Discharge Instructions: Unna Boot (Child)

Your child will be going home with an Unna boot in place. An Unna boot is a dressing and wrap combination that's applied from the foot to the knee. An Unna boot has a special medicine in the gauze to help heal burns or skin sores and protect new skin. There are two kinds of bandages: white and pink. The white bandage is changed every  1 to  3 days. In most cases, the pink bandage is changed  1 time a week. Your child will need to visit the healthcare provider to have the Unna boot changed. Here’s what you need to know about home care.

Home care

Some do's and don'ts:

  • Make sure your child doesn't get the Unna boot wet.

  • Cover the dressing completely with a plastic bag before your child takes a shower. Tape the plastic to the skin or use a rubber band above and below the dressing.

  • If your child needs to take a tub bath, have your child dangle the limb with the Unna boot on the side of the tub and out of the water.

  • Take the plastic bag off when your child is done with their shower or bath.

  • Keep your child’s skin clean and dry.

  • Every day, wash any other burns or sores not covered by a dressing.

  • Remember, some drainage from the Unna boot dressing is expected. Don’t be alarmed if the soiled dressing has an unpleasant odor to it. This is normal. It happens because the drainage from the wound dries to the dressing.

  • Don’t allow your child to stand or sit in the same position for more than  30 minutes at a time.

  • Keep your child’s legs raised (elevated) using pillows as much as possible. This will help keep swelling down.

Follow-up

Make a follow-up appointment as advised.

When to call your child’s healthcare provider

Call the healthcare provider right away if your child has any of the following:

  • Tingling or numbness in the injured body part

  • Fever (see "Fever and children" below)

  • Severe pain that can't be relieved

  • Decreased ability to move extremity in the Unna boot

  • Unna boot that feels too tight or too loose

  • Swelling, coldness, or blue-gray color in the toes

  • Drainage from Unna boot that smells different than usual

  • Unna boot that is damaged or has rough edges that hurt

  • Unna boot that gets wet

  • New blisters or ulcers

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° (38°C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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