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Facial Lacerations in Children

Hwang, Kun MD, PhD*†; Huan, Fan MS, RN*†; Hwang, Pil Joong MD, MS; Sohn, In Ah PhD, RN

Journal of Craniofacial Surgery: March 2013 - Volume 24 - Issue 2 - p 671–675
doi: 10.1097/SCS.0b013e31828026d8
Brief Clinical Studies

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 2). 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 2). 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.

From the *Center for Advanced Medical Education by BK21 Project and †Department of Plastic Surgery, Inha University School of Medicine; and ‡Department of Emergency Medical Technology, Gachon University, School of Health and Science, Incheon, Korea.

Received November 9, 2012.

Accepted for publication November 24, 2012.

Address correspondence and reprint requests to In Ah Sohn, PhD, RN, Department of Emergency Medical Technology, Gachon University, School of Health and Science, 534-2 Yeonsu-dong, Yeonsu-gu, Incheon 406-799, Korea; E-mail:

This work was supported by the grant from INHA University (INHA Research Grant).

The authors report no conflicts of interest.

© 2013 Mutaz B. Habal, MD