How do you know if your child needs stitches

Stitches for Cuts, Punctures, and Bites

Written by WebMD Editorial Contributors

Medically Reviewed by Poonam Sachdev on October 01, 2021

In this Article

• What Are Stitches?
• How Do I Know If I Need Stitches?
• Before You Go to the Doctor

You’re chopping food for dinner and slice yourself by accident. Or maybe your child gets gashed while playing on gravel. It looks like it might be serious. 

First of all, if it’s an emergency, call 911. Some signs are when the injury:

• Bleeds excessively
• Spurts blood
• Does not stop bleeding after 10 minutes of firm pressure
• Is to the chest, abdomen, or neck
• Happens along with any emergency symptoms: severe pain, fast breathing or trouble breathing, vomiting, dizziness, unconsciousness
• Is to the eye or in the throat. If something is stuck in those areas, leave it in place. Keep the person calm.

If the injury is not an emergency, but is worse than a simple scrape or scratch, you may not be sure what to do. Do you just bandage deeper cuts and wounds, or do you go get stitches?

What Are Stitches?

Stitches in your skin are like those in your clothes -- a run of thread that holds things together. They’re made from lots of different materials, such as nylon or silk. And some, like the ones used for mouth injuries, dissolve on their own.

When you need them, stitches are important because they:

• Give you support and strength while your skin closes up
• Lower your chances of bleeding and infection
• Minimize scars

So it helps to know when to take care of a cut on your own and when you need to see a doctor.

How Do I Know If I Need Stitches?

From the size of the wound to its location, there are a lot of signs that you need stitches or at least to have a doctor check things out.

How big is it? You’ll want to see a doctor if the wound:

• Looks very deep, even if it’s not especially long or wide
• Is more than a half-inch long
• Opens so wide that you can’t get the edges together with just a little pressure
• Has ragged edges
• Has debris in it such as dirt, glass, or gravel

How badly is it bleeding? You’ll likely need stitches if the wound:

• Bleeds enough to soak through a bandage
• Keeps bleeding even after you apply direct pressure for 5 to 10 minutes
• Spurts blood

What caused it? For some wounds, you may need a tetanus shot as well as stitches. Tetanus is one of the standard shots for children. Adults need a booster every 10 years.

Get care right away if the wound is from an:

• Animal or human bite
• Dirty or rusty object
• Pointed object that might have driven deep into the skin, especially if the wound happened through the bottom of a shoe -- stepping on a nail, for example

Where is the wound? See your doctor if the wound is on any of these areas:

• Around a joint, such as your elbow or knee
• Touching a bone
• Face
• Hand
• Genitals
• Mouth
• Near your eye

Is it getting infected? Finally, you’ll need a doctor if you or a child in your care has any signs of infection:

• Chills or fever of 100 F or higher
• Red streaks near the wound
• Skin gets redder or more painful
• Sore is warm, swollen, or oozing pus
• Feeling like you’re going to throw up

If you have any doubts, it’s best to call your doctor.

Before You Go to the Doctor

If you do need stitches, here are a few tips before you head to the doctor.

Leave it in. If you have an object, such as a nail, stuck through your skin, leave it there. It may keep the bleeding from getting worse. But if the object that caused the puncture is small and you can easily remove it, do so.

Don’t eat or drink. This one’s mostly for kids. They may need medicine to keep them calm so the doctor can put stitches in. If they’ve had anything to eat or drink, they may have to wait longer for treatment.

Apply pressure. Use a clean towel or bandage to apply direct pressure to the wound. Try to keep the injured area raised above the heart to help stop or slow bleeding. If blood soaks through, don’t remove the old bandage. Just put another one right on top of it.

Clean the wound. If you can, clean the injury. Don’t use hydrogen peroxide or iodine – both can irritate your wound. Also, avoid scrubbing. Instead, you can:

• Wash your hands with soap and water.
• Run tap water over the wound to clean it out. Then, if possible, wash the area with mild soap and water and rinse again.
• Pat dry the injured area with a clean towel. Avoid anything fluffy that might stick to the wound, such as cotton balls.
• Apply an antibiotic cream.
• Put a clean bandage over it to protect the wound from dirt or further injury.

Treat the pain.  For pain, give acetaminophen or ibuprofen. Check with the doctor first, though, if you have any medical conditions or take any other medicines.

Ask Dr. Warner: When Does My Child Need Stitches?

