Instructions for wound care of ulcerated infantile hemangiomas

Cleaning

Apply a pea-size amount of lidocaine-numbing ointment (if prescribed) to ulceration 20 minutes before cleaning the wound. Do not use lidocaine more than 3 times daily.
Gently clean wound with a mild cleanser/wash once daily. Gently rinse with clean water after cleansing. Scabbed area will come off naturally. Do not pull or tug on it.
Cleaning tips:
- Do not use wash cloth directly on wound.
- You may try 1 of the following:
  - Gently use fingers to clean the area.
  - Drizzle soapy water over wound with wash cloth, then rinse by drizzling with clean water.
  - Use 2 spray bottles, 1 with soapy water and the other with clean water. Gently spritz/spray with soapy water followed by spritz/spray of clean water.

Dressing

Apply thin layer of antibiotic ointment (if ordered) followed by thick layer of plain petroleum jelly.
Use hydrocolloid-type dressing. Leave dressing on for up to 24 hours, if possible; otherwise change it as needed.
Dressing tips:
- Applying ointments directly to dressing and not to the wound will reduce pain.
- Apply petroleum jelly to dressing first, then prescription ointment on top.
- Then place dressing on wound. This way, when the dressing is applied, the medicated ointment is closest to the open skin.

Courtesy of Denise W Metry, MD.

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