Lacerations with Stitches and Adhesive Strips

A laceration is a tear, cut, or opening in the skin caused by an injury. Lacerations may be small, and need only minor treatment at home. Or they may be large enough to need emergency medical care.

Stitches (sutures) are special types of thread that hold wound edges together while they heal. Stitches help speed healing, stop bleeding, reduce scarring, and decrease the chance of infection in the wound.

Sterile adhesive strips can sometimes be used on small, shallow wounds instead of stitches. They have many of the same benefits as stitches, but are much easier to apply.

Lacerations may need stitches if they involve the face, are longer than 1/2 inch, are deep, are spread open at rest, or are bleeding heavily.

• Calm your child and let them know you can help.

• Apply pressure with a clean cloth or bandage for several minutes to stop bleeding. If the bleeding is heavy, hold pressure for 5 to 10 minutes without stopping to look at the cut. If the cloth becomes soaked with blood, put a new cloth on top of the old one. Don't lift the original cloth.

• Once bleeding has stopped, wash your hands with soap and water and then wash the wound area well with soap and water. Do not touch the wound area until you have washed your hands thoroughly to help prevent germs from entering the wound. Don't scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes.

• Cover the area with an adhesive bandage or gauze. Change the bandage twice a day or whenever it becomes wet or dirty.

• Call your child's healthcare provider. Or if bleeding is severe, call 911 or take your child to the emergency room for further care, as soon as possible.

Your child's healthcare provider will determine the treatment for lacerations that need more than minor treatment at home. In general, call your child's provider for lacerations that are:

• Bleeding heavily and haven't stopped after 5 to 10 minutes of direct pressure

• Deep or longer than 1/2 inch

• Located close to the eye

• Large cuts on the face

• Caused by a puncture wound or dirty or rusty object

• Embedded with debris, such as dirt, stones, or gravel

• Ragged or have separated edges

• Caused by an animal or human bite

• Excessively painful

• Showing signs of infection, such as increased warmth, redness, swelling, or drainage

• Involved with an additional injury, especially a head injury or a broken bone

• Are linked to numbness or weakness of a finger, toe, or joint. This may mean damage to a nerve or tendon has occurred.

Also call your child's healthcare provider if:

• Your child hasn't had a tetanus vaccination in the past 5 years, or if you are unsure when your child's last tetanus shot was given

• You are concerned about the wound or have any questions

If your child's healthcare provider or an emergency room (ER) provider needs to place stitches or use sterile adhesive strips to close a laceration, you will be given specific directions for how to care for them. Treatment at home will be based on the location, depth, and size of the laceration, type of stitches used, and any special needs noted by your child's provider. Antibiotics may be given to help prevent infection in the wound. A tetanus booster may be needed depending on your child's wound.

Some stitches dissolve and don't need to be removed. Other stitches need a healthcare provider to remove. Your child's provider or the ER provider will let you know when to return to have stitches removed. Don't try to remove your child's stitches yourself.

Some general guidelines for caring for lacerations with stitches or sterile adhesive strips include the following:

• Keep the area clean and dry.

• Carefully follow the healthcare provider's instructions for care of the wound.

• Make sure your child doesn't do any activity that may lead to reinjuring or opening the wound.

• Watch the wound for signs of infection, such as increased warmth, swelling, redness, drainage, or pain.

• Watch the stitches to make sure they are intact and keeping the wound edges together.

• Return for follow-up care, as advised by your child's provider.

• Keep the wound out of prolonged direct sunlight. Once the wound is completely healed, use sunscreen to help protect the area of new skin. Sunburn or sun exposure can increase scarring.

• Keep butterfly strips in place until they start to loosen. They will fall off after a few days.