Bumps, bruises, and cuts may go hand in hand with healthy active youngsters, but no parents want to see their children injured. If an injury results in a cut, Dr. Warner’s advice can help you determine whether your child needs medical care.

It’s a scenario every parent dreads. An unexpected tumble can transform laughter into tears in a moment. When an impact breaks skin, how should a parent assess cuts to determine whether they need professional medical attention and possibly stitches?

“This is an excellent question,” says Dr. Warner, a sports medicine physician and surgeon with Summit, who regularly treats injured children and young athletes. “There’s no hard and fast rule about how to know when a child’s cut requires stitches, but there are certainly some injury situations that do require a trip to one of our OrthoQUICK clinics.”

Your first steps to treat a wound are to wash it well, stop the bleeding, and gently pinch the sides of the wound together. If the wound is clean, shallow, and less than an inch long, you can generally treat it yourself with antiseptic or antibiotic ointment and a bandage. Don’t delay; the risk of infection increases the longer a wound remains open.

Although many minor cuts can be treated at home, Dr. Warner advises that injuries accompanied by any of the following circumstances are best treated by a physician:

• “If the cut happens on a baseball field, while a child is playing in a river or creek, or during another scenario that makes for a dirty wound, even a small cut can be contaminated with a significant amount of dirt or bacteria,” Dr. Warner explains. “This could lead to an infection and a serious problem. These injuries should be seen quickly by a physician so they can be appropriately cleaned, and sutured closed if needed.”

• “Even when the cut is a clean injury, if the wound is long or significantly widened, it should probably be closed with stitches,” Warner notes.

• Deep wounds that cut down to fat, muscle, or bone should be medically evaluated. “If a deep wound is over a joint, on the hands or fingers, or on the face, it’s particularly important to have a doctor treat it for both functional and cosmetic reasons,” says Dr. Warner.

• “Another type of wound that should be evaluated by a doctor is a cut that doesn’t stop bleeding,” says Dr. Warner. “Most bleeding from a minor cut will stop within a couple of minutes with some gentle pressure. If bleeding continues for more than 15 minutes, go to a doctor without delay. Injuries to the head and face tend to bleed a lot just because there is a lot of vasculature in the head. Head injuries, more than others, should get medical attention so that your child doesn’t lose too much blood or heal with an unpleasant scar.”

“If you have any concerns about a cut, the safest option is to bring your child in for evaluation,” concludes Dr. Warner. “Even wounds that don’t need stitches may require a physician’s attention to reduce infection risks. We are always happy to assess an injury and have it professionally cleaned and disinfected.”

Community health flourishes when specialized orthopedic care is conveniently available close to home. Summit Orthopedics is proud of our fellowship-trained subspecialty teams offering the full spectrum of orthopedic expertise in bone, tendon, ligament, muscle, and joint conditions—in addition to our wellness, prevention, and rehabilitation services. We have the expertise to proactively improve fitness, evaluate discomfort, and deliver personalized treatment to quickly and safely return you to the lifestyle you love.

Start your journey to a healthier, more active self. Visit our Facebook page to learn about our wellness services and schedule a free wellness consultation online. Find your orthopedic expert, request an appointment online, or call us at (651) 968–5201 to schedule a consultation.

Summit has convenient locations across the Minneapolis-St. Paul metro area, serving Minnesota and western Wisconsin. We have state-of-the-art centers for comprehensive orthopedic care in Eagan, MN, Plymouth, MN, Vadnais Heights, MN, and Woodbury, MN, as well as additional community clinics throughout the metro and southern Minnesota. 

More resources for you:

• Summit Orthopedics: Now in Lakeville

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Facts about suturing. Your baby from birth to two years

Suture Facts

Does the wound require suturing? Sutures accelerate healing and minimize the risk of inflammation and scarring. If the edges of the wound diverge or you can see under the skin flap, a suture is required.

As mentioned above, scalp injuries are accompanied by profuse bleeding, but after the bleeding stops, you will be surprised at the tiny size of the wound. The same blood vessels that abound here and caused the panic quickly heal the wound, and head wounds rarely become inflamed. These considerations and the absence of cosmetic concerns obviate the need for a small head wound to be sutured.

Another site that bleeds generously but heals quickly on its own is the bridle that connects the upper gum to the lip, known as the frenulum, and is richly vascularized. It, as a rule, is necessarily damaged and bleeds after falling on the face. The frenulum rarely needs stitching, and it heals quickly, one has only to press a bandage soaked in cold water to it for a while or let the child suck on an ice-cream candy. The same can be said about language.

