A child cuts his chin after he falls off the "monkey bars" on the playground; an adolescent gets a laceration while chopping wood; an adult cuts a hand while working in a woodshop. At some point in your life, you will probably have to make a decision about obtaining medical assistance for a wounded victim, and if not for someone else, perhaps even for yourself.
It can be difficult to judge when a wound should be seen by a doctor for stitches.If stitches are needed they should be made by a physician within six to eight hours of the injury since germs can be trapped under the skin. Stitching wounds allows faster healing, reduces infection and reduces scarring. Even though stitching is almost a ritual in our society, its only purpose is to pull the edges together to hasten healing and minimize scarring. Stitches are not recommended if the wound can be held closed without them.
Wounds not usually requiring stitches include:
1. Those in which the skin's cut edges tend to fall together.
2. Cuts less than one inch long that are not deep.
Gaping wounds may be closed by using a "butterfly" bandage if all of the following are found:
1. The wound is less than eight hours old.
2. The wound is very clean.
3. It is impossible to get to a physician because of distance.
Whether a "butterfly" bandage or "steristrips" (strips of sterile paper tape) are used, apply either of them so that the edges of the wound join without "rolling under." If a dressing is needed, it may be applied directly over the strips.
All wounds, large or small, present one common danger - infection. To prevent infection and to provide proper care of stitched (sutured) wounds attempt to:
- Keep the wound and dressing clean and dry. Do not shower or bathe the injured area.
- If the dressing gets wet, remove it, blot the wound dry with sterile gauze and reapply a clean, dry dressing.
- Remove the dressing applied by the physician after two days. Reapply a sterile dressing and repeat this procedure every two days until the stitches are removed, unless otherwise instructed by a medical professional.
- If signs of infection occur, immediately contact a physician. Signs of infection include:
1. Wound becomes red, swollen, tender or warm.
2. Wound begins to drain or fester.
3. Red streaks appear up the arm or leg.
4. Tender lumps appear in the groin or under the arm.
5. Chills or fever occur.
Stitches in the face are often removed in less than a week. In the joints, they are often removed in two weeks. Stitches on most other body parts require removal within 6 to 10 days. Some stitches dissolve naturally and do not require removal.
Your physician will tell you when the stitches are to be removed. Unless there is some other reason to return to the doctor and with his approval, you can perform this simple procedure. Using tweezers, lift the stitch away from the skin. Cut the stitch at the end as close to the skin as possible and pull it out. This reduces the amount of stitch which needs to be pulled through the skin. For cutting use a pair of small, sharp scissors or a fingernail clipper.
- Interested in teaching first aid? The National Safety Council's new First Aid Institute solicits companies, businesses, schools, church groups, and other groups to become prospective training agencies. A training agency offers this flexible, hassle-free first aid training program using state-of-the-art materials. Call the National Safety Council at 1 (800) 621-7616 Ext. 7206 for more information.
- Alton Thygerson is a professor of health sciences at Brigham Young University.