|SSM Cardinal Glennon Children's Medical Center|
How Stitches Help Kids Heal
Everybody gets cuts, and some cuts are bigger than others. That's why a lot of kids need stitches at one time or another — usually on their face, chin, hands, or feet.
Stitches aren't for scratches. They're for bigger cuts that probably wouldn't heal well on their own. You might take a fall and hit your head or step on something sharp — ouch! Or you might have surgery and get an incision, a cut a doctor makes.
That's where stitches come in. They join the sides of the cut together so that it can heal. If you need stitches, you don't need to worry, but you do need to take care of the stitches until the skin heals.
What Are Stitches?
Stitches are loops of thread that doctors use to join the edges of a cut on your skin. It's a lot like sewing fabric together. But after a few days or a week, the skin heals and the stitches come out.
Once the edges are touching, the doctor ties a knot in the thread so your skin will stay that way until it heals. Doctors have many different kinds of thread, called sutures (say: SOO-churz), including some made of nylon, silk, and vicryl (say: VY-kril). Vicryl thread actually dissolves in your skin, so you don't even need to get those stitches removed. This kind of thread is used mostly on the lips, face, or in the mouth.
Another way of closing a cut is to use glue! Sometimes, if a cut isn't too deep or wide, and is on a flat area like the forehead, the doctor will use special skin glue to keep the cut's edges together until it heals. It usually dissolves by itself in 7 to 10 days.
Another option for tiny cuts is a small sticky strip called a butterfly bandage. It keeps the edges of a shallow cut together for a few days, and then it usually comes off in the bath.
How Does a Doctor Put Stitches In?
If you need stitches, the nurse or assistant will usually start by putting a numbing gel on top of the cut. When the skin is numb, he or she will begin cleaning your cut with sterile water, which is squirted into the cut to remove harmful germs and dirt. You're probably wondering if this will hurt. Actually, you won't feel much pain at all during the cleaning and sewing of the cut.
Sometimes a liquid numbing medicine will be put into the skin with a small needle. These substances, called anesthetics (say: an-es-THEH-tiks), may numb the area so you feel hardly any pain at all. It's a lot like the medicine used to numb your mouth when you have a cavity filled.
The doctor also will make sure that whatever cut you (such as a piece of glass) isn't still in the cut.
Using a very tiny needle, the doctor will sew your cut together with the sutures. Although the area will be numb, you might feel a tug as the doctor pulls the stitches together. Stitches are done the same way at the end of surgery. If you get these at the end of surgery, you won't feel it — you won't even be awake!
How Does a Kid Take Care of Stitches?
Your doctor will tell you how to care for your cut after it has been closed. It's important to follow the directions carefully with your mom's or dad's help. Different kinds of materials — sutures, glue, and butterflies — need different kinds of care.
The doctor probably will tell you to keep your cut dry for at least 1 to 2 days. Most stitches should not get wet. Some cuts with stitches need to be covered with an antibiotic (say: an-ty-by-AH-tik) ointment and a bandage to prevent infection. Glue, on the other hand, shouldn't be coated with ointment. It's important that you don't tug or pull on the stitches, even if they get itchy. And don't ever try to take the stitches out by yourself.
If you notice that you've popped or torn a stitch, or if your cut is hot, red, swollen, or oozing pus (a yellowish or greenish thick liquid), be sure to tell a parent. You may need to see the doctor to check if the cut is infected.
Getting the Stitches Out
Dissolving stitches, glue, and butterflies come out or off on their own. The doctor or nurse has to remove other kinds of stitches. The stitch is cut at the knot, and the little thread is pulled out. You may feel a bit of pulling, but it won't hurt. It takes a lot less time to remove stitches than it does to put them in. And once the stitches have been removed, your skin will be fine!
The doctor will tell you how to care for your skin after the stitches have been removed. You may be told to avoid getting direct sun on the area of skin for a while. Sunscreen will be recommended whenever you go in the sun. The doctor also might give you a cream for your skin to make the scar better. Before long, it will probably be hard to see the place where your cut used to be. Most important, your skin will be totally healed!
Reviewed by: Steven Dowshen, MD