How to tell if your kid needs stitches

Karen Meissner will never forget the day her then-four-year-old daughter, Maria, got stitches. The mom from Elmira, Ont., had left Maria with her parents for the day. According to Grandma, Maria was swinging her body between two armchairs like a gymnast when her arms gave out and her face hit the hardwood floor. The impact was hard enough to split Maria’s chin open. “My mom bandaged her up right away and called me,” says Meissner. “By the time I got there, Maria wasn’t upset anymore, but she also wouldn’t let me take bandage off to check it out.”

Based on her mom’s detailed description of the wound, Meissner decided to take Maria to the emergency room. She knew she’d made the right decision as soon as the doctor peeled off the bandage. “The wound was wide open, and I could see tissue,” she recalls. “I still get squirmy when I think about it.” The doctor used a needle to freeze the injured area and gave Maria three tiny stitches.

According to Toronto paediatrician Eddy Lau, when your child gets this type of wound, the depth and size of the injured area, and the amount of blood loss, are good indicators for figuring out if stitches are required. But if you have any doubt, see a doctor. First, Lau says, immediately apply pressure with a clean cloth to stop the bleeding. Ice may prevent swelling. Then assess the damage, but do so quickly. Lau says a wound that has been open too long isn’t ideal for stitching, and fast action may minimize scarring. “If the gash looks deep or the bleeding is significant, go to the emergency room. Don’t wait.”

A dissolvable glue-like substance is often used in ER settings for simple, relatively small lacerations, as an alternative to stitches. “It’s basically Krazy Glue,” Lau explains. The doctor will clean the wound and make sure there’s no risk of infection before he puts it on.

“Doctors may require the stronger holding power of traditional stitches for jagged wounds that don’t line up,” Lau says. “However, the logistics of removing them are tricky. Kids can get upset or scared, so some doctors use dissolvable stitches instead, which aren’t quite as strong but work well for clean cuts. And it means one less visit to the doctor afterward.”

Maria hasn’t let the tumble scare her away from activities, and Meissner won’t be surprised if Maria’s first encounter with stitches isn’t her last. “She is brave,” she says. “She’s learning the monkey bars now and is back to her adventurous self.”

At-home care

Keep the wound dry for the first 24 hours to allow the skin to come together and start healing, and try not to let it get wet until the stitches have dissolved or are removed. Let the area air out, but keep it clean. If any scabs form, don’t let your child pick at them, and get the wound checked out if you see signs of infection, such as redness, swelling, pain or discharge.

Most common stitch spots

Kids younger than 12: chin, forehead or mouth

Older kids: knees, feet or hands

This article was originally published in June 2014. 

Read more:
Tips to relieve your child's fear of the doctor A cut above: healing children's wounds Summer first aid guide: how to treat minor injuries