Wound healing:To stitch or not to stitch?

How do you know if a cut or wound needs stitching? The advantage to stitches is that the doctor can line up the edges of the cut squarely and cleanly, and the stitches keep the edges in place while the cut heals. This is particularly important if the cut is on a part of the body that moves a lot. If the wound is jagged or uneven, stitches are usually preferred.

You may need stitches for:*

* Deep cuts [more than 0.25 inches (6.35 mm) deep] that have jagged edges or that gape open

? Deep cuts that reach down to the fat, muscle, bone or other deep structures

* Deep cuts over a joint, especially if the cut opens when the joint is moved or if pulling the edges of the cut apart shows fat, muscle, bone or joint structures

* Deep cuts on the hands or fingers

* Cuts on the face, lips or any area where there is concern over possible scarring (for cosmetic reasons). Cuts on the eyelid often need sutures for both functional and cosmetic reasons

* Cuts longer than 0.75 inches (19.05 mm) that are deeper than 0.25 inches (6.35 mm) when the edges are pulled apart

* Cuts that continue to bleed after 15 minutes of direct pressure

* Puncture wounds where the cosmetic appearance of the wound will be greatly improved or where stitching is needed to restore function, such as in an injury to a tendon or ligament.

You may not need stitches for:

* Cuts with smooth edges that tend to stay together during normal movement of the affected body part

* Shallow cuts less than 0.25 inches (6.35 mm) deep that are less than 0.75 inches (19.05 mm) long

* Puncture wounds
These wounds tend to be smaller, and stitches don’t speed healing or reduce scarring

These wounds tend to be deep, narrow and hard to clean, which increases the risk for infection. Stitching such a wound may seal the bacteria in, increasing the risk of infection

If such a wound becomes infected, it will usually drain better and heal faster if it is not stitched.

* These types of cuts need to be evaluated by a health professional, but may not always require stitching.