A and E, they said she needed to see a plastic surgeon. He took a brief look and said it needed to be stitched under general anaesthetic. I think it was so she was still and they could examine it properly as well. This was 10 months ago. If you examined her fingers you would have to look hard to find the scar.
It was however the scariest 2 hours of my life while she was in surgery.
I bit through my lip aged 3, it was stitched at the local doctors. I still have a scar.
Go and see the doctor and see what he says.
Maybe squeaky, but DS1 is 10 now and not at all traumatised or scared of hospitals - just proud of his scar!
In the event we took the doctor's advice, which was that any risk is too big if it's not necessary.
Take him in, please.
I cat my lip open when I was 3 or 4. My uncle was a doctor and he cut his GP surgery short to come to hospital to supervise the stitching to avoid bad scarring. There was quite a lot of scar tissue, but my uncle ensured there was so that I could have it fixed when I had stopped growing. At 16 I had my lip restructured to get rid of the scar tissue and give me a more natural looking top lip. If I hadn't had it stiched I would have had a very odd lip and it wouldn't have been as easy to fix.
I would definetely take him, they would not advise you to bring him in to be put under general anesthetic for something trivial.
You are probably talking about an anaesthetic for all of fifteen minutes. Scars are unpredictable on the face and so do get extra care, it's not like your knee. Particularly with small children the underlying muscle structures etc can be constrained by scar tissue which makes the face develop differently and can make the scar even more noticeable.
If it was my child I would go and I would ask all the questions in the world before making the decision but ultimately I'd go ahead.
Hope he feels better soon btw, poor little thing.
Its not that I want to ignore their advice, its more other people planting seeds of doubt after the fact.
I absolutely take on board all comments and will 100% be attending the appointment tomorrow to see what the surgeons advice is.
Again, thanks all x
why would you listen to untrained people instead of the professionals in the first place?
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