Most minor cuts and scrapes heal on their own, with little more intervention needed than mild soap and water to keep them clean. But more serious cuts or incisions from surgical procedures may require stitches, or sutures, to hold tissues together while they heal. The goal is to piece together the edges so that skin and other tissues can fuse back together. Then the stitches are removed.
Although it's natural to feel a little anxious if you're getting stitches, especially if you've just experienced trauma, the procedure is generally painless. And stitches will help cuts heal with minimal scarring or risk for infection.
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It's not always easy to tell if a cut requires stitches. Ultimately, it's up to your health care provider to determine if stitches are needed. You should seek medical care for any cut that:
Is deep, jagged, or gaping
Is on the face or another part of the body where scarring may be an issue
Bleeds profusely, without stopping, after 20 minutes of direct pressure
If any of these criteria apply to your injury, see a doctor as soon as you can. In the meantime, apply direct pressure to help control bleeding. It might also help to raise the injured area above the level of your heart, if possible.
There are certain instances in which stitches may not be advised, such as puncture wounds, though you may still need to see a doctor, especially if you have not had a tetanus shot in more than five years.
Once a health care provider has assessed your injury and determined that you need stitches, the first steps he or she will take in treating the wound are to clean and numb the area, though not necessarily in that order. Although cleaning a wound is not very painful in most cases, the doctor may first administer a local anesthetic, similar to what your dentist might use, to maximize your comfort. If your injury seems particularly contaminated, however, cleansing it -- usually with running tap water and a mild soap -- may be a higher priority.
Once the area is numb, the doctor will take a closer look to make sure there’s no dirt, debris, or other foreign objects inside the cut before sewing it together. An X-ray may also be ordered to help look for remaining debris. If you cut yourself on a piece of glass or sharp metal, for instance, it’s crucial to ensure that there are no remaining shards inside the cut.
The doctor may remove any dead tissues to help the healing process. He or she will then pull the edges of the cut together and, for each stitch, loop thread through either side of the cut and tie a knot to hold the wound closed.
Doctors can use different types of surgical thread made from materials such as silk or nylon, which may be in single filaments or braided. There's even surgical thread that is designed to dissolve over time so that the stitches don’t need to be removed. These are used most frequently in deep cuts.