Lacerations With Stitches
What is a laceration?
A laceration is a tear, cut, or opening in the skin caused by an injury. Lacerations may be small, and need only minor treatment at home. Or they may be large enough to require emergency medical care.
What are stitches?
Stitches, also called sutures, are special types of thread that hold wound edges together while they heal. Stitches help speed healing, stop bleeding, reduce scarring, and decrease the chance of infection in the wound.
What are sterile adhesive strips or "butterfly" strips?
Sterile adhesive strips can sometimes be used on small, shallow wounds instead of stitches. They work the same as stitches.
How do I know if my child's cut needs stitches?
Lacerations that involve the face, are longer than 1/2 inch, are deep, are spread open at rest, or are bleeding heavily, may require stitches.
First-aid for lacerations requiring stitches
Calm your child and let him or her know you can help.
Apply pressure with a clean cloth or bandage for several minutes to stop bleeding. If the bleeding is heavy, hold pressure for 5 to 10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one. Don't lift the original cloth.
Once bleeding has stopped, wash your hands and then wash the area well with soap and water, but don't scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes.
Cover the area with an adhesive bandage or gauze. Change the bandage twice a day or whenever it becomes wet or dirty.
Call your child's doctor, or if bleeding is severe, call 911 or take your child to the emergency room for further care, as soon as possible.
When should I call my child's doctor?
Specific treatment for lacerations that require more than minor treatment at home will be determined by your child's doctor. In general, call your child's doctor for lacerations that are:
Bleeding heavily and hasn't stopped after 5 to 10 minutes of direct pressure
Deep or longer than 1/2 inch
Located close to the eye
Large cuts on the face
Caused by a puncture wound or dirty or rusty object
Embedded with debris such as dirt, stones, or gravel
Ragged or have separated edges
Caused by an animal or human bite
Showing signs of infection such as increased warmth, redness, swelling, or drainage
Involved with an additional injury, especially a head injury or a broken bone
Are associated with numbness or weakness of a finger, toe, or joint. This may mean damage to a nerve or tendon has occurred.
Also call your child's doctor if:
Your child has not had a tetanus vaccination within the past 5 years, or if you are unsure when your child's last tetanus shot was given
You are concerned about the wound or have any questions
Treatment for lacerations with stitches and sterile adhesive strips
If your child's doctor or an emergency room (ER) doctor needs to place stitches or use sterile adhesive strips to close a laceration, you will be given specific instructions for how to care for your child's stitches. Treatment at home will be based on the location and size of the laceration, type of stitches used, and any special needs noted by your child's doctor. Antibiotics may be given to help prevent infection in the wound. A tetanus booster may need to be given depending on your child's wound.
Some stitches dissolve and don't need to be removed. Others stitches require a healthcare provider to remove. Your child's doctor or the emergency department doctor will let you know when to return to have stitches removed. Don't try to remove your child's stitches yourself.
Some general guidelines for caring for lacerations with stitches or sterile adhesive strips include the following:
Keep the area clean and dry.
Carefully follow the doctor's instructions for care of the wound.
Make sure your child avoids any activity that may cause him or her to reinjure or open the wound.
Watch the wound for signs of infection, such as increased warmth, swelling, redness, drainage, or pain.
Watch the stitches to make sure they are intact and keeping the wound edges together.
Return for follow-up care, as advised by your child's doctor.
Once the wound is completely healed, use extra sunscreen on sunny days to help protect the area of new skin.
Butterfly strips are generally left in place until they start to loosen and will eventually fall off after a few days.
March 01, 2018
Basic Principles of Wound Management, Up To Date, Closure of skin wounds with sutures, Up To Date
Fraser, Marianne, MSN, RN,Perez, Eric, MD