Stitches, Wounds, and Lacerations - Don't Fear the Needle

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Sewing is one of the fun things that we do in the emergency department. Repairing a laceration provides the immediate gratification of a job well done, seeing the skin edges come together to provide a nice scar, and it's one of the few times that the emergency doctor can sit down and spend time visiting with a patient.

While providing a nice scar is important, the two reasons we truly care for wounds is to make certain that the structures that run underneath the skin are not damaged and are functioning appropriately and that we can minimize the risk of infection. So it's with regret that I have to disagree with a quote in an article in USA Today by dermatologist Ranella Hirsch ("First aid made simple," by Kim Painter, 2007). She says that "Many doctors now use a medical super glue to close minor wounds. There's no painful stitching, and the wounds heal just as well, she says: "It's a win-win for everybody."

The implication made in Dr. Hirsch's take on stitching is that stitches hurt and that the skin is the most important thing in wound repair. But beauty is only skin deep, and while wounds may appear minor, they all need to be explored to make certain that things like tendons, nerves and joints haven't been damaged. And cleaning out the wound to remove debris is also a task that needs to happen before the skin gets sutured.