Your community matters

Wound care: Do I need stitches?

Thank you for being one of our most loyal readers. Please consider supporting community journalism by subscribing.


In North Carolina, there doesn’t seem to be a season that is not good for playing outside, except, maybe, in extreme temperatures of summer and winter. Along with that outside fun come falls, scrapes, cuts and bruises.

There was a time when no one was concerned about getting scraped up. We just washed it off and went on our ways. In these times of superbugs, however, we must be more vigilant. Not every scratch attracts flesh-eating bacteria, but even the smallest break in the skin has the potential to get ugly. The overuse of antibiotics over the years have resulted in stronger, antibiotic-resistant strains of germs. Fortunately, there are still a few drugs that will work on even the resistant ones.

Information on wound care can fill a book, so I’ll start with identifying those that might need stitches and cover additional issues with succeeding articles. Stitches can give your skin support while it is healing from a cut, can help prevent infection from setting in, and minimize scarring. You may need stitches:

• If the cut is deeper than a quarter of an inch and/or greater than half of an inch long. Even if the wound is not wide, a deep wound may be more likely to get infected and should be evaluated by a healthcare provider. Wounds heal from the inside out so it may take longer for the edges of the top layer of skin to come together and heal in a deep wound.

• If the cut is so wide that you can’t bring the edges together without pressing them.

• If you can see fat, bone, or a tendon. If you can see fat, the cut will need stitches. If you can see a tendon or bone, immobilize it in its current position and go to the hospital. A tendon looks like a white or yellowish band under the fatty layer of skin, and a cut tendon can cause permanent disfigurement and nerve damage. If you don’t have a splint, you can use clean Popsicle sticks, rolled up magazines, pillows, or any other clean household item you can find that will immobilize the injured area.

• If the cut has ragged edges.

• If the cut is embedded with dirt, grass or gravel that you can’t get out.

• If the blood soaks through a bandage, if you can’t stop the bleeding after 5-10 minutes of pressure, or if it spurts blood. This is an arterial bleed. It needs pressure and to be seen as soon as possible.

• If the cut is over a joint. If the cut opens when the joint is bent, it will need to be evaluated by a provider. These wounds tend to heal slowly since they can open as they are starting to heal. Delayed healing can increase the danger of infection and scarring.

• If the cut is deep and on your hand or finger. Hand injuries can affect the mobility needed to accomplish everyday tasks. They need to be evaluated for changes in motion and sensation.

• If the cut is on the face. If you are sure the cut does not require stitches, just keep it clean and watch for infection, but if there is any doubt at all, go to an emergency room. Depending on how big and where the cut is, they may want to call a plastic surgeon, who stitches with much finer suture material and may use different techniques to reduce scarring for cosmetic reasons.

These are only guidelines for you. If you have any doubts or concerns, go to an emergency room, or an urgent care center if the cut is minor. It’s better to be overcautious than to get into trouble.