Wound Care

If your child has a complicated or slow-healing wound — whether it’s from an injury, a surgery or any other illness — the pediatric wound care specialists at Nemours can help. Staffed by physicians from general surgery, plastic surgery and orthopedic surgery, along with highly trained wound nurses and other health care professionals, our specialty program is dedicated to providing compassionate, focused pediatric wound care for the child and family.

Whether we meet a child as an inpatient in the hospital or at an outpatient appointment, our treatment goal is the same: To prevent infection, promote healing, reduce pain, and minimize scarring so kids can get back to doing the things they love.

 
Learn More About Pediatric Wound Care

The benefit of coming to a pediatric-focused wound care center is that we understand the issues that only affect children and will take these into consideration when planning which dressings and medications will be part of your child’s treatment.

What Kinds of Wounds Do We Treat?

Your child might see a pediatric wound care specialist for multiple types of wounds, including:

  • abscesses — A build-up of pus under the skin, usually caused by infection, an abscess often needs to be drained in order to heal. In these cases, a doctor will open the skin to release the pus and treat the underlying infection.
  • burns — minor first- and second-degree skin wounds due to heat, chemical or electrical burns
  • gastrostomy site breakdowns — A gastrostomy tube (also known as a “G-tube”) is a tube placed through the skin of the abdomen directly into the stomach to provide an alternate feeding method to children who can’t receive adequate nutrition by mouth.
  • pilonidal cysts — A pilonidal (pronounced pie-low-NYE-dul) cyst is an abnormal sac under the skin that contains embedded hair and skin debris. It’s almost always located near the tailbone, at the top of the crease of the buttocks. Pilonidal cysts, like abscess, may require incision and drainage or excision (cutting out the cyst) in order to heal.
  • pressure sores — Prolonged periods of inactivity, such as sitting in a wheelchair or lying in a bed, can lead to open skin wounds known as “pressure sores.” Children who have reduced mobility due to spina bifida, spinal cord injury or other neurological or developmental delays are at greatest risk for developing pressure sores. Some medical devices that exert pressure on one particular area of skin (such as splints, casts or oxygen masks) can also contribute to the development of sores.
  • surgical wounds — Any type of surgical incision is considered a wound. Although most surgical wounds in children heal well on their own, some do benefit from the assistance of our pediatric wound care staff.
  • wounds caused by trauma — Any type of traumatic accident, bite (human or animal) or gunshot can result in a wound that requires care.
A Customized Plan for Healing

Because every wound is different, and so is every child, our pediatric wound care staff will design a customized treatment plan for your child. Rest assured that we’ll be there — with you — throughout the healing process, regularly monitoring your child’s comfort level and overall health, and taking every precaution to prevent infection.

We understand that managing a serious wound can be stressful, for children and families alike. We will work to alleviate some of that stress by making pain management a priority. Our pain management specialists use many techniques, not just medications, to bring your child relief. We work with you to make sure you’re comfortable with any necessary pediatric wound care you may have to perform at home, like dressing changes.

Coordinated, Convenient Pediatric Wound Care

If your child is recovering from a wound — and especially if he or she is also dealing with an underlying medical condition or infection — it can be hard to manage the many appointments. That’s why we always do our best to have children evaluated by several specialists on the same day, each time they visit. It’s all part of our commitment to coordinated care — and to making our patients’ and families’ lives just a little bit easier. It’s the Nemours promise: to treat your child as we would our own.

Nemours/Alfred I. duPont Hospital for Children, Wilmington


Second floor, surgical area
1600 Rockland Road
Wilmington, DE 19803
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For Appointments: (302) 651-4200

Hours: Wednesdays, 1–4:30 p.m.

 
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Additional Providers:

  • Danielle Jaszczyszyn, APN, WCC (Wound Care Certified)
  • Tom Kopec, BSN, WCC
  • Jenna Ryan, MSN, WCC
 
What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
Returning Patients
  • Patient Presents Without Legal Guardian (PDF)
    English | Spanish
    Note: A parent or legal guardian must be with a child for a first visit.
 
Forms & Resources
Returning Patients
  • Patient Presents Without Legal Guardian (PDF)
    English | Spanish
    Note: A parent or legal guardian must be with a child for a first visit.
Resources for Patients & Families

Nemours/Alfred I. duPont Hospital for Children offers exceptional, compassionate pediatric wound care, whether your child is staying in the hospital or coming in for follow-up care at our outpatient clinic.

Our multidisciplinary staff includes doctors from general surgery, plastic surgery and orthopedic surgery, as well as specially trained wound nurses and other health care professionals. Together, we’ll formulate a customized plan to help your child’s wound heal and minimize any accompanying pain and stress.

 
What to Expect at Your First Visit

Because every wound is different, and so is every child, we’ll spend plenty of time at your child’s first visit going over your child’s medical history. We’ll assess the wound, review how it occurred, and ask about any chronic conditions or allergies your child may have and any medications your child is taking. We may also order blood tests and additional tests.

