Clinical context (Clean and contaminated traumatic wounds in stable children — primary care assessment for irrigation, tetanus, closure, and antibiotic need)
First-line therapy
Wound care (no routine antibiotics) • local
Duration: Single encounter ± follow-up · Copious irrigation with saline or clean water under pressure · remove foreign bodies and devitalized tissue · hemostasis · dressing · document neurovascular status and tetanus history
Dose is calculated using the amoxicillin component.
Max 875 mg/dose (amoxicillin) · Max 1750 mg/day · Duration: 3–5 days · Amoxicillin/clavulanate for high-risk contaminated wounds (soil, feces, intraoral through-and-through, delayed presentation >12–24 h with crush) — NOT routine for clean minor cuts
Enter weight on Kids to calculate doses
Clinical notes
• Irrigation is the most important step — reduces infection risk more than antibiotics (IDSA, AAFP wound care principles).
• Tetanus prophylaxis: assess vaccination status — Tdap/Td booster if indicated; TIG for tetanus-prone wound with incomplete primary series (AAP Red Book, WHO).
• Primary closure: low-infection-risk facial lacerations (<6–8 h, clean) may be closed after irrigation; avoid primary closure of puncture wounds, animal/human bites (see Bites card), heavily contaminated wounds, or high-tension hand wounds (AAFP, IDSA).
• Antibiotics NOT indicated for uncomplicated clean minor wounds — reserve for established infection, high-risk contamination, or immunocompromise (IDSA SSTI, CHOP).
• Refer urgently: neurovascular compromise, tendon exposure, joint penetration, uncontrolled bleeding, compartment syndrome signs, or need for sedation/repair beyond primary care scope (AAFP, NICE).
• AAP Red Book — Wound management and tetanus prophylaxis (2024)
