Stitches or Staples

Which Does My Child Need?

Kids love to play. Between playgrounds, sports fields and the ins and outs of everyday activities, bumps, cuts and scrapes can happen. Every once in a while, medical attention is needed. Here are some common questions we get from parents about cuts, scrapes and scratches.

How Do I Know When My Child’s Cut Needs Medical Attention?

Any open wound that you think may need to be closed should be seen by a doctor as soon as possible. Ideally, wounds should be checked and closed within about six hours to help prevent wound infections; however, some open wounds can be closed as late as after 12-24 hours.

In general, staples are only used to close cuts to the scalp. Skin glue is most commonly used on the face and sometimes on fingers and toes. Stitches (sutures) can be used on any part of the body.

Here are some indicators that your child may need to have a cut closed:

• A cut is split or gaping.
• A cut is longer than ½ inch (12 mm).
• Cuts on the face that are longer than ¼ inch (6 mm) usually need closure with sutures or skin glue.
• In the mouth, inside the lip or on the tongue, cuts less than 1 cm usually do not need stitches unless the cut continues to bleed.

What is the Process of Getting Stitches at After Hours Pediatrics Urgent Care?

Here is our typical process for evaluating and treating your child’s wounds:

• A provider evaluates the cut to assess the need for wound closure. If the provider deems that repairing the cut may be complicated, you may be referred to an Emergency Department for your child’s wound care.
• A numbing cream is applied over the cut, which avoids the need for a numbing shot in most patients. The cream takes about 30 minutes to work.
• The wound is cleaned.
• The provider will discuss wound repair options with the family (and the child, if appropriate), as well as evaluate the best ways to assure that the child is as comfortable as possible during the procedure.
  • Injectable local numbing medications can be used if the numbing cream doesn’t work well enough.
  • A nasal spray containing a safe, mild, short-acting sedative that doesn’t put him or her to sleep can be used. It takes the edge off of the child’s anxiety and can help to keep them from remembering stressful parts of the procedure.
• We conduct the wound closure procedure while educating your family through the process to reduce any anxiety or fear. Family members may stay in the room during the procedure and often can help keep the child calm and distracted.
• We apply a dressing to the area and instruct the family on how to care for the wound. We often use absorbable suture material on the face, which means the child won’t have to go through the potential stress of having the stitches removed.

What is Skin Glue?

Skin glue, such as Dermabond, is sometimes used to close wounds. Doctors apply the liquid on small, superficial wounds to securely hold the edges together.

Your doctor will evaluate your child’s wound before making the decision whether to use skin glue or regular stitches, since there are many factors that need to be considered before choosing one or the other. Skin glue is most commonly used on the face, fingers and toes. It is not suitable for use with large or deep cuts or over areas close to joints.

At After Hours Pediatrics Urgent Care, our goal is to make sure your child’s wounds get the right care to encourage good wound healing and minimize scarring, and to do so in a way that causes as little stress as possible, not only for our patients, but also for those who care for them.

Click here to read more Doctor’s Orders articles