A thorough evaluation is critical because how quickly a wound heals often depends on other conditions. For example, many different factors can affect wound healing including:

  • chronic health problems — Heart disease, diabetes, kidney disease, immune system disorders and cancer can all negatively affect the body’s natural healing process by interfering with healthy blood flow, nutrient absorption and immune response.
  • infection — Wound healing is an active, energy-using process. An infection anywhere else in the body can tax the body’s resources, diverting them away from the wound.
  • medications — Certain medications, such as corticosteroids and nonsteroidal anti-inflammatory drug (NSAID) pain relievers (such as ibuprofen), are known to inhibit tissue healing.
  • nutrition — The body needs a steady supply of nutrients to fuel the healing process. Inadequate nutrition can greatly delay healing.
  • radiation and chemotherapy — These life-saving cancer treatments have the unwanted side effect of killing healthy cells and suppressing the body’s ability to fight infection.
  • smoking — Smoking disrupts the healing process by preventing oxygen from reaching the cells.

After we meet with you and your child, we’ll create an individualized treatment plan that focuses on preventing infection, supporting the healing process, and taking steps to ensure that the wound won’t recur.

 
How Do We Care for Wounds?

Wound care is a rapidly advancing field of medicine, but it requires special considerations for our pediatric patients. For example, although children are generally quicker to heal than adults, their skin is also typically more sensitive. The benefit of coming to a pediatric-focused wound care center is that we understand the issues that only affect children and will take these into consideration when planning which dressings and medications will be part of your child’s treatment.

Typical pediatric wound care involves performing the following steps on a regular basis:

  • irrigation — Wounds heal better when they remain moist. Irrigation is the steady flow of a solution (usually saline or salt water) on the wound to hydrate it and remove debris.
  • cleaning — Using moistened gauze pads, a nurse will gently and carefully remove dried blood, dead skin and any other debris from the wound.
  • dressing — There are many dressing choices available made of various materials. Some contain additives (such as iodine, silver, collagen or antibiotics) and some do not. Your child’s doctor and wound nurse will discuss the best option for your child. Wounds that can be stitched closed might simply require routine cleansing and fresh bandages. Other, deeper wounds might heal better if left open and “packed” (when gauze is applied inside an unstitched wound to help it heal from the inside out). We always try to choose the gentlest, most effective dressing so as not to cause additional pain on removal.

Depending on the type of wound, your child may require a course of antibiotics to prevent infection. Pain medications may be necessary as well if the wound is severe.

 
Follow-Up Appointments and Home Care

At subsequent appointments, we’ll carefully inspect the wound, noting the color, amount and odor of drainage. We’ll measure the wound to make sure it’s healing well and check for any signs of infection. Afterward, we’ll clean and re-dress the wound.

In many cases, if they’re willing, parents and caregivers can be taught how to properly clean and care for a wound at home. We’ll discuss whether home care is an option for your child, and if so, your comfort level in taking it on. We can also arrange for visits from a home health care nurse to assist you if necessary.

 
Making Your Child’s Comfort a Priority

We understand that young children can’t always describe their pain accurately. That’s why we work hard to make sure children are as comfortable as possible as we care for their wound. Pain management specialists can alleviate discomfort, and also reduce anxiety and stress by offering sedation for certain procedures.

Learn More About Sedation »

 
Other Members of Your Child’s Comprehensive Pediatric Wound Care Team

As part of your child’s care, we’ll consider all the other factors that promote good healing. In addition to our pediatric wound care program’s physicians, advanced practice nurse (APN) and nurses, as part of our wound care clinic, your child will also have access to:

  • behavioral health experts — psychologists, psychiatrists and social workers who can evaluate your child’s emotional status and address your family’s concerns
  • Child Life specialists — certified professionals who can help your child deal with stress by providing creative therapies and opportunities for play
  • infectious disease specialists — doctors who specialize in diagnosing and treating infections
  • nutritionists — dietary experts who can recommend foods that are high in helpful nutrients or low in harmful ones, and show you how to find and prepare foods that give your child a nutritional advantage
  • occupational and physical therapists — experts in fine and gross motor skills who can address mobility issues and offer solutions to help prevent skin breakdown
  • wheelchair seating clinic — run by rehabilitation experts in assistive technology who can recommend seating and positioning changes to help minimize the risk of pressure sores if your child uses a wheelchair

Working together, we’ll manage your child’s integrated treatment plan seamlessly.

 
Keeping Everyone Up to Date

We believe that one of the best ways to advance medicine to benefit children is through collaboration. With the help of our award-winning electronic health record (EHR), we work closely with our own Nemours care providers, as well as physicians and health care professionals in the community.

NemoursOne, our electronic health record, is a secure, online environment that connects all phases of care for a child — inpatient, outpatient, at home and at the referring physician's office. So, no matter who your child is seeing within our hospital or at one of our satellite locations, everyone can access the same information at the same time.

Using a special physician portal, primary care and referring physicians can also securely access information about the care provided by the Nemours medical team so that they can monitor your child’s progress any time, day or night. Through a special program called the “Student Health Collaboration,” public school nurses in Delaware can also access your child’s electronic medical record (with your permission) so that they can understand your child’s condition and treatment, and be better informed about how to best care for your child during the school day.

Parents can also keep track of what’s going on with their child’s care. MyNemours is your free, personal access to select areas of your child’s medical record, including test results. It’s also your key to direct, confidential electronic communication with your child’s Nemours medical providers. With MyNemours you can:

  • request an appointment
  • renew prescriptions
  • communicate with your child's medical provider
  • view and print select medical information like your child's growth chart or immunization record
  • manage health care information using your computer, iPhone or Android mobile device