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How to Tell if a Cut Should Get Stitches

Updated on March 1, 2017
eHealer profile image

I have worked as an RN for over 25 years in several specialties, and I am an educator for various universities on the West Coast.

Illustration by eHealer
Illustration by eHealer | Source

Most cuts, abrasions, and lacerations will heal on their own and require only a small amount of wound care. Apply warm water with a mild soap and clean the skin thoroughly, apply an antibiotic ointment, and cover with a clean Telfa pad or band-aid.

However, for lacerations and cuts that cannot be mended by simple wound care alone, you may need to visit your local emergency room or emergency care clinic for a few stitches to ensure healing and avoid infection. Lacerations that require stitches may continue to bleed, even after several days of cleaning and the application of a gauze bandage.

When do You Need Stitches?

Cuts or abrasions that may or may not need stitches is sometimes tricky to figure out without a healthcare provider, but there are simple rules to follow that can help you decide. Open wounds that continue to bleed after 20 minutes of pressure are most likely in need of stitches, or sutures. Continue to apply pressure to the wound to control bleeding and get to an emergency room as soon as possible. Lacerations that are jagged, deep, or gaping may also need a few sutures to pull the skin together and allow healing to take place.

  • Facial lacerations or other places that may leave a scar
  • Feels numb around the laceration
  • Continues to bleed after 20 minutes of pressure
  • The cut is over a joint that can't be mobilized

Kinds of Wounds that Require Stitches

Wound Type
Appearance
Stitches or Not
Laceration
Deep cut that usually has straight edges
Most likely will need sutures to join the edges for healing
Puncture
A deep whole from a long and thin sharp object
No, may need a Tetanus shot though
Abrasion
Skin resembles a road rash burn
No, cleanse and apply antibiotic ointment and gauze
Avulsions
A piece of skin has been peeled or pulled completely away
May or may not be suitable, depends on the size of the skin tear, bleeding, and placement
Stitches Promote Healing and Reduce the Chance of Infection

What Types of Wounds Need Stitches?

Several different types of wounds may need stitching to reduce infection and promote healing.

  • Lacerations may be straight and deep enough to require sutures. The edges may be trimmed is needed, and the underlying fatty tissue (yellow) may be visible in the wound which would definitely need sutures to close the wound.
  • Punctures may be deep but don't usually require sutures. Punctures are wounds that may be from sharp objects, such as pins or toothpicks, that pierce the skin and cause a small round puncture site. These wounds may require a tetanus shot if it is not current.
  • Avulsions are when the skin is pulled completely off of an area of the body. These may be suturable if they large enough.
  • Abrasions are scratches and won't need sutures, but will need a good cleansing and wound dressing.

Emergency Measures for Cuts and Lacerations

If You Have Severed a Finger or Toe

Apply firm pressure to the injured finger or toe to stop bleeding. Place the severed finger or toe in a plastic bag filled with ice and take it to the emergency room with the injured person.

Your Laceration or Cut is Bleeding in Spurts in Time with Your Heartbeat

Most likely, you have nicked or cut into an artery. Apply pressure and call 911 or go to the hospital immediately. Arterial wounds may bleed quickly and large arteries cuts can be fatal. Never apply a tourniquet, apply pressure directly to the wound.

Be Sure Your Tetanus Shot is Current

Tetanus shots are recommended at least every five years, but it also depends on where you live. Ask your healthcare provider when a booster shot for tetanus is necessary.

The Procedure for Stitches (Sutures)

The physician may first numb the area to be stitched with an injection for anesthesia, clean the wound, or trim the edges (after it is numb) to suture together in a straight line. The physician will use a silk based suture to stitch the wound together. Keep sutures dry and follow the instructions your healthcare provider gives you.

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    • Perspycacious profile image

      Demas W Jasper 3 years ago from Today's America and The World Beyond

      I would have marked this as "Funny," but that would have meant that it left me in stitches! I will check out Hub limericks for that. Nice seeing your translucent face again.

    • thumbi7 profile image

      JR Krishna 4 years ago from India

      Excellent hub with useful information. I liked the layout of the hub your explanations in simple language

      Voted up and shared

    • JCielo profile image

      JCielo 4 years ago from England

      eHealer, this is such an informative article and very useful indeed. It could certainly help us make the decision whether ot not to go to ER and not waste their time unnecessarily. Although I do agree with 'tipstoretireearly' about taking a cautious approach in certain circumstances. Voted up and useful.

    • cam8510 profile image

      Chris Mills 4 years ago from Maple City, Michigan

      eHealer, Thank you for providing such sound information. I have done a lot of firsthand research on this topic. Unfortunately it is the kind of firsthand research that included a sharp object cutting into the hand. I work in a hospital lab in the histology department. We use very sharp blades and I have been to the ER three times for severe cuts. It's a good thing I work in a hospital, right?

    • Diana Lee profile image

      Diana L Pierce 4 years ago from Potter County, Pa.

      This is a very useful hub. My son was always hurting himself somehow when he was a teenager. One time he helped my brother unload sheets of tin and ended up with deep puncture wounds across his hand. This required daily soakings and redressing the wound to avoid it healing on the outside and not on the inside. I'm glad Tetanus shots last 10 years.

