Do You Need Stitches?

Accidents will happen. Knowing what to do and when makes all the difference.

Chopping veggies for dinner can be therapeutic — and sometimes dangerous. One wrong move and that sharp knife can go from friend to foe in an instant. But how do you know if your cut is worthy of a trip to the emergency room (ER)?

The answer isn’t as simple as you might think, according to Ronald Strony, Jr., MD, chair of emergency medicine at Geisinger.

You’ve got a cut – now what?

There are a few things to consider before going to the ER with a cut or injury.

For minor wounds, keep the area clean by flushing it with water (“Tap water is fine,” says Dr. Strony), control the bleeding with pressure and keep the wound covered.

Bleeding

If your wound continues bleeding after 15 minutes of continuous pressure, you might want to head to a hospital. Most times people don’t hold pressure on the wound long enough to stop the bleeding, says Dr. Strony.

If blood is spurting from the wound, it’s probable a main artery was hit, and time is of the essence.

“When this happens, don’t wait — call 911,” says Dr. Strony.

Size/depth

Size is subjective, but if a cut is too deep to clean, an ER trip might be warranted. If you’re sure it’s not a 911 emergency, Dr. Strony suggests consulting a virtual urgent care doctor.

“A provider can take a look at your wound virtually and tell you if you need to go to the ER,” he says.

Location

Depending on where your wound is, you may need stitches (or another closure method). Cuts on the face, joints, mouth or genitals are typically more difficult to heal. Also, if a laceration causes damage to nerves — so you feel numbness or tingling in the affected area — definitely see a doctor as soon as you can.

“Another example would be a wound where underneath there is a broken bone — absolutely go to the ER,” says Dr. Strony.

Cause

If the wound is caused by a dirty object or rusted metal, don’t wait too long to see a doc.

“If you have a contaminated wound, you should really get it seen and treated within six hours,” says Dr. Strony.

Most of the time, the longer you wait to get treated, the more your risk of infection increases, and your wound might take longer to heal.

However, depending on some of the other criteria, if you’re going to the ER just to get a tetanus vaccine after a minor injury, you can save yourself an immediate trip.

“You can get a tetanus shot a day or two later,” says Dr. Strony.

Risk factors for infection

Certain conditions can make even minor wounds dangerous. They include:

Diabetes
Obesity
Peripheral artery disease
Malnutrition
Chronic kidney failure
Taking steroids or immunosuppressive drugs
Having a history of forming keloids (thick, raised scars)
Connective tissue disorders

If you have one or more of these conditions, talk to your doctor about wound care. And if you do get a minor cut, visit an urgent care provider just to be safe.

Keep an eye on your wound, even after it’s treated. If you were prescribed antibiotics, make sure you take them as directed by your doctor to avoid infection.

Signs of infection in the affected area include:

Redness
Swelling
Pus
Hot to the touch
Pain and tenderness
Fever

If you suspect infection, talk to your doctor.

Tools for closing wounds

There are many ways doctors can close wounds, depending on the location, potential for scarring and risk of infection.

Sutures

Sutures, or stitches, are surgical threads a doctor uses to sew a wound closed. They can be made from nylon, polypropylene, silk or polyester. Stitches also come in absorbable, meaning they will dissolve on their own, or non-absorbable, which require removal by a doctor.

Skin glue

Skin glue is typically used on minor wounds on areas where scarring is a concern, such as the face. It creates a waterproof barrier for the cut, and it can be used along with stitches to close a wound.

Staples

Staples require removal by a doctor. Medical staples allow doctors to quickly close wounds with minimal damage. Providers typically use staples for head lacerations, but they can be used in many different circumstances.

Dr. Strony says his preference is for staples (in areas other than the face, hands, feet or joints) over any other method for wound closing. “I will use staples first, then skin glue and then sutures,” he says.

First aid basics

Cuts happen. Knowing basic first aid can help you start healing faster.

Hold a clean gauze pad or bandage over the area for at least 15 minutes before lifting it to check the wound. Continuous pressure is important to control bleeding.
Gently wash the area with soap and water after the bleeding stops.
Flush the area to remove debris.