When my son was about 15 mos old he had an incident with a treadmill (on my in-law's watch, a still sore subject presently) where his hand got stuck in it and a good portion of his palm's skin was burned off. It was grotesque, and VERY painful. My in laws did not seek treatment right away, and didn't clean the wound (there were bits of treadmill still stuck in it two days later when I came back from my business trip.) So, when I brought him to the ER, they had to remove the layer of infected skin, remove dirt & debris, and then apply a burn treatment. It was horrific, and as @Marc experienced, he had to be restrained.
I had to change the dressing once a week, or, as often as it got dirty, wet, or removed by a baby who doesn't want a bandage getting in the way of putting Legos in his mouth ( ;-p ) which ended up being every day. He had NO SKIN on his entire hand. Here's our method:
- Get a helper. Someone with nerves of steel.
- Prepare your bandage/dressing and have ALL necessary objects within reach. Here are the two essential objects that you haven't been using: a baby sized stretchy knit winter glove with all but the index finger cut off, and a baby crew sock (long enough to go to AT LEAST her elbow) with. 5 little slits cut in the toe for her fingers to slip through. This will cover your sterile gauze bandage and prevent it from getting ripped off and keeps it somewhat cleaner/thereby reducing how often you have to do this.
- Have a really, really, super-awesome reward ready, and visible, but out of reach.
- Begin a "countdown to all done" count as slowly as you need to, but not too slow that she loses you between numbers. Count to ten beginning the moment she will first feel something, and ten should come the exact second you let her up. This is a GREAT method to use now, and any time she'll experience something painful.
- To clean the finger use just soap and water. It's mild and doesn't hurt so much. (Maybe she'll even play in the sink in soapy water? Mine had to keep his dry, but I've used this trick on other occasions.) If she fights, have your helper hold her arm over the sink and use a squirt bottle to shoot a steady stream of saline on her finger. Use clean gauze to dry. (Soapy water would need a rinse, with saline you can skip it) She might already be screaming. Sorry dear, that's life. Speak softly and soothingly.
- Slather that finger with ointment. Whatever the doctor recommends. I use A&D, or bacitracin. Neither one hurts. I do mean slather!
- Get your sterile gauze on there. I used the roll kind. It's thin so you can wrap around the tiny finger. Those squares they sell are no good for baby hands. Wrap it around MANY times, going all the way down the finger and back up until the finger is like a Q-tip. Secure with a piece of water proof tape. If you want it to stay dry, wrap the whole thing in tape. It doesn't have to look good!
- Get the glove on. It's kinda tricky to not rip the glove since it's been cut. Have backups ready.
- Put the sock over the glove and all the way down the arm. This, paired with long sleeves, keeps the kid from getting it off.
- IMMEDIATELY ADMINISTER THE SUPER-AWESOME REWARD, and lots and lots of praise. Just don't coddle too much. You want her to learn that she was not in danger, and "it's no big deal."
If you can keep your cool, she will eventually take your cues and will relax, somewhat. Kids trust their parents, if you trust in yourself.
I did this on my kitchen table, baby laying on a towel, helper using appropriate amount of body weight to hold down torso, legs, and unaffected arm. Helper usually held baby's hand between his chest and helper's, to give him something to squeeze. We made sure his face was not covered, and he could see what was happening. I think it's better for them to see what's being done. It teaches them to deal with pain in a healthy way, and to trust you.
In between dressings, try to gently, nonchalantly touch and handle the injured hand. This desensitizes her so she won't associate you touching her hand with pain. Encourage her to use her hand (now that she's all bandaged up and well protected!) This was especially important for us, since our baby's mobility was at risk, but it's good advice anyway-to help her forget the trauma. If you get to a point where she doesn't fight so much, try touching her palm and talking to her while you are bandaging to get her to realize you aren't hurting her. She may calm down. Practice getting closer and closer to the cut.
Above all: Don't worry. She won't remember this on her wedding day.
(FYI: my boy's palm is totally, 100% recovered and fully functional, and now sits calmly for immunizations as a result of the trust we now have, and the "countdown to all done")