It happens to everyone. While making dinner, I had a knife in my hand and was deboning chicken when the knife slipped. I sliced into my thumb, and blood started dripping on the counter and floor. With a paper towel pressed over the cut, I grabbed the saline wound wash and started rinsing it out.
It was time for me to make the critical decision: whether to clean and bandage the cut and watch it for the next week or head to urgent care for sutures. Treating it at home was free, but there was the risk of infection. Urgent care costs more, and I wasn’t sure if it was really necessary to make the 20-minute drive.
It’s hard enough when you’re anxious because you’ve just injured yourself, but that moment’s adrenaline cannot override this important care decision. How do you know when to take care of a wound yourself or when stitches are necessary? Our guide is designed to help you decide the right approach to wound care.
Follow These Guidelines to Determine if Stitches Are Best
The most immediate indicator of whether a wound needs stitches is whether it stays closed when pressure is applied. That’s not the only rule to consider.
1. Amount of Blood
Bleeding occurs with any cut, but the amount and type of bleeding are essential to determine if medical care is needed. Use these factors as part of your assessment.
- Pulsing or Spurting Blood: If blood is spurting out in sync with your heartbeat, you’ve most likely hit an artery in the arms, legs, or neck. Use pressure and a tourniquet if you know how, and call 911 or go straight to the ER. Artery cuts divert blood from your organs, which can be dangerous without expert care.
- Uncontrolled Bleeding: When you get a cut, it’s going to bleed. Most small cuts stop bleeding within 10 minutes of firm pressure. If the bleeding hasn’t stopped after 15 minutes and you’re still soaking through a cloth or sterile pad, go to urgent care for stitches.
2. The Cause of the Wound
It’s also important to consider how you got the wound. Certain cuts, no matter how deep, should be seen at urgent care to ensure they heal properly.
- Bites: If an animal or another person bites you, go to urgent care. Saliva contains bacteria that can cause a dangerous infection. The wound must be properly sterilized, and drains may be placed in the wound while it heals. This helps drain the wound of bacteria. Antibiotics are also prescribed.
- Puncture Wound With Embedded Object: You may have seen scenarios on TV or in movies where an object impales a person. Medical professionals do not pull it out until they’re fully prepared. If you have accidentally shot a nail into your leg while using a nail gun, pulling that nail out could lead to dangerous situations where you bleed heavily from a major artery.
- Rusty or Dirty Objects: If you got a cut from a rusty garden tool, cut yourself on a nail, or were cut by a rusty car frame, the risk of tetanus is high. If you haven’t had a tetanus shot in a few years, you need a booster. The wound also needs to be cleaned properly to remove any dirt or rust.
3. Loss of Function
Wounds don’t usually just affect the top layers of skin. They also cut into your capillaries, fatty tissue, blood vessels, and even nerves. If a deep cut affects ligaments, muscles, nerves, or tendons, it’s going to cause a loss of function.
- Inability to Move: If you’ve cut your finger or toe and cannot flex that digit, you’ve possibly damaged a tendon.
- Numbness: When you cut yourself and the area feels like it has fallen asleep or is tingly, you may be experiencing nerve damage.
- Reduced Strength: If the affected limb feels weak or lacks strength, you’ve damaged some of the underlying structures, such as the blood vessels, ligaments, muscles, nerves, or tendons.
4. Size and Depth
The depth and size of a cut also help determine whether it needs to be sutured.
- Depth: Any wound that’s deeper than a quarter of an inch (about the width of a standard pencil) should be seen by a doctor. If you see any fatty tissue (yellowish), go straight to the ER for stitches. Any wound where fatty tissue is exposed needs stitches.
- Gaping: If you need to force the edges together to get them to touch, go to urgent care for stitches.
- Length and Width: If a wound is longer than half an inch (about the size of a blueberry), it should be stitched.
5. Type of Wound
Sometimes, the type of wound helps determine whether stitches are necessary.
- Abrasions: Superficial wounds that you can take care of at home.
- Avulsions: A severe wound where the skin and tissue are torn away.
- Incisions: Clean, intentional cuts that are typically associated with a surgical procedure.
- Lacerations: Irregular cuts or tears in the skin that are caused by a sharp object or blunt force injury, such as being punched.
- Puncture Wound: A deep hole that’s caused by the skin and tissue being pierced with a sharp object, such as an arrow or nail.
6. Wound Location
The wound’s location is also worth considering when deciding what to do.
- Face: The face is a delicate area. When there’s a cut on an eyelid, forehead, lips, or nose, the area is highly visible. Wounds can damage important structures such as the tear ducts, so care is needed during suturing to prevent further injury and minimize scarring.
- Feet and Hands: Packed with nerves and tendons. Cuts in these areas need professional care to prevent the loss of feeling or movement.
- Joints: Cuts on joints such as the elbow, knee, or knuckle take longer to heal. Every time you move that joint, the cut reopens. Stitches prevent the wound from reopening.
Don’t Ignore the 6- to 8-Hour Window
Timing is the most overlooked factor in wound care. You have a limited number of hours before healing begins. If a wound starts to heal, it is too late for stitches because of the risk of bacteria being trapped below the skin. It’s better to watch and wait.
Typically, this window is less than 8 hours. You’ll have to watch the wound for signs of infection as the wound continues to heal. Scars are more visible if stitches were necessary. Antibiotics may be prescribed to ward off infection. Those indicators are:
- A fever
- Redness or red streaks around the cut.
- Signs of pus
- Swelling
- Warmth
Do not ignore the signs of infection. Left untreated, the infection can reach your bloodstream and put your life at risk.
Trust Your Instincts
If you’re on the fence and think you might need stitches, go to Premium Urgent Care. It’s better to have a medical expert tell you stitches are unnecessary than to deal with a noticeable scar, infection, or nerve damage.
Premium Urgent Care is open weekends and later into the evening than a family doctor. We also welcome walk-ins, so you never have to hope there’s an appointment available. Skip an expensive ER trip and come to one of our locations for wound care, sutures, and tetanus shots.