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If
necrotic material is present a hydrocolloid gel is
used and the lesion is covered by a second,
nonadherent dressing and is held in position by
tubular gauze.
If
bleeding is a problem, calcium alginate dressings
are used.
If
there is a cavity, the dressing is torn up into
small strands that are used to pack the cavity;
again a second, nonadherent dressing is used over
this. If there is a significant cavity in an
exudative lesion, hydrocolloid gel can be used to
fill the cavity. Hydrocolloid gel is also useful for
frequent application to an ulcerated surface such as
the lower lip where dressings are impractical.
For
ulcerated and painful hemangiomas, duoderm dressings
can be used in order to reduce pain, and most ulcers
close in 1 to 2 weeks. If small skin breakdown is
present, cleansing and a topical antibiotic should
be used. If obvious ulceration is present,
saline-soaked dressings should be applied wet and
removed dry, to debride the crust and eschar so as
to hasten reepithelialization. For pain, lidocain
jelly may be helpful.
References:
Mulliken JB. Pediatric Dermatology 1997;14:57-83
/ Rogers M. Pediatric Dermatology 1997;14:57-83
/ Rothman KF. Pediatric Dermatology 1997;14:57-83
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