Does My Child Need Stitches?

Article at a Glance

• A cut needs stitches if it is bleeding uncontrollably or if it is longer than ½ inch.
• Ideally a cut should be stitched up within six hours of the injury.
• Your child might also need a tetanus shot to prevent a serious infection.

It is no wonder kids are accident-prone. They are still developing their motor skills, they are full of energy, and have very little sense of cause and effect. It is the perfect recipe for disaster. Usually it is no more than a bruise or a small scrape, but sometimes children get a laceration or cut that needs medical attention.

What is the difference between a cut and a scrape?
A scrape is a wound on the surface of the skin that doesn’t go all the way through the skin. A cut goes all the way through the layer of skin and down to the fatty tissue. Scrapes and scratches don’t need stitches, but some cuts do.

Why use stitches?
Stitches help the two edges of the cut come together and heal properly. This helps prevent scarring and infection. Cuts should be closed with stitches, staples, or a skin adhesive within 6 to 8 hours of the injury to prevent infection.

Does it need stitches?
Your child will probably need stitches if the cut:

• Is still bleeding even after applying pressure for five minutes.
• Is spurting blood.
• Is longer or deeper than ½ inch.
• Is on the face or neck and longer than ¼ inch. If it is close to the eye, it should be seen no matter how long it is.
• Gapes open with or without movement.

When else should I call the pediatrician?
Sometimes your child’s cut might not need stitches, but it could still need medical attention. Call your child’s pediatrician if the wound:

• Was caused by a rusty or dirty object.
• Is a puncture wound.
• Has something sticking out of it like a splinter or glass, or if there are rocks or dirt embedded in it.
• Shows sign of infection like redness, swelling, pus, or it feels warm.
• Was made by a bite from an animal or human.
• Is still severely painful even after a couple of hours.
• Still hasn’t healed after ten days.

When is a tetanus shot needed?
Puncture wounds or wounds contaminated with soil or fecal material are more prone to getting tetanus. These kinds of wounds should be seen by a doctor as soon as possible. Children who have already had the full series of tetanus shots (with a booster within the last ten years) should get a booster within 48 to 72 hours of the injury. Children who are unvaccinated or not fully vaccinated should get a tetanus shot as soon as possible. For vaccinated children the shot is no longer useful if administered a week after the injury, this increases to 3 weeks for unvaccinated children.

For more information on first aid and to find out if emergency care is needed, visit our “Is Your Child Sick?” section on cuts, scrapes or bruises.