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Should Your Child See a Doctor?

Suture Questions

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Definition

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

When to Call Your Doctor for Suture Questions

Call 911 If…

 
  • Your child is not moving or is 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
 

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 (such as Polysporin) 3 times a day (no prescriptio needed). (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 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 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 "When to Call Your Doctor" symptoms.


References

  1. Knapp JF. Updates in wound management for the pediatrician. Pediatr Clin North Am. 1999; 46: 1201-1214.
  2. Shafi S and Gilbert JC. Minor pediatric injuries. Pediatr Clin North Am. 1998; 45:831-852.

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.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/22/2010

Copyright 1994-2011 Barton D. Schmitt, M.D.

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