In some cases, small wounds, less than 1.5 cm in length, if the edges do not separate, can be closed with the new Steri-strips (an improved version of the patch).

How to use Steri-strips

You will need 6 mm Steri-strips, a cotton-tipped applicator (Q-tip), benzoin and scissors.

1. Wash and dry the wound as above.

2. Cut strips approximately 12-25 mm long.

3. Use the applicator to generously apply glue (benzoin) to the edges of the wound, but do not touch the wound itself, otherwise it will sting.

4. Connect the edges of the wound. If three strips are required, glue the first strip in the center to hold the edges of the wound together, and then glue one more on each side of it. If the cut is small, two strips are sufficient.

If you can't decide if your child needs stitches, have your doctor or the doctor in the emergency room examine the wound.

Parent as surgical assistant . If your child needs stitching, be sure to stand next to your child for support while the doctor does his job. Tell your child honestly what to expect. Don't say it won't hurt if it will actually hurt. Such false assurances cause a loss of credibility.

How to deal with scarring . In most cases, scarring is due to how the wound was cared for, not how the suture was placed. Try these ways to prevent a cosmetic defect:

• Follow all of your doctor's advice on wound care and the above recommendations for keeping the wound clean. Wound infection is the main cause of scarring.

• Bring your child for stitch removal on the scheduled day. If the suture is left for too long, it increases the risk of inflammation.

• Massage the damaged area. Take an aloe vera moisturizing lotion or vitamin E oil and rub it into your skin. These healing touches increase blood flow to the wound.

• Keep the wound out of the sun, especially on the face. During the first six months of healing, do not expose the wound to direct sunlight. The scar may become darker than the surrounding skin, making it more visible. Use sunscreen with an SPF (sun protection factor) of 15 or higher, or wear a wide-brimmed hat to cover or keep the wound in shade.

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Does your cut need stitches? Find out how to spot it

5 things you need to know before you see a doctor

It's hard to tell if your cut or scrape needs to see a doctor.

Everyone has skinned knees, small cuts, stab wounds or animal scratches.

Many injuries heal without medical intervention. However, some injuries require stitches or other medical intervention to heal properly.

An adult cut or childhood injury may require medical attention, but how do you know?

It can be difficult to determine if an injury requires suturing or not. “Most people find it difficult to tell if stitches are needed or not.”

Cuts and puncture wounds are a serious concern for parents and if you are not sure how serious the injury is, it is best to see a doctor.

Signs that a cut needs to be seen by a doctor

Certain lacerations and other wounds require medical attention or emergency care. Seek emergency medical attention if wound:

• Deep enough to show underlying skin or yellow subcutaneous fat
• Opened so wide that you cannot close the edges by gentle pressure on the wound
• Placed on or across a joint (Nerves, tendons, or ligaments may also be damaged.)
• Is the result of an animal or human bite (You may need a tetanus shot, oral antibiotics, or stitches.)
• Puncture by a foreign object
• Formed by strong projectile pressure, e.g. bullet
• Contaminated or formed from a very dirty or rusty item
• Bleeds profusely (and does not stop bleeding)
• Located in a place whose appearance is very important, such as the face
• Located on or near the genitals (genital organs)

If you decide to call an ambulance, there are a few things you need to know:

1. Do not touch foreign objects

Do not remove foreign objects (such as a stick or piece of metal) stuck in the wound. The fact is that you do not know what the foreign object is pressing on from the inside. There were cases in which the object pressed on the artery and, thereby, blocked the bleeding. If it is pulled out, then nothing else will block arterial bleeding, which can lead to sad consequences.

2. Bites and contaminated wounds need special treatment

If you, a family member or loved one has been bitten by an animal or other person and the injury is more serious than a superficial abrasion - or caused by a very dirty or rusty object - call an ambulance immediately.

An adult will need to get a tetanus shot if they have not received it in the last 10 years.

Most children have been vaccinated against tetanus, but such wounds should still be examined by a doctor. Your doctor may prescribe oral antibiotics.

3. If possible, clean the wound

If possible, clean the wound gently before going to the hospital.

Doctors recommend using tap water and diluted antibacterial soap. This is a good way to cleanse almost any wound.

Hydrogen peroxide is not very good for washing wounds as it damages tissue.

The best thing a parent can do before taking a child to the hospital is clean the wound, but only if time and skill are available.

4. If you think you may need stitches, avoid eating or drinking.