A search of the Internet can be confusing for parents and others trying to determine whether they or their children need stitches for a cut or laceration.
Depending on where you look, you’ll find a variety of different criteria to use when deciding if stitches are necessary.
The best advice? Err on the side of caution, says Dr. Christopher Register, an emergency department physician at Tidelands Georgetown Memorial Hospital. If you’re debating whether stitches might be necessary, that’s a sign it may be a good idea to seek medical attention.
When it comes to serious cuts and lacerations, it’s important to seek care immediately rather than wait, he says. Wounds need to be cleaned to avoid infection, and the sooner a patient seeks care, the better chance of avoiding or minimizing the appearance of a scar.
That can be especially important to patients who have suffered cuts to the face.
“It’s safe to say that any significant wound on the face, or any wound that’s bleeding or gapes should be evaluated for wound closure,” he says. “Anywhere you have an open wound is a site for possible infection.”
A medical professional can determine the best approach to address the wound, Dr. Register says.
Stitches are nylon threads sewn and knotted to close a wound. Steri-Strips are adhesive tape that pull together the sides of the wound.
Newer to medicine are skin glue, which is an adhesive like Super Glue, and staples, Dr. Register says.
Staples are convenient for closing some wounds because they’re faster than sewing. That’s particularly important for children who might be hard to wrangle under such conditions, he says.
Using staples can help doctors avoid sedation, which is important because “you never want to sedate a child if you don’t absolutely need to,” he says.
The only guaranteed way to avoid the need for stitches is to avoid the injury altogether.
“Probably the most common injury I see is self-induced,” he says. “People punch something, or they’re using a knife to cut a box open or they’ve fallen off a ladder or otherwise crashed.”
How to evaluate the need for stitches
Minor cuts, such as paper cuts, can be cared for at home. In those cases, clean the cut with water and soap and apply a bandage to keep it clean.
Deeper or longer cuts may require medical attention. If you suffer a cut, wash it with water, apply pressure to stop the bleeding and evaluate the injury.
When stitches may be necessary:
- The cut is deeper than a quarter inch in length and/or is deep enough to expose fat, muscle or bone.
- You are unable to close the edges of the cut using gentle pressure.
- The cut was caused by, or exposed to, a contaminated object such as something very dirty or rusty, raising concerns about possible infection.
- The cut is over a joint and there’s concern about potential damage to nerves, tendons or ligaments
- The wound is on the face or in the genital area
- The cut continues to bleed after applying pressure for 15 minutes
Dr. Christopher Register
Emergency Department Physician, Tidelands Georgetown Memorial Hospital
Kirksville College of Osteopathic Medicine
Naval Medical Center Portsmouth
The Brody School of Medicine at East Carolina University, Emergency Medicine