Cuts and Wounds: When Do You Need Stitches?

Most cuts can be cleaned and covered at home. But some need closing within hours to heal well and reduce scarring and infection. Here’s how to decide.

Imagine slicing your hand while cutting a bagel. It bleeds heavily and the edges gape open. You press on it with a clean towel for ten minutes, it slows, but the gap is still there. You head to an urgent care clinic and have it closed within the hour. Two weeks later it’s barely visible.

First aid for cuts

1. Wash your hands or wear gloves if available.
2. Press firmly on the wound with a clean cloth for 10 minutes without peeking.
3. Raise the injured part above the heart if you can.
4. Once bleeding stops, rinse under clean running water.
5. Pat dry and cover with a clean dressing.

Signs a cut may need stitches or closure

• The edges gape open and don’t come together easily
• It’s deeper than about 6 mm (a quarter of an inch) or you can see fat, muscle or bone
• It’s longer than 1 to 2 cm, or on the face, lips, eyelids, joints, hands or genitals
• Bleeding hasn’t stopped after 10 minutes of firm pressure
• There’s dirt or debris you can’t remove

Wounds are best closed within about 6 to 8 hours, so don’t wait until the next day. Depending on the cut, a clinician may use stitches, skin glue or adhesive strips.

But what about tetanus and infection?

Check your tetanus vaccination status, especially for dirty wounds or those from soil, rust or animals; you may need a booster. Watch for infection over the next few days: increasing pain, swelling, warmth, spreading redness, pus or fever. Animal and human bites need medical review, as they often need antibiotics.

Call emergency services for bleeding that won’t stop, spurting blood, numbness or inability to move fingers or toes beyond the cut, or an object stuck in the wound (don’t remove it).

Sources: NHS (Cuts and grazes), Mayo Clinic (Cuts and scrapes: First aid), American Academy of Dermatology, British Red Cross.