Take the Stress Out of Stitches
I’m completely paranoid about my kids getting a cut that would require stitches. I’m not sure why, because I put in and take out stitches all the time and can see that:
- While not fun, kids (even really young ones) tolerate the procedure beautifully.
- Now with the new skin “superglues” sometimes you don’t even need stitches to close a wound.
- Cuts (formally known as lacerations) heal pretty well when cared for correctly.
So in the spirit of connecting with all the other paranoid parents out there worried about their kid getting a similar type of cut, I thought I’d share some things that are good to know if you have to face this fear.
First, have a sense of what types of cuts need to be evaluated by a doctor. Not all breaks in the skin that bleed need an immediate trip to an emergency department or urgent care center. Abrasions (the scraping off of the very top layer of the skin) like a skinned knee or lip rarely need stitches, but just a pretty good scrub of the wound, application of an over-the-counter antibiotic ointment like Bacitracin or Neosporin, and close observation.
Deeper cuts that are gaping open, continuing to bleed, or are on a delicate area of skin like over joints or on the face should always be seen as soon as possible by a doctor. If your pediatrician isn’t available, visit one of the pediatric emergency specialists at PM Pediatrics, which provides urgent care just for kids from birth through college. Once a laceration is older than about 12 to 18 hours — even if it ordinarily would need stitches — it’s too late. This is especially crucial on the face where scarring is important (as we all want our kids to be as blemish-free for life as possible!). One of the goals of stitches is to make a nice cosmetic wound closure so don’t delay in getting a facial laceration seen! Each PM Pediatrics office is open 365-days a year, until midnight.
Once the wound is glued or stitched and dressed, it’s important to follow your doctor’s instructions closely. Any opening in the skin is at risk for infection, so it’s crucial to understand these signs. Fever or pus drainage (thick yellow or white fluid) from the wound is worrisome, as are increasing pain and red streaks around the wound. Should you see any of these signs, have the cut looked at promptly. Sometimes the fix can be quick and simple, like reopening the wound slightly to help drainage (better than the whole thing opening up!), or adding antibiotics early in the course of infection to save headaches later on. There may be a little debate among healthcare providers on whether or not wounds should be covered, but I’m a big fan of covering them with a dressing for the first 24 hours and then having them open to the air to help dry out and heal faster. A stitched wound should be dry on day one and then washed gently with soapy water twice a day, thereafter. Make sure you’re clear on exactly when the stitches should come out, or if they are absorbable and don’t require removal.
My final tip is to cover all cuts year-round with high-SPF sunscreen for at least one year post-injury to help prevent further scarring. Sun damage to skin is a well-known fact, but sun damage to already damaged skin is even worse. Be careful and have a gorgeous, healthy child!
Now I feel better. Maybe just going through the steps of what I already know and practice will help me be less anxious when my kid, Luke, barrels down the slide at the playground, face-first. I hope it does the same for you! Let me know if you have any good tips for managing cuts and scrapes, let’s learn from each other.
Christina Johns, MD, is an experienced pediatric emergency physician and children’s medical expert at PM Pediatrics, a specialized pediatric urgent care provider with offices in New York, New Jersey and Maryland. The go-to medical expert parents trust, Dr. Johns brings the breadth and expertise of the cutting-edge urgent care practice to educate the community at large. For the PM Pediatrics location nearest you, visit PMPediatrics.com.