8.AUG.2019 5 MIN READ | 5 MIN READ

“Does it require stitches, antibiotics or just a bandage?” We answer common questions about cuts and lacerations, so that you’ll know what to do in case of an accident.

It is tricky knowing when to seek a doctor’s attention for a cut. Everyone’s bound to get scratches, scrapes, skinned knees from household accidents.

Most of the time, these open wounds are minor and heal without medical intervention. However, there are times when injuries are more severe, requiring stitches and medical attention to heal properly.

In cases like these, you need to be able to determine if immediate medical attention is required, as the risk of infection increases the longer the wound is left open.

In case you’re wondering: cuts are often caused by sharp objects (like kitchen knives and scissors), while lacerations are caused by blunt trauma (like hitting your leg against a jagged rock wall). While the former is usually shallower than the latter, both types of wounds can often be severe enough to require a visit to your neighbourhood doctor.

Should I visit the Accident & Emergency (A&E) for medical care?

Seeking medical help
The urgency of the injury largely depends on the size (length & depth), location and amount of bleeding. Seek medical help immediately at a hospital’s A&E department if your injury is wide, jagged, or deep with persistent bleeding.

Here’s what you should look out for:

  • Deep enough such that the yellow fatty tissues under the skin can be seen
  • Discolouration of the skin (darkening or cyanotic)
  • Gaping wide enough that gentle pressure cannot close the wound
  • Located on a joint as that could mean damaged nerves, tendons or ligaments
  • Muscle weakness or paralysis in the affected area
  • Numbness around the area
  • Or on a cosmetically significant area (eg. face)
  • Persistent bleeding

Apart from these, the cause of the injury is also important. If it is the result of an animal bite or a dirty/rusty object, you may need a tetanus or rabies booster alongside oral antibiotics.

For children that have had their vaccinations, these injuries still require medical evaluation.

If in doubt, always check in with a doctor or nurse if stitches are required.

What do I do on the way to the A&E?

Knowing how to properly apply first aid can reduce bleeding and prevent infection. Here are some general care steps you can take while on the way to the A&E.

  1. Clean the wound gently. Thoroughly irrigate the injured area using tap water or saline solution.
  2. Do not attempt to remove foreign objects stuck in the wound. Not knowing how severe the injury is can risk serious consequences – such as unblocking an arterial blood flow when the foreign object is removed.
  3. Elevate injured area on the way to the A&E.
  4. Stop the bleeding with direct pressure.

What treatment will I undergo to close the wound?

Stitches are one of the most common ways of closing a wound. They stop bleeding, protect underlying tissue, reduce risks of infection and lessen scarring. Other methods include surgical staples and skin closure adhesives.

What are the different types of stitches?

Types of stitches
There are 2 main types – absorbable and non-absorbable stitches.

Absorbable stitches need not be removed as they rapidly break down and lose their holding strength between 5 – 60 days. These are more commonly used for internal injuries.

Non-absorbable stitches may last from 6 months to 2 years, depending on type and size. They will require removal by a medical professional once the wound is healed. These are more commonly used for external wounds, and will quite likely be the type of stitches you’ll be getting.

I’ve never gotten stitches before. Will they be painful?

Fret not – numbing medication will be applied to the injury for a painless experience. The stitch site will then be covered in gauze and a bandage.

When will the stitches be taken out?

Stitches are removed after a period ranging from 4 – 14 days. Facial stitches are often removed no later than 7 days as healing takes place faster as compared to other parts of the body. Stitches on limbs usually require the longest healing period and might extend past 14 days.

The doctor will advise on exactly when the sutures will be removed. In some cases, there may be removal of alternating sutures. This means that not all sutures on a wound will be removed in one sitting.

Common time periods for removal are as follows:

  • Face: 3 – 5 days
  • Scalp: 7 – 10 days
  • Arms, Legs: 10 – 14 days
  • Joints: 14 days or more

What are some possible complications I may encounter after having stitches?

See the doctor immediately if you notice these signs of infection:

  • Darkening of the would
  • Increased swelling
  • The presence of pus or any foul-smelling discharge
  • Progressive pain and tenderness around the wound
  • Fever

What should I do after receiving stitches?

Care of stitches
After having your wound stitched up, proper care is required so that the cut heals well and does not get infected. Here’s some general advice to take note of:

  • Keep stitches dry and covered with a bandage. Non-absorbable stitches need to be kept dry for the first 1 – 2 days, while absorbable stitches have to be kept dry longer (as per instruction).
  • For the days after, gently wash the wound area with soap and water. Do not let it soak in a bath or in a pool – Having it wet for long periods slows the healing and increases the chances of getting an infection.
  • Pat the wound dry and apply prescribed ointments after your shower.
  • Take a break from the gym and other rigorous activities that put a strain on the stitches. If it breaks, the cut will reopen.

What can I do after the stitches are taken out?

Heed the doctor’s recommendation. If you are concerned about scarring, seek the doctor’s input on recommended creams and lotions. Protect the scar from the sun with sunscreen and covered clothing.

However, should you be in doubt over the severity of your injury, make your way down to the A&E to seek immediate medical attention.

Think Prevention!

Always take precaution in all that you do; take that extra step to childproof all table corners, sharp objects, or doors that may slam shut. Let’s keep mishaps at bay!

 

Article reviewed by Dr Othello Dave, deputy medical director at Parkway Hospitals

References

Laceration or incised wound: Know the difference. August 14, 2014. Retrieved 11/06/2019 from https://www.acepnow.com/article/laceration-incised-wound-know-difference/

Does your cut need stitches? Find out how to tell. August 6, 2015. Retrieved 9/06/2019 from https://health.clevelandclinic.org/does-your-cut-need-stitches-find-out-how-to-tell/

Patient Education: Stitches and Staples (The Basics). March 1, 2019. Retrieved 9/6/2019 from https://www.uptodate.com/contents/stitches-and-staples-the-basics

Removing stitches (Sutures). n.d. Retrieved 9/6/2019 from https://www.emedicinehealth.com/removing_stitches/article_em.htm#facts_about_and_definition_of_removing_stitches_sutures

Patient Education: Taking care of cuts and scrapes (The Basics). September 21, 2017. Retrieved 10/6/2019 from https://www.uptodate.com/contents/taking-care-of-cuts-and-scrapes-the-basics?topicRef=16586&source=see_link

Ouch! Do I need stitches for this cut? March 6, 2018. Retrieved 11/6/2019 from https://www.abingtonhealth.org/healthy-living/health-news/library/articles-related-to-general-health/ouch-do-i-need-stitches-for-this-cut/

Closure of minor skin wounds with sutures. June 28, 2018. Retrieved 11/6/2019 from https://www.uptodate.com/contents/closure-of-minor-skin-wounds-with-sutures

8.AUG.2019
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Dr Othello Dave
Deputy Medical Director
Parkway Hospitals

Dr Othello Dave is an ENT specialist – head and neck surgery (Philippines).