If a cut is too deep, wide or severe to heal properly with sticking plasters or bandages, stitches, also known as sutures, may be needed.
The procedure to insert the stitches is generally painless, and stitches will help cuts heal with minimal scarring or risk of infection.
Signs a cut may need stitches
It's not always easy to tell if a cut requires stitches. Ultimately, it's up to a doctor or nurse to determine if stitches are needed. You should seek medical care for any cut that:
- Is deep, jagged or gaping
- Is on the face or another part of the body where scarring may be an issue
- Bleeds profusely, without stopping, after 20 minutes of direct pressure
- Feels numb
If any of these criteria apply to your injury, seek medical advice as soon as you can. In the meantime, apply direct pressure to help control bleeding. It might also help to raise the injured area above the level of your heart, if possible.
There are certain instances in which stitches may not be advised, such as puncture wounds, though you may still need to seek medical attention, especially if you have not had a complete course of tetanus vaccinations, which consists of five vaccinations commenced in the first few months of life.
Stitches - the procedure
Once a doctor or nurse has assessed your injury and determined that you need stitches, the first steps he or she will take in treating the wound are to clean and numb the area, though not necessarily in that order. Although cleaning a wound is not very painful in most cases, the doctor may first administer a local anaesthetic so you won't feel pain from the stitching.
If your injury seems particularly contaminated, however, cleaning thoroughly may be a higher priority.
Once the area is numb, the doctor will take a closer look to make sure there’s no dirt, debris, or other foreign objects inside the cut before sewing it together. An X-ray may also be arranged to help look for remaining debris. If you cut yourself on a piece of glass or sharp metal, for instance, it’s crucial to ensure that there are no remaining shards inside the cut.
The doctor may remove any dead tissue to help the healing process. He or she will then pull the edges of the cut together and, for each stitch, loop thread through either side of the cut and tie a knot to hold the wound closed.
Doctors can use different types of surgical thread made from materials such as silk or nylon, which may be in single filaments or braided. There's even surgical thread that is designed to dissolve over time so that the stitches don’t need to be removed. These are used most frequently in deep cuts.