ZocdocAnswersHow do you know if a cut needs stitches?

Question

How do you know if a cut needs stitches?

Cut myself while I was cooking last week on the inside of my thumb. It was pretty bad/deep, but I just bandaged it and kept it clean. It doesn't seem to want to heal. Is it too late to get stitches? Will my cut eventually close up on its own?

Answer

Wounds are considered clean, contaminated, or dirty on the basis of the amount of bacteria present. Clean wounds are routinely approximated or suture-closed. Contaminated wounds, on the other hand, can be approximated partially but the risk of leading to a wound infection can be high. Dirty wounds are routinely not approximated right away. Instead, it is allowed to heal by secondary intention-or by allowing the skin edges to slowly come together. This process can take several weeks or more depending on the size of the wound. Sometimes a wound is too large to come close together by secondary intention so a skin graft can be used to close the defect. This is not to say that your wound meets any of the above descriptions. In general, it is very important to keep your wounds clean with daily debridement. This will provide a healthy environment for the epithelial cells to take residence and migrate across the wound. A wound on the hands and face less than 12 hours can be vigorously washed and closed under a sterile environment because these areas have higher blood supply and thus are much less likely to get infected. I think it is good idea that you visit a primary care doctor or E.R. where it can be evaluated to rule out infection and the presence of a foreign body. Good luck.

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