When to Stitch a Wound?

Q:

Dear ER Doc

Is there a general rule to when a cut needs to be stitched up? 

With major cuts that are long and/or deep – it is pretty obvious that a trip to the hospital in needed. And for everyday minor cuts – it is equally obvious to wash it and slap on a band aid. 

                                                                                                                                                                                          But sometimes there’s an “in between” cut in my family. Be it me with a
kitchen knife or my son getting a cut from some glass on the playground.
These are not “minor” but I am not sure if it really makes sense to go
through the time and expense of getting stitches. Any thoughts?

A:

Briefly, the first thing you want to do is take a look at the wound and determine if the skin edges are lined up well.  Then, see if the skin stays together when the area is moved.  You will find that in highly mobile areas, such as fingers, wounds often open up when there is movement.  In this circumstance I will usually put in stitches to keep the skin edges together and healing.

Also, you want to be sure that there is no deep structural injury to the tendons, blood vessels, nerves, etc.  This often requires evaluation, and “exploration” of the wound by a doctor.  It is especially important to make sure there is no foreign material in the wound itself, and that the wound has been thoroughly cleaned.

This may not be a satisfying answer, but I usually tell people that if there is any doubt, have the wound checked out by a physician, so that proper wound care can be done.

Be sure and look at my upcoming entry on “when you cut yourself” as well.