Dermtv - How to know when you need stitches [dermtv epi #293]

[music] Hello, I’m Dr. Neal Schultz [pause] and welcome to DermTV. We all get cuts and scratches from time to time, but how do you know when that cut or scratch really requires stitches to make it heal its best? Certain amount of common sense is involved, and a hair-line scratch that bleeds for a minute or two, in which you just can’t really see much in the scratch, probably doesn’t need stitches. So, as an example, we have a thin, long scratch here, in which you can see a slight yellow discoloration in which really would be red, and would bleed for only a minute, that type of scratch isn’t going to need a stitch. Do you remember when you were a kid, and you were running and you fell and scraped your knee, and you had a 1 or 2 inch area that was bloody, and bleeding for a few minutes, but you couldn’t see any holes or gaps in the wound? That doesn’t need to be stitched. But, when the wound actually has depth to it, where you can move the sides of the wound apart, and if you look inside, you can see a different color, you can see red or you can see yellow. Then that would probably needs stitches. So, let me show you what I mean. When I press on this wound, or when I pull apart the sides, I can actually see a different color in there, I can see blue instead of just black and yellow, (obviously these aren’t the real colors). And, when I pull one side of this, I can actually see the depth, I can see how deep this wound goes. So, when you have this type of mobility on the sides of the wound, and you can see different colors inside, that is the time you probably need to have it stitched. And the only reason that we get stitches is for cosmetic reasons, so that you get a much smaller scar or no scar. But, if you never got a stitch, all you would do is just get a scar your skin is still going to heal. And, one more point, for the stitches to be effective, they have to be put in within 12 to 18 hours of the time you have the wound, because after that time, the skin has already started to heal, and it puts a coating on the two sides of the wound, so they won’t stick together, even with stitches.