On 10:01 AM by NY Drs. Urgent Care
As stated in our previous post, sometimes it's hard to tell if an open wound is in need of stitches, which will help the cut heal properly and reduce scarring. If you're not sure whether or not it deserves stitching and want to save yourself an unnecessary trip to the hospital if it doesn't, here are some helpful tips and methods you can use to find out if your open wound is really in need of serious medical attention.
  • Most importantly, try to stop the bleeding . Use a clean cloth or slightly damp paper towel, and apply firm pressure to the open wound for about 5 minutes. Remove to check if it's still bleeding.
  • If it's bleeding uncontrollably, do not proceed to any other steps and go to the hospital immediately. If the open wound stops bleeding, continue reading.
Carefully analyze the open wound:
  • Is the open wound caused by a puncture from an object? Usually puncture wounds go into the skin and come back out or the item that caused the puncture can still be in the skin. This is called an "impaled object". Puncture wounds have more of a hole rather than a spread break in the skin like lacerations do.

  • Lacerations are similar to puncture wounds since they both cause a break in the skin, but lacerations typically have length and depth unlike puncture wounds. Lacerations are what is commonly known to us as a "cut".

  • Is it an accidentally re-opened surgical wound? Surgical wounds are caused by scalpels and are similar to lacerations, but the edges of the skin aren't as ragged and uneven. More in fact, smoothly cut.
  • Is the open wound an avulsion? Avulsions are caused by skin being torn in sections, flaps or numerous areas torn away completely with no skin.
  • Is it an abrasion? Abrasions are scratches, scrapes or minor cuts that go no deeper than the epidermis, the top layer of skin. However, determining if it needs stitching is the depth of the abrasions. If it's a deep cut, then it would be a laceration or can be an avulsion, depending on the shape.
  • Now that you've got a good idea of what kind of wound you have, evaluate if the open wound needs stitching. Here are three ways to do so:

  • Look at the depth of the open wound. Is the open wound deep enough to where you can see yellow, fatty tissue? Is bone exposed? Is there a lot of flesh exposed? Is the wound more than 1/4 inch (6 mm) deep? If so, the wound can be eligible for stitching.
  • Look at the width. Can the wound be pulled together easily or pinched together with ease? Usually a bandage and gauze can do this for you, and the wound can scab over in less than 12 hours by itself to start healing. However, if the wound is too wide to be held together with bandaging easily, then it will need stitching as this will pull the skin together so it can heal correctly.
  • Look at the location of the open wound. If the open wound is located on a specific area of the body where there is a lot of movement involved, it will most likely need stitching to prevent re-opening of the wound caused by movement and stretching of the skin. For example, an open wound on the legs or fingers (especially where joints connect) would be eligible for stitches whereas an open wound on the forehead would not really need stitching. However, the other two steps apply and should all be taken into consideration together, even if it's a cut on the forehead. Depth and length play a big part in the determining of stitching also. Keep this in mind.
  • How long has it been since you have had a tetanus shot? Tetanus shots last no longer than 5 years and then you'll have to be re-vaccinated. If it's been longer than 5 years since you've had a tetanus shot, go to the hospital. While you are at the hospital, you can have the doctor evaluate the cut also to see if it will need stitching.
  • There are also numerous types of wounds that should always immediately have the attention of a doctor such as: Animal or human bites
  • Debris that are unable to be removed from the wound. Puncture wounds also qualify for this if the object cannot be removed without help from medical specialists.
  • Uncontrollable bleeding. If so, immediately call an ambulance.
  • If you or the victim is diabetic.

  • Edges of the wound cannot be closed together.
Help and images from Wikihow.com