Cuts: When Stitches Are Needed
It is important to determine if your wound needs to be closed by a doctor. Your risk of infection increases the longer the wound remains open. Most wounds that require closure should be stitched, stapled, or closed with skin adhesives (also called liquid stitches) within 6 to 8 hours after the injury. Some wounds that require treatment can be closed as long as 24 hours after the injury.
Wash the wound well and stop the bleeding, then pinch the sides of the wound together. If the edges of the wound come together and it looks better, you may want to consider seeing your doctor for treatment. If treatment may be needed, do not use an antiseptic or antibiotic ointment until after a doctor has examined the wound.
The location and type of wound also affects how soon it should be treated.
- Wounds that have an increased risk of infection, such as dirty cuts or crush injuries, are usually closed within 6 hours after the injury. Occasionally a wound that has an increased risk of infection will not be closed until after 24 hours, or may not be stitched at all, so that adequate cleaning and antibiotic treatment can be done initially to prevent infection.
- A cut with a clean object, such as a clean kitchen knife, may be treated from 12 to 24 hours after the injury depending on the location of the cut.
- A facial wound may be treated to reduce scarring.
Treatment by a doctor is more likely to be needed for:
- Wounds that are more than 0.25 in. (6.5 mm) deep, that have jagged edges, or that gape open.
- Deep wounds that go down to the fat, muscle, bone, or other deep structures.
- Deep wounds over a joint, especially if the wound opens when the joint is moved or if pulling the edges of the wound apart shows fat, muscle, bone, or joint structures.
- Deep wounds on the hands or fingers.
- Wounds on the face, lips, or any area where you are worried about scarring (for cosmetic reasons). Wounds on the eyelids often need treatment for both functional and cosmetic reasons.
- Wounds longer than 0.75 in. (20 mm) that are deeper than 0.25 in. (6.5 mm).
- Wounds that continue to bleed after 15 minutes of direct pressure.
The types of wounds listed above usually need an evaluation by a doctor but may not always need to be closed by a doctor.
Treatment by a doctor may not be needed for:
- Wounds with smooth edges that stay together during normal movement of the affected body part.
- Shallow wounds less than 0.25 in. (6.5 mm) deep and less than 0.75 in. (20 mm) long.
- Most puncture wounds.
- The wounds tend to be smaller, and treatment does not speed healing or reduce scarring.
- The wounds tend to be deeper, narrower, and harder to clean. Closing a puncture wound with stitches, staples, or skin adhesive may seal bacteria into it, which increases the risk of infection.
- If a puncture wound becomes infected, it will usually drain better and heal faster if it is not closed with stitches, staples, or skin adhesive.
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer H. Michael O'Connor, MD - Emergency Medicine
Current as ofSeptember 9, 2014
Current as of: September 9, 2014
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