A Stitch in Time - When to Get Stitches

We have all likely dropped a glass bowl and had to clean up the pieces, or slipped our grip on a knife while prepping dinner. Most of the time, a cut or wound can be easily treated with a Band-Aid and a little antibiotic ointment. However, when is it necessary to head to the doctor for a stitch or two?

Stitches provide support and strength while your skin heals and also lower the chance of infection that may come from an open wound. It also brings the skin edges together so that an ugly scar is less likely to form.

Tips on Cleaning a Wound

Most cuts and scrapes are manageable with at-home first aid. You should always wash your hands before tending to any wound.

Rinse with large amounts of water to remove any dirt or debris.
A minimal amount of soap (not moisturizing soap) can be used to clean very dirty wounds (grease, other contaminants), but clean wounds do not need soap. Soap may cause some irritation.
Use a cloth or gauze to apply gentle pressure to the wound until bleeding stops.
Cover cuts or scrapes with a bandage. If you are not allergic to it, a little bit of antibiotic ointment can protect the cut from dirt and help it heal faster. However, it is important that the skin has a chance to dry for a few hours each day under a bandage without ointment.

When to Seek Medical Attention

You should seek medical attention if the wound is deep, or in a vital area such as the face, hands, ears, etc). Stitches may be required if the wound will not stop bleeding after applying pressure, reopens and bleeds frequently, or spurts blood.Any wounds that have gaps, gaps with movement, or may have cut or damaged a nerve or tendon may require a trip to the doctor.

How Long Do I Have?

The sooner, the better. If you are injured and think you may need stitches, it is best to let a medical professional make that decision. Even if the wound is small enough to heal on its own, you are better off being safe than sorry and having it looked at. The longer a wound goes without treatment, the less effective the stitches will be and the greater your risk of infection. Most wounds that require stitches need to be closed within 6-8 hours of the incident.

When to Get a Tetanus Shot

A tetanus shot or booster is required if you have not had a booster in the past 10 years or in the past five years if the wound is large, dirty, caused by a bite, projectile, or has a foreign body (like a splinter) in it. The bacteria that causes tetanus (lockjaw) can enter the body through an open wound. While not all wounds will require a tetanus shot, a tetanus infection can lead to serious health problems, and in some cases, death. The examining doctor will administer a tetanus shot on a case-by-case basis according to the CDC guidelines.

Tips on Caring for Stitches

Take proper care of your stitches to prevent scarring or damage to the skin.

Keep stitches bandaged and dry for the first 24 hours, unless specified by the physician.
After the first day, you can gently wash the wound with soap and water; it does not need to be covered during a shower, however, baths should be avoided and the wound should not be soaked or exposed to water for a period of time. I.e., no dishwashing (hurray!)
If desired, apply a small amount of petroleum jelly or antibiotic ointment to keep the wound from drying out, and clean and cover with a bandage.
If the wound is in a place that may open easily with movement, keep activity to a minimum and/or use a splint or bulky bandage to avoid re-opening the wound.
Make sure you wash your hands before and after cleaning the wound.
Follow up with your health care provider to be sure the wound is healing properly.
Have the sutures removed after the appropriate number of days which can vary from 5 days on the face, 7 days for the scalp, 10 days for most other wounds, and 14 days for areas where the skin is under a lot of tension with movement, like the knee.

Be sure to speak with your doctor about caring for your stitches, as each case may be different. If you have further questions about caring for your wound after leaving the office, make sure you call and speak with your doctor or nurse.

You should especially seek further medical attention if the wound:

Is red, painful, or leaking pus or other fluid from the wound, as this could indicate infection.
The wound is bleeding even after applying direct pressure.
You experience numbness or tingling around the wound.
You are running a fever over 100 F.
The wound has split open or stitches have come out too soon.

With a little help from the stitches, you should be on the road to recovery!