    • mizjo profile image

      mizjo 4 years ago from New York City, NY

      Kids will always find a way to split themselves open! I have had five of them, and only one so far has had no stitches on some part of herself. All eight cuts between the other four have needed stitches, and thank goodness we lived near hospitals while they were young.

      I always did make sure the cuts were cleansed and pressure applied to them while getting to the ER, and did the necessary dressings at home so none ever got infected.

      You've written a great article on this common emergency, and everybody should get a chance to read it. Voted up and Useful and shared everywhere!

    • eHealer profile image
      Author

      Deborah 4 years ago from Las Vegas

      Thanks Tips, I am so glad you think this hub is helpful. Yes, even minor cuts and abrasions can be a problem for the elderly and those with conditions that inhibit healing. Thanks for your supportive comments, Tips!

    • tipstoretireearly profile image

      tipstoretireearly 4 years ago from New York

      Very useful and voted up! This article will help in deciding when to seek professional help for the many occasions when someone in my family gets a cut. As a side note, its probably good to err on the side of seeking help when the patient is in poor health with a compromised immune system. When my elderly father-in-law suffered a seemingly minor abrasion recently, even a good cleaning wasn't enough to prevent a deeper infection due to his compromised immune system.

    • eHealer profile image
      Author

      Deborah 4 years ago from Las Vegas

      Sorry Jamie, your son deserved better. For lacerations that are straight and right on, bond glue can be used in the emergency room, it's painless to apply and works well on facial lacerations that doesn't leave scars. I am so sorry your Doc messed up! Thanks for sharing!

    • Jamie Brock profile image

      Jamie Brock 4 years ago from Texas

      Thank you for sharing this.. very informative! One time we were at my son's pediatrician office for his annual check-up and my son (I think he was 2 at the time) was getting antsy started running back and forth in the exam room... he tripped and slammed right into the sharp corner of the desk and split his forehead open. It all happened so fast.. he was screaming and blood was pouring. The doctor ran in and put some clear butterfly bandages over it and said it would be fine but he now has a HUGE scar on his forehead. I now know he definitely needed real stitches... I wish we had taken him to the ER but I trusted that she knew what she was doing. I appreciate this hub.. very informative, useful, voted up!

    • Jackie Lynnley profile image

      Jackie Lynnley 4 years ago from The Beautiful South

      Great tips and even with stitches cocoa butter stick helps keep it from scarring. Learned that years ago.

    • Natashalh profile image

      Natasha 4 years ago from Hawaii

      My mom would always try to give me stitches and I hated them! When I cut myself badly, I would try to hide the injury until it was too old to stitch. I have at least one injury that didn't heal correctly that totally could have used stitches! Oh, well.

    • DzyMsLizzy profile image

      Liz Elias 4 years ago from Oakley, CA

      Uh,,,,yeah...I have a scar on my chin from a fall off my bicycle when I was a kid....it was pretty jagged. The sadists at the ER stitched it up MINUS anesthetic, on the grounds that "the novocaine might make the tissue swell and it would scar worse." You know what? The stitches into an already injured area hurt like hell, and I didn't really care about a scar (which happened anyway)! Their treatment put me in permanent fear of going to the ER for anything! Luckily, it was my only experience there to date.

      In later years, I did a nice slice on the back of my hand with a razor blade cutter while helping my mom with some shelf paper. By then, I'd had first aid classes, and I put pressure on it and held it while instructing my mom how to cut down some adhesive tape (or a band aid--don't recall which this many years later) into a butterfly bandage. I put a couple of those on, and it healed fine. Maybe I should have had stitches, but you know what? Unless I make a fist and stretch the skin, that scar is invisible.

      I've had to take kids and grandkids to the ER. When my youngest fell and needed stitches above her eye, I had managed to numb it pretty well with ice while my friend drove us, so she didn't get novocaine, either..and I nearly fainted! Just a few years back, I was "on call" for my grandsons, then old enough to be left on their own for a few hours, and sure enough one of them managed to do a number on his finger in his bicycle sprocket...had to run him to the ER...and at least, they numbed it for him. I guess they've advanced a bit.

      Anyway--very interesting and useful information, and so voted and shared.

    • RTalloni profile image

      RTalloni 4 years ago from the short journey

      How often have I wondered whether a wound needed stitches! This is an excellent guide that is easy to read and therefore will be easy to remember.

    • profile image

      lovedoctor926 4 years ago

      Useful information. I have a cut on top of my right eyebrow. Not sure if maybe from plucking my eyebrows with a pair of new tweezers or maybe from pulling the skin too hard while waxing brows.

    • bac2basics profile image

      Anne 4 years ago from Spain

      Hi ehealer. I have to agree with glimmer, great advice even if it did make me feel a bit sick LOl.

    • Glimmer Twin Fan profile image

      Glimmer Twin Fan 4 years ago

      This is an incredibly useful hub! I can't tell you over the years how many cuts I or my family have had that we were not sure about. I have a big scar on my knee because I did not get stitches. Up, useful, shared. Tried to pin, but it wouldn't let me. Will try again later. Everyone should have this info!