Facial Lacerations in Children

Abstract

The aim of this study was to evaluate the demographics and treatment of facial lacerations in pediatric patients. A retrospective record-based analysis was administered on 3783 patients (<15 years of age) presenting with facial lacerations from March 2002 to February 2011. Males were injured more frequently across all age groups (65.3%) and especially in the 13- to 15-year-old group (81.3%) (P = 0.012, Pearson χ). Overall, 48.9% of injuries occurred outdoors and 45.1% in homes. Only 6.0% occurred in schools or kindergartens. Injuries that occurred in schools or kindergarten increased with the age groups (from 2.3% for 0- to 3-year-olds to 19.1% for 13- to 15-year-olds). In the age groups younger than 12 years, injury occurred more frequently on the weekend. In the 13-to 15-year-old group, however, injury occurred more frequently on weekdays (odds ratio, 2.46). Injury occurred most frequently at the times of 7 to 9 PM and least frequently from midnight to 6 AM. The most frequent cause of injury in children was by being struck or by bumping something (32.5%), followed by slip-down (31.5%). Accidents involving furniture and stairs accounted for 9% each. Accidents caused by stairs decreased with age (from 10.2% for 0-3 years of age to 5.5% for 13-15 years of age, P = 0.000, Pearson χ). In a little less than half (47.2%) of the cases, parents accompanied their children at the time of injury. In the 13- to 15-year age group, only 17.9% of the children were accompanied by their parents. Foreheads (26.4%) took the brunt of most frequent injuries, followed by the eyelids (20.6%), eyebrows including the glabella (19.7%), and chin injuries (15.7%). Only 58 cases had associated injuries. Among 3783 cases of facial lacerations, 3745 patients did not have facial bone fractures or associated injuries and were managed under local anesthesia or through dressings only. A sound knowledge about the epidemiology of lacerations might be beneficial for the prevention of pediatric facial lacerations, which occurs more frequently than facial fractures. It is noteworthy that slip-down showed a peak in kindergarteners (4-6 years, 36.1%) and then decreased with age. The incidence of slip-down might be reduced if attention is paid when the kindergarteners are walking on steep stairs or steep flights of stairs. Injury at the educational institutions increases with the pupil's age, and therefore safety management in schools is important.

Analysis of Patients with Facial Lacerations Repaired in the Emergency Room of a Provincial Hospital

“…The percentages of males and females with a facial laceration that underwent primary repair in the emergency room between March 2011 and February 2013 were 72.6% (2,348) and 27.4% (886), respectively. The M/F ratio for all study subjects was 2.65, and the bias toward men was greatest in adolescents, as has been mentioned previously in several reports [ 3 , 4 , 5 , 6 ]. In adolescents, the proportion of males was significantly higher than in the other groups (P<0.001).…”

Etiology, pattern and outcome of management of facial lacerations in Dar es Salaam, Tanzania

“…Results of this study revealed that facial lacerations were predominantly distributed around the midline region of the face following a T-shaped distribution, over the forehead, upper orbit, upper lip, lower lip and chin. Similar findings have been reported in other literature (Lo and Aslam, 2005;Roccia et al, 2011;Hwang et al, 2013). The prevalence of lacerations with a T-shaped distribution is attributed to the anatomic bony prominences of the maxillofacial region, which predisposes an individual to soft tissue injuries (Roccia et al, 2011).…”

Epidemiological Investigation of Facial Soft Tissue Injury in Chinese Preschool Children

“…This could highlight the role of teachers and parents in injury prevention, in particular to ensure there is adequate supervision and to provide a safe environment for the children. Injuries occurred least frequently between midnight and 6 AM, because children are sleeping, which is supported by the conclusion of Kun Hwang et al 11 The monthly distribution peaked in December (1222, 11.25%) and revealed the lowest occurrence in June (770, 7.09%). We speculated that the higher number of injuries in December may be relevant with the wearing of clothes and shoes.…”

“…It is thought that children move to protect their forehead as age increases. 11 In the study, bumping, including hitting the ground, wall, stair, furniture, and so forth after tumbling or slipping, was the most frequent cause of injury in preschool-aged children, with higher prevalence among the younger age groups. Several factors contribute to these findings: (a) with increasing age, security of motion and balance increases.…”