Suture Questions

Symptoms

DEFINITION

• This topic covers common questions about sutures or stitches
• Skin glue (Dermabond) is also covered

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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.

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

• 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
• Wound looks infected (redness, red streaks, swollen, pus)
• Fever occurs

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

Care at Home

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). If needed, use a sponge bath.
   • 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) or ibuprofen as needed (see Dosage table).
2. Removal Date: Guidelines for when particular sutures (stitches) should be removed:

   Face	4-5 days
   Neck	7 days
   Arms and back of hands	7 days
   Scalp	7-10 days
   Chest, abdomen or back	7- 10 days
   Legs and top of feet	10 days
   Palms, soles, fingers or toes	12-14 days
   Overlying a joint	12-14 days

3. Removal Delays: Don't miss your appointment for removing sutures. Leaving sutures in too long 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 pick it off. (Reason: prevent scarring)
6. Call Your Doctor If:
   • Looks infected
   • Fever
   • Sutures come out early
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Photo Example

Laceration - Scalp (After Staples)

This photo shows a scalp laceration after it has been closed with 4 metal medical staples.

Wound Infection - Suture Site

There is a pimple where a stitch comes through the skin. The pimple suggests a low-grade infection.

Source: LMS Inc.

Copyright 2000-2009. Self Care Decisions, LLC. Used by Permission.