Suture Questions

 

Definition

• 
  
• This guideline covers common questions about sutures or stitches.

See More Appropriate Topic (instead of this one) If

• Your child has a cut and you wonder if she needs stitches, see SKIN INJURY.
  
• Wound looks infected, see WOUND INFECTION. (To go directly to these topics, click on the links following this document.)
  

WHEN TO CALL YOUR DOCTOR FOR SUTURE QUESTIONS

Call 911 Now (your child may need an ambulance)

• 
  
• Not moving or too weak to stand

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick.
  
• Major surgical wound that's starting to open up.
  
• Bleeding that won't stop after 10 minutes of direct pressure.
  
• Suture came out early and wound has re-opened.

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• 
  
• You think your child needs to be seen.
  
• Suture came out early and wound is still closed.
  
• Suture removal is overdue.

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns.

Parent Care at Home If

• Sutured wound with no complications and you don't think your child needs to be seen.

HOME CARE ADVICE FOR SUTURES

1.  Suture Care for a normal sutured wound:

• Keep sutured wounds completely dry for first 24 hours (4 hours for Dermabond skin glue).
  
• After 24 hours, can take brief showers.  Avoid swimming, baths or soaking the wound until sutures are removed or Dermabond has fallen off.  (Reason: water in the wound can interfere with healing).
  
• Apply antibiotic ointment 3 times a day (Reason: to prevent infection and a thick scab).  (Caution: don't apply any ointments or creams to Dermabond skin glue.)
  
• Cleanse with warm water once daily or if becomes soiled.
  
• Change wound dressing when wet or soiled.
  
• Dressing no longer needed when edge of wound closed (usually 48 hours).
  
• EXCEPTION: dressing needed to prevent sutures from catching on clothing.
  
• For pain relief, give acetaminophen (e.g. Tylenol) every 4 hours OR ibuprofen every 6 hours as needed (see Dosage table).
  
  

2.  Removal Date:  
Guidelines for when particular sutures (stitches) should be removed:

• Face                                  3-4 days
  
• Neck                                     5 days
  
• Scalp                                    6 days
  
• Chest or abdomen               7 days
  
• Arms and back of hands      7 days
  
• Legs and top of feet           10 days
  
• Back                                   10 days
  
• Palms and soles                 14 days
  
  

3.  Removal Delays:  Don't miss your appointment for removing stitches.  Stitches removed late can leave unnecessary skin marks and occasionally scarring.  It also makes suture removal more difficult.

4.  Suture Out Early:  
If the sutures come out early:

• Reinforce the wound with tape or butterfly Band-Aids until the office visit.
  
  

5.  Wound Protection:  
After removal of sutures:

• Protect the wound from injury during the following month.
  
• Avoid sports that could re-injure the wound.  If a sport is essential, apply tape before playing.
  
• Allow the scab to fall off naturally.  Do not try to remove it.
  
  

6.  Call Your Doctor If:

• Looks infected.
  
• Fever.
  
• Sutures come out early.
  
• Your child becomes worse or develops any of the "Call Your Doctor" symptoms.
  

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. Pediatric HouseCall Online. Copyright © 2000-2003 Barton Schmitt, M.D.FAAP
Reviewed 8/2003
Revised 8/2003

See Other Topics: