The human skin is completely laid out at birth. This is also the reason why the skin surface of babies and small children is two and a half to three times as large as that of adults. However, the cohesion of the epidermis and dermis is still very weak, which is why blisters can form more quickly. The epidermis matures over time, the skin structures interconnect and the skin becomes firmer.
Wound healing and its peculiarities in children
What makes baby skin so different?
The skin is the largest and heaviest organ of the human body and has important functions. This is true from birth. In fact, the skin area of infants is two and a half to three times larger than that of adults. Thus, the topic of wound healing is a significantly important one, especially for parents of babies and toddlers. Due to the nature of baby skin, it is significantly more sensitive than adult skin.
Are wound problems "normal" for babies?
The sweat glands and thermoregulation are also not yet sufficiently developed in the first months of life. Until the lipid barrier is fully formed, babies still lose a lot of water through the skin, which becomes dry and brittle and thus susceptible to inflammation. The typical rosy baby skin does not appear until the age of two to four months. All this means that the barrier function of infants' skin is not strongly developed and thus cannot provide adequate protection against infections caused by bacteria, viruses or fungi. In the diaper area, incontinence in particular, 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 thromobocyte adhesion and aggregation. In addition, the platelet plug forms and the blood coagulation cascade is activated. A fibrin clot is formed. This phase is characterized by crusts and necrosis. The cleansing phase then begins, during which vasodilation occurs to transport macrophages and neutrophil granulocytes to the wound area. Inflammatory cells repel germs, remove dead tissue, and release chemotactic agents and growth factors. Wound secretions exude. During this phase, the cells and hormones of the immune system are significantly involved 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 into the wound margins. The fibroblasts form collagen under the degradation of the fibrin network, while the migrating endothelial cells give rise to capillaries, which provide optimal wound perfusion and ensure metabolism. A cellular matrix of fibroblasts, enthodel cells, macrophages, collagen, fibroneticin and hyaluronic acid, which gives its name to the granulation tissue, is formed. Bright red, glassy-transparent granules, the vascular trees of the numerous capillaries, appear here.
EPITHELIALIZATION PHASE
In the final phase, the epithelialization phase, the replacement tissue forms and scarring occurs, which can take several weeks. One-third of the diameter of the wound closes solely by shrinkage, as the granulation tissue becomes dehydrated and vascularized. The remaining two-thirds close by new formation of scar tissue, forming collagen fibers that cross-link and stabilize in bundles. Epithelial cells finally close the wound surface.
The meaning of "time"
The general requirements for phase-appropriate wound therapy can be summarized by the acronym TIME. TIME is composed of the abbreviations of the following English terms:
TISSUE MANAGEMENT
repeated debridement of necrotic tissue
INFLAMMATION AND INFECTION
Inflammation or infection control
MOISTURE BALANCE
Regulation of the moisture balance
EPITHELIAL ADVANCEMENT
Förderung der Epithelisierung
Why does baby skin heal faster?
Due to the relatively large skin surface of infants and young children, many active ingredients absorbed through the skin can reach relevant blood levels more quickly than in adult skin. In addition, the more rapid provision of fibroblasts on the one hand leads to more rapid formation of collagen, which is instrumental in building up the skin, and on the other hand to more rapid formation of granulation tissue, which acts as a temporary tissue during wound healing and prevents the formation of new blood vessels.
What to look out for in baby wound healing?
Special aspects should be taken into account when treating wounds in infants and young children, as most wound care products were developed for adults and children's skin should be exposed to as few substances as possible overall. Here, attention should be paid in particular to active substances of concern. These include some antibiotics, such as zinc, neomycin, alcohol, antiseptics, and salicylic acid.
Corticosteroids can also cause skin damage. Also in skin care products it is important to pay attention to a low percentage of emulsifiers and preservatives. Substances such as dyes, fragrances, lanolin and Peru balsam 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 band-aids, with adhesive material or tape will cause the epidermis of this easily vulnerable skin to tear off when removed. The Millis diaper dressing is a better alternative here, as these do not stick together and can be easily removed from the skin without tearing the epidermis.
What is Millis?
Millis is a wound protection insert, which is provided with skin-caring, natural active ingredients and soothing on the sore bottom and diaper dermatitis. At the same time, the insert is dry and particularly soft, and thus does not lead to further stress due to moisture or unnecessary strain.
The application of Millis is simple and uncomplicated, it does not smear and can be easily transported and applied on the go. The lightness of the material contributes to the fact 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 products and, thanks to the Oeko-Tex 100 standard, is not only safe but also particularly kind to baby's skin. The effectiveness of the insert is clinically confirmed and the Verträglickeit 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 applied to the affected area on the sore, freshly cleaned bottom and lightly pressed into the cleft of the buttocks for better hold. Subsequently, the fresh diaper is closed as usual and ready.
By the skin contact and the movement of the baby, the capsules burst and thus gradually release the active ingredients, which act over many hours on the sore buttocks. Thus, the insert contributes to the care of irritated baby skin during diaper wearing. On average, a baby moves twice as much as an adult during sleep, which is why Millis are perfect for use overnight. Thanks to the simple, uncomplicated application, the affected areas are not unnecessarily irritated or strained by rubbing. Urine can transcend through the insert and is thus kept away from the irritated area.
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