General Tips

• Carefully consider which means of transportation works best depending on the student’s age, maturity level, location, and how far they live from the school.
• Leaving a few minutes early is helpful so that the student does not feel rushed and remembers to be cautious.
• Students should not travel alone to school if at all possible. Try to arrange for them to go with others.
• Students should report any uncomfortable situation that they may encounter when traveling to and from school to their parents and teacher.

Crossing the Street

• Always look both ways and then look left again. It may seem obvious, but many accidents happen because people fail to perform this simple task.
• Try to cross the street at a corner with a crosswalk. If there is a pedestrian traffic light, cross when you have the right of way.
• Most schools have crossing guards to help students safely get across the street. It is important to be alert and follow their directions.
• Do not assume that someone else in the group is looking for cars on your behalf or that on-coming traffic can see you crossing.

Walking, Biking, Skateboarding, etc.

• Walk on the sidewalk. If there is no sidewalk, walk on the left side of the road facing the traffic.
• Wear bright colors or put reflective tape on backpacks so that drivers can see you.
• Never walk out from in between two cars.
• When riding a bicycle, scooter, or skateboard always walk it across the street instead of riding it. Also, wear the proper safety equipment (helmet, elbow pads, etc.) when necessary.
• To avoid distraction, do not listen to mp3 players or use cell phones.

Taking the Bus

• At the bus stop, wait on the sidewalk and never step out into the street until the bus has fully stopped.
• If there are enough seats, always stay seated and buckle seat belts if they are available.
• When walking near the bus, be far enough away so that the bus driver as well as other drivers can clearly see you when crossing the street.
• If taking public transportation, practice the commute so that you are confident and always have a back-up travel route in case there are any problems.

Driving

• Watch out for pedestrians and follow school traffic signs.
• Be sure that everyone in the vehicle is safely buckled.
• When carpooling with another student’s parents, make sure that they are a safe driver.
• Use caution when getting in the car with new drivers.
• Know what to expect when dropping off students at school. Sometimes there are designated areas or students have to be walked in.
• Find out the school’s pick-up policy and whether or not they require a list of people who are allowed to take students home.

Discover More

• Safe Kids USA: Child Pedestrian Safety Rules.
• American Academy of Pediatrics: Safety Tips.
• Safe Kids Worldwide: Pedestrian Safety.
• Elmer’s Safety Village: Safety Activities.
• Ask a Cop: Rules for School Bus Safety.
• National Highway Traffic Highway Administration: The School Bus and You.
• Teen Driving: General Tips.

stitches on a lip

“So, doctor, will my child have a scar?”

As a plastic surgeon, I am asked that question all the time.  Whether it’s a cut on a knee from a fall off a skateboard or an injury to the forehead from a swingset, parents are concerned about the appearance of a scar following their child receiving stitches. The truth of the matter is that, yes, there will always be a permanent scar following any injury requiring stitches. Just how noticeable that scar will be to the casual observer, however, is what’s important.

a scar on a leg showing stitch marks

What exactly is a scar?

Stedman’s Concise Medical Dictionary, one of the more popular references used by health care professionals, defines a scar as “any fibrous tissue replacing normal tissue destroyed by injury.”

When a skin wound is caused by an accident, stitches are placed to hold the tissue together until the body’s natural healing process repairs the wound.  This process usually takes place within five to seven days and the stitches can be removed.  Though the wound is said to be “healed”, the resulting scar, made of living tissue, is considered “immature” and will undergo a variety of changes over the next 12-18 months before taking its permanent appearance.  This period of time is called the scar’s “life cycle” and the process of change called “remodeling”.  This entire maturation process- from the initial placement of stitches to the final phases of scar remodeling-  is influenced by a variety of factors.  Some of these can be controlled; others cannot.

Factors We Cannot Control

1. Genetics. Genetics plays a huge role in the ultimate appearance of a scar.  Individuals with fair skin, light hair, and light eye color have a greater tendency to develop reddened and raised scars.  Individuals with dark hair, dark colored eyes, and olive to dark skin, in contrast, form scars that blend better with the person’s own skin color.

2. Location. The location of the wound influences the scar’s ultimate appearance.  A scar close to the shoulders, elbows, and knees, where there is a lot of natural motion and therefore tension, will widen during the maturation process.  This widening is in contrast to scars on the cheeks or forehead which heal in a fine line because of the relatively little motion present on these parts of the body.

So what can you do to reduce scarring?

1. Have your wound stitched by a qualified physician. The skill of the medical practitioner placing the sutures will affect the outcome.  Meticulous attention to detail, careful technique, a tension free closure, and fine sutures can all result in improved scar shape and appearance.  Among doctors, plastic surgeons pride themselves at being the best at placing sutures that minimize scarring and are often called upon in situations where scarring is a concern.

2. Protect scars from the UVB rays of the sun. Protecting scars during their maturation will help them take on the color of the individual’s natural complexion.  Scars overexposed to the sun during maturation will take on a reddened or cranberry colored appearance.  Sunscreen with at least a 30 SPF has been shown to be effective at minimizing scar reddening.

3. Firmly massage the scar with an oil-based moisturizer. Doing so has been shown to help keep the tissue soft and flat.  The physical manipulation of the scar works the magic.  A massage from 3-5 minutes, once or twice daily, can help flatten and soften the scar and improve its appearance on your skin.

TV and print ads are loaded with advertisements for gels, lotions, and creams claiming to “erase” and “eliminate” scars.  These remedies tend to be very expensive and their effectiveness is not supported by scientific studies.

4. Get an evaluation by your doctor. For those individuals whose scar becomes persistently red or raised over time an evaluation by your doctor may determine if certain scar treatments are right for you.  Silicone sheeting (Mepiform) and gels (Scarguard) applied to the surface of scars or cortisone injections into the scar have been proven to be effective in improving the appearance of scars.

So, for all of you parents out there wondering if your child will have a visible scar, you now have some tools at your disposal to minimize the appearance of any scars.

—–
About the Author: Dr. Michael J. Lacqua completed his Plastic Surgery training at the University of Missouri, Kansas City before returning to his hometown of New York. He is the Chief, Division of Plastic Surgery, at Richmond University Medical Center, Staten Island, NY.

Discover More:

• Learn more about plastic surgery
• Would you like to ask a question to Dr. Lacqua?  Contact Us.

See scar-related products on Amazon.com