Here’s How To Tell if Your Cut Needs Stitches

Many minor cuts and lacerations heal without medical intervention. But some injuries need treatment, like stitches, to ensure proper healing. And that means a trip to urgent care or, sometimes, the ER.

So, how do you know if you need stitches? Pediatric emergency medicine physician Purva Grover, MD, offers guidance on when to visit an urgent care or ER for a cut and what qualifies a wound for stitches.

Signs you might need stitches

Certain lacerations almost always require a visit to the ER or urgent care center for stitches. Here are some of the ways Dr. Grover figures out whether a wound needs stitching.

The injury is deep

If your wound is deep enough to expose your dermis (the middle layer of your skin) or you can see the yellow, fatty tissue underneath your dermis (subcutaneous fat), you need immediate medical attention and, likely, stitches.

Healthcare providers have the tools and training needed to address deep cuts. In addition to stopping the bleeding and closing the wound, they may:

• Get imaging done to see if any muscles, nerves, tendons, ligaments or organs were injured
• Figure out if you need surgery to ensure proper healing
• Provide numbing and pain relief
• Clean and disinfect the wound
• Give you antibiotics — sometimes through an IV — to guard against infection

The wound is gaping

If your cut is gaping open — meaning you need more than gentle pressure to press the edges together — it’ll need stitches or some other kind of medical intervention, like surgical staples.

Some wounds need to be closed at multiple levels. That process usually happens in surgery. The surgeons use dissolvable stitches to repair wounds deeper down in your body and slowly work their way up. This reduces the gaping and tension for easier wound closure.

It’s bleeding profusely

If you put direct pressure on your wound for 10 or 15 minutes and it hasn’t stopped bleeding or slowed considerably, it’s time to go to an urgent care or ER.

If blood is spurting out of your wound, call 911 or emergency services immediately. This kind of bleeding can be life-threatening. Emergency medical technicians (EMTs) have medications, specialized equipment and wound dressings in the ambulance that can help stop the bleeding and encourage clotting.

“If you come to the ER or call emergency services about bleeding, tell them if you’re taking blood thinners,” Dr. Grover urges. “That information can change your treatment plan. You may need medication or a more advanced wound-closure technique to stop the bleeding, for example.”

Once providers have stopped the bleeding, they can stitch, glue or staple the laceration closed.

There’s a joint involved

If your cut is on or directly impacts one of your joints, it will probably need stitches and may need to be checked by a specialist to rule out nerve, tendon or ligament damage. Depending on the location and severity of your injury, the joint may also need to be immobilized in a splint. That will keep you from bending the joint and popping the stitches.

The injury is from a bite

If an animal or human bit you badly enough to draw blood, seek medical attention immediately. You may need stitches. Dr. Grover says your physician may also prescribe oral antibiotics to prevent infection.

Adults who haven’t had a tetanus booster shot within the past 10 years will be encouraged (but not forced) to get one. Ditto for children who haven’t had the vaccine yet.

A foreign object is embedded in your skin

It’s a natural impulse, but don’t remove a foreign object — like a piece of wood or metal — that’s stuck in your wound. Go straight to the ER.

“You don’t know what’s been struck,” Dr. Grover notes. “More than once, I’ve seen cases where the object struck an artery and was blocking the bleeding. In those cases, pulling it would have meant uncontrolled bleeding, which can have devastating consequences.”

It’s the result of a high-pressure impact

If you have an open wound because something struck you hard and fast, you need to have it examined at an ER or an urgent care center. Here are a few examples that fit the bill:

• A gunshot wound
• Being impaled by an object
• A crush injury that causes bleeding

The wound is contaminated

If your injury got dirty or a rusty object caused it, it needs medical attention. The staff at the ER or urgent care will clean the wound and remove any lingering debris before stitching up your wound. You may also be offered a tetanus shot, antibiotics or both.

You’re worried about scarring

If the injury is in an area that could significantly affect your appearance — like your face — Dr. Grover recommends going to the ER for stitches. Depending on the severity of the wound and where it’s located, it may need evaluation and treatment by a plastic surgeon.

It’s on or near your genitals

If you have a bleeding wound on or near your genital area, it’s important to go to an ER or urgent care.

Your kidneys, bladder, intestines, colon and reproductive organs are complex and sensitive bits of equipment. Injuries in these areas tend to bleed heavily. And they have to heal in an environment that’s darker, warmer and wetter than most of your body. And — since these organs are all squished together in your lower abdomen — it’s easy to injure several at once, without even realizing it.

When you have a bleeding injury to your genital region there’s a high risk of infection and other complications, including:

• Difficulty peeing or pooping (incontinence)
• Sexual dysfunction
• Nerve damage or changing sensation
• Chronic pain
• Fertility issues
• Disfiguration

When it comes to open wounds on or near your genitals, it’s better to be safe than sorry.

Self-care before medical attention

Whether you’re on your way to the hospital for stitches or you’re trying to figure out if you should be, there are a few things you should know about caring for cuts. Dr. Grover offers the following tips.

• Avoid eating and drinking: Don’t give an injured child (or a squeamish adult) anything to eat or drink before going to the ER. “If they ate recently and start getting upset, they may vomit, escalating an already stressful situation,” Dr. Grover explains. “While they’re rarely needed, it’s best to avoid a heavy meal, in case the providers need to use sedatives or anxiety medications.”
• Clean the wound (if possible): Gently clean the injured area with tap water and diluted liquid antibacterial soap. And steer clear of hydrogen peroxide. Dr. Grover says it doesn’t work well for wound cleaning and may cause further tissue damage.
• Don’t remove anything that’s stuck in the wound: Glass, rocks and other items that aren’t easy to get out of a bad injury should be removed by a medical professional.
• Only drive if it’s safe: Don’t get behind the wheel if your injury makes it hard to drive, you’re feeling overwhelmed or you’ve lost more than a coffee cup worth of blood. Let someone drive you or call emergency services. If your wound is spurting blood, call for an ambulance.
• Try to stop the bleeding: On the way to the hospital, apply direct pressure to the wound and (if you can) keep it elevated above your heart.

What happens if you don’t get stitches?

If you’re waffling about going to the ER or urgent care, you’re probably asking yourself: How long after a cut is too late for stitches? Unfortunately, the window is pretty short — about 24 hours. While you can technically get stitches over a day later, they aren’t going to be as effective.

But what happens if you don’t get stitches at all? The answer depends on how serious your injury is, but generally, not getting stitches when you need them can:

• Increase infection risk
• Cause more intense scarring
• Slow the healing process
• Cause additional pain

The good news? You don’t have to make this decision alone. You can always call your primary care provider — or, if they’re closed, an urgent care center — for advice. They can help make sure that you get patched up properly.