Editor’s note: Wellness Word is an informational column which is not meant to replace a health care professional’s diagnosis, treatment or medication.
Does it need stitches?
Your five-year-old hit her forehead at the park. Your two-year-old was bitten by a yappy little dog. Your ten-year-old knocked his chin in a roller skating collision. All these scenarios, and the cuts that come with them, may leave you saying, “Does this need stitches?”
The answer to that question, of course, depends on lots of factors. Thankfully, a lot of wounds simply need more than a Band-Aid and feel-better kiss. However, there are others that need a bit more attention. Here are some injuries that should be evaluated by a doctor or other qualified healthcare provider:
Wounds that are very dirty (containing soil, gravel, or other material that may need to be removed)
Cuts that are longer than ½ inch
Gaping wounds in which fat or muscle under the skin is visible
Cuts that go all the way through the skin
Injuries to the face or other cosmetically sensitive areas
Cuts that continue to bleed after you apply firm, direct pressure with a clean cloth or gauze
Injuries from any mammal bites (cats, dogs, toddlers)
Any cut in a child who has not received a tetanus vaccination
Your child’s provider will discuss options for wound treatment.
One of the most important parts of wound care is preventing infection, so your provider will thoroughly wash the wound before using any of these techniques. Pain control (anesthesia) will depend on the injury.
Skin glue: The edges of the skin are brought together, then glue is applied. It dries within seconds to a minute or so. This type of glue is specially formulated for medical use and should not sting. Glue works great for smaller wounds in areas of the body where there isn’t a lot of tension. Medical glue is the only type of glue that should be used for wounds, so put away that hardware store superglue.
Bandages (steri-strips): These may be used along with the glue to bring the skin back together. Your provider will let you know how to care for them.
Sutures (stitches): This procedure takes the longest compared to the other techniques. The provider will sew the wound closed after using a numbing medication for pain control. The “thread” is called suture and your provider will discuss which type of suture is best for different injuries. They will let you know how long the sutures need to stay in place.
Staples: These work like sutures, but can be better for injuries on the scalp or injuries that would require lots of sutures. You’ll need to come back to the office to have the staples removed with a specialized device.
Just like every kid is different, every injury is different. If you have questions about how to manage your child’s wound, reach out to a qualified medical professional for some help.
Dr. Laurel Hoffmann MD, MPH
Pacific Crest Childrens Urgent Care