I. Will the stitches leave scars after the head and facial skin laceration is closed? Parents bring their children to our hospital and the doctor stitches up their wounds. Parents are often concerned about scarring that affects their appearance. All wounds will leave scars after they heal, but some scars are not obvious and do not affect the appearance much. Scars are very big and obvious often related to the following reasons: 1, whether the wound is clean, regular: clean, no dirt, skin edge neat wound is more conducive to the growth of granulation tissue, it is smaller than the scar left by pollution, foreign bodies, necrotic tissue, the edge of the wound is not neat, so the wound suture before effective debridement, disinfection is very important; 2, whether the wound is infected, bleeding, cracking: there is infection, 3. sutures: sutures with silk threads are more likely to leave scars than absorbable threads (commonly known as cosmetic sutures); 4. personal constitution: some people are born with scars, which can leave unsightly scars even if the wound heals smoothly; 5. the child’s cooperation during suturing: although this is not a direct cause of the size of the scar, it is important for young, uncooperative patients to have their scars removed. However, for small, uncooperative children, wound healing will be smoother if thorough debridement and optimal suturing can be performed under general anesthesia. What is the problem with repeated vomiting after head trauma? Children often vomit after a head injury. Some children can vomit so badly that they start vomiting as soon as they eat or drink a little bit of water, or even vomit in jets, and the vomiting symptoms can last for hours or even a day. Vomiting after a child’s head injury is usually due to increased intracranial pressure or the vomiting center at the base of the fourth ventricle is affected. Children with vomiting should come to our hospital immediately for a cranial CT scan to rule out intracranial hemorrhage and skull fractures. It is recommended that the child be hospitalized to prevent dehydration and electrolyte disturbance, and to provide sedation and neurological improvement medication. Third, what should children do after head trauma? Children are more likely than adults to have headache, vomiting, convulsions and coma after a head injury. On the other hand, children’s condition deteriorates faster than that of adults. Sometimes children cry and fuss continuously after the injury, but it doesn’t take long before they are in a coma and convulsions, so they don’t receive timely and standardized treatment. Therefore, we suggest that parents should first remain calm after finding head trauma, simply understand how the child fell, where the child’s head landed, whether the child was injured elsewhere in the body, and whether there were any headaches, vomiting, convulsions, coma, bleeding and other abnormalities after the injury, and then immediately send the child to a nearby hospital qualified to treat pediatric trauma for examination, and if necessary, do a cranial CT examination to further understand the intracranial For children with serious symptoms, hospitalization and close observation are recommended. Why do I need to be hospitalized if I have a skull fracture? Skull fracture will be found through CT head examination after a child’s head injury. Skull fractures are slow to heal and may take several months and do not require hospitalization. However, children with skull fractures are prone to intracranial hemorrhage (epidural hemorrhage, subdural hemorrhage, etc.) for nearly 1 week after the injury, which is called delayed hemorrhage and can be life-threatening to the child. In order to prevent this risk, we recommend that children with skull fractures who are hospitalized after the injury can be monitored closely so that late bleeding can be detected by doctors in time and treated accordingly. Why do children have “panda eyes” after a head injury? Some children find that their eyes are darkened after a fall, which often indicates that the child has a fracture of the anterior cranial fossa, which is a fracture of the skull around the forehead and orbits, and bleeding into the skin or eyelids to form petechiae. The fracture is often accompanied by a tear in the dura mater (the membrane between the brain and the skull), and the cerebrospinal fluid flows out of the fracture, which we call a cerebrospinal fluid nasal leak. Therefore, when you see a child with “panda eyes”, you should pay attention to whether there is fluid coming out of the nostrils (perhaps clear or bloody). We recommend taking the child to the hospital for a cranial CT and 3D reconstruction of the skull base, as well as hospitalization for regular treatment. VI. How to treat scalp hematoma? Children with head injuries often have subscalp hemorrhage, which appears to be an obvious bulge in the scalp with a “big bag” that seems to have “water” under the skin when touched. For scalp hematoma, we advocate applying ice or cold compresses immediately after the injury to help stop the bleeding and limit the edema, and then starting local heat or physical therapy treatment 2 days later to promote the absorption and dissipation of the hematoma. However, for hematomas that are large, slowly absorbed or located at the forehead, we recommend waiting until the hematoma is stable and does not increase in size before treatment. There are two ways to treat the hematoma: one is to give it aspiration by puncture, and the other is to use other methods to promote the hematoma to absorb on its own. Children who need hematoma aspiration are hospitalized. The hematoma can be aspirated only after the coagulation function is normalized in the hospital, and pressure bandages are applied to prevent rebleeding. The gauze on the head can be removed after a period of bandaging, and the blood that is not aspirated but remains can be promoted to dissipate through physical therapy. Seven, how can nosebleeds after head injury? Many children have nosebleeds after a head injury. First, the fracture of the anterior skull base, that is, the fracture of the bone plate above the nasal cavity and orbit, the external force not only makes the bone plate crack but also causes the nasal mucosa and dura mater to tear, and the fluid in the head (cerebrospinal fluid) mixed with blood flows out of the nostril along the fracture. The bleeding will stop only after the torn dura mater has healed; secondly, nasal trauma, where trauma causes bleeding from nasal fractures and ruptured nasal mucosa, bleeding from minor breaks will stop soon, but bleeding from ruptured small nasal arteries can be very aggressive and requires the assistance of an otolaryngologist. For a child with nosebleeds, we recommend a cranial CT and 3D reconstruction of the skull base to find the fracture line through CT; at the same time, we ask an ENT physician to assist in the nasal examination.