Human skin is completely formed at birth. This is also the reason why the skin area of babies and toddlers is two and a half to three times larger than that of adults. However, the cohesion of the epidermis (upper skin) and the dermis (corium) is still very weak, which is why blisters can form more quickly. The epidermis matures over time, the skin structures network and the skin becomes firmer.
Wound Healing and its Special Features in Children
What makes baby skin so different?
The skin is the largest and heaviest organ in the human body and has important functions. This applies from birth. In fact, the skin surface of small children is two and a half to three times larger than that of adults. The topic of wound healing is therefore a significantly important issue, especially for parents of babies and small children. Due to the nature of baby skin, it is significantly more sensitive than the skin of adults.
Are wound problems in babies "normal"?
The sweat glands and thermoregulation are also not sufficiently developed in the first months of life. Babies still lose a lot of water through their skin until the lipid barrier is fully developed, which makes it dry and brittle and therefore prone to inflammation. The typically rosy baby skin does not appear until the age of two to four months. All of this means that the barrier function of the skin of small children is not well developed and therefore cannot offer sufficient protection against infections caused by bacteria, viruses or fungi. In the diaper area, incontinence, which is common in babies, leads to wound problems.
The three phases of wound healing
EXUDATION PHASE
In the exudation phase, skin injuries often lead to bleeding. The body then initiates hemostasis, which in turn leads to vasoconstriction and thrombocyte adhesion and aggregation. In addition, the platelet plug forms and the blood coagulation cascade is activated. A fibrin clot forms. This phase is characterized by crusts and necrosis. The cleansing phase then begins, in which vasodilation occurs to transport macrophages and neutrophils to the wound area. The inflammatory cells fight off germs, remove dead tissue and release chemotactic substances and growth factors. wound secretion exuded. During this phase, the cells and hormones of the immune system play a key role in killing invading germs and in the healing process.
GRANULATION PHASE
In the granulation phase, new tissue is formed and the wound is filled. Fibroblasts and endothelial cells migrate to the edges of the wound. The fibroblasts form collagen as the fibrin network breaks down, while the migrating endothelial cells form capillaries that ensure optimal wound blood flow and metabolism. A cellular matrix of fibroblasts, enthodeline cells, macrophages, collagen, fibroneticin and hyaluronic acid develops, which gives the granulation tissue its name. Here you can see light red, glassy-transparent granules, the vascular trees of the numerous capillaries.
EPITHELIZATION PHASE
In the last phase, the epithelization phase, the replacement tissue forms and scarring occurs, which can take several weeks. A third of the diameter of the wound closes exclusively through shrinkage, as the granulation tissue becomes less watery and less vascular. The remaining two-thirds close through the formation of new scar tissue, with the formation of collagen fibers that network and stabilize in bundles. Finally, epithelial cells close the wound surface.
The meaning of "time"
The general requirements for phase-appropriate wound therapy can be summarized with the acronym TIME. TIME is made up of the following English terms:
TISSUE MANAGEMENT
repeated debridement of necrotic tissue
INFLAMMATION AND INFECTION
Inflammation or infection control
MOISTURE BALANCE
Regulation of moisture balance
EPITHELIAL ADVANCEMENT
Promotion of epithelialization
Why does baby skin heal faster?
Due to the relatively large skin surface of babies and small children, many active ingredients that are absorbed through the skin can reach relevant blood levels more quickly than in adult skin. In addition, due to the more rapid availability of fibroblasts, collagen is formed more quickly, which plays a key role in the structure of the skin, and granulation tissue is built up more quickly, which acts as temporary tissue during wound healing and prevents the formation of new blood vessels.
What should be considered when healing babies' wounds?
Special aspects should be considered when treating wounds in infants and small children, as most wound care products were developed for adults and children's skin should be exposed to as few substances as possible overall. Particular attention should be paid to questionable active ingredients. These include some antibiotics , such as zinc, neomycin, alcohol, antiseptics, and salicylic acid.
Corticosteroids can also cause skin damage. It is also important to ensure that skin care products contain a low proportion of emulsifiers and preservatives. Substances such as dyes, fragrances, lanolin and balsam of Peru can also cause skin irritation. As a precaution, care products such as creams should first be tested on a small area of skin before they are applied over a large area.
Wound dressings such as plasters with adhesive or tape lead to the tearing of the epidermis of this easily injured skin when they are removed. The Millis diaper liner is a better alternative here as these do not stick and can be easily removed from the skin without tearing the epidermis.
What is Millis?
Millis is a wound protection insert that is provided with skin-caring, natural active ingredients and has a soothing effect on sore buttocks and diaper rash. The insole is dry and particularly soft and therefore does not lead to any further stress from moisture or unnecessary strain.
Millis is simple and easy to use, non-smearing and easy to carry and use on the go. The lightness of the material means that the insert is hardly noticeable to the child in the diaper. Millis is made of a material that is already used in many other baby hygiene items and, thanks to the Öko-Tex 100 standard, is not only harmless but also particularly kind to baby's skin. The effectiveness of the insert has been clinically confirmed and the compatibility has been dermatologically proven with a "very good".
The natural active ingredients aloe vera, ubiquinone and almond oil are applied to the insert in the form of tiny capsules. When changing diapers, Millis is placed on the affected area on the sore, freshly cleaned buttocks and pressed lightly into the buttocks for a better grip. The fresh diaper is then closed as usual and that's it.
Through contact with the skin and the movement of the baby, the capsules burst and gradually release the active ingredients, which act on the sore buttocks for many hours. The insert thus helps to care for irritated baby skin while wearing diapers. On average, a baby moves twice as much as an adult during sleep, which is why the Millis can also be used perfectly overnight. Thanks to the simple, uncomplicated application, the affected areas are not unnecessarily irritated or strained by rubbing. Urine can transcend through the pad, keeping it away from the irritated area.