In this subreddit we get a lot of posts asking whether something needs stitches or not including self harm posts which are quickly deleted as per the r/firstaid rules. In this post I'll go over when a wound would need stitches or when it can be managed at home.
A lot of the posts in here, especially the self harm posts that are deleted, clearly need stitches as the edges of the wound are gaping open. The short answer is if the edges do not touch (which is typical with cuts made by a sharp object) it will require some sort of stitches.
When I say stitches I'm also taking about all types of skin closures they may do at the hospital including glue and wound closures.
Here is an example (NSFW this is a picture of cut skin)
As you can see the edges of the wound are not touching and it is gaping open. These need stitches.
When do I need stitches
Wounds that are more than 6 mm (0.25 in.) deep, that have jagged edges, or that gape open.
Deep wounds that go down to the fat, muscle, bone, or other deep structures.
Deep wounds over a joint, especially if the wound opens when the joint is moved or if pulling the edges of the wound apart shows fat, muscle, bone, or joint structures.
Deep wounds on the hands or fingers.
Wounds on the face, lips, or any area where you are worried about scarring (for cosmetic reasons). Wounds on the eyelids often need treatment for both functional and cosmetic reasons.
Wounds longer than 19 mm (0.75 in.) that are deeper than 6 mm (0.25 in.).
Wounds that continue to bleed after 15 minutes of direct pressure.
Ideally as close to when you received the injury as you can but typically up to 24 hours.
When do I not need stitches
When the wound is not open or gaping open, cuts that are not deep, or types of injuries that do not cause the edges of the wound to open and close through movement. Wounds with smooth edges that stay together during normal movement of the affected body part.
Shallow wounds less than 6 mm (0.25 in.) deep and less than 19 mm (0.75 in.) long.
As you can see the wound is not gaping open and moving the part of the body that is injured does not cause the wound to open up or start bleeding again.
No access to health care or insurance/self treatment options
If you do not have health care insurance, don't have access to free health care, have limited health care options, or have financial barriers preventing you from seeking health care it is understandable that you may be resistant to seeking medical treatment. If the cut is small, wound closures may help. For larger gaping wounds(lacerations), there is often too much tension to overcome for at home wound closure kits. For gaping wounds, the body will use scar tissue to fill the gap which will create a visible scar.
For wounds that need stitches, you risk further injury, scaring, infection, and complications that could end up costing you more money.
Self harm/fear of going to the hospital
A lot of self harm injuries caused by a sharp object need stitches. Typical self harm locations usually have some tension to the skin so if you cut too deeply it is more likely to gape open and will usually not close with at home wound closures.
If you have a self harm injury and you cut yourself deeper than you intended it usually needs stitches. Nearly 100% of the posts I see connected to self harm are large gaping injuries that more than exceed the criteria listed above for stitches. People who cut themselves often will typically know they went too deep and that is why they are asking for help. For large self harm injuries, not going to the hospital means you will have a large scar in that spot for the rest of your life as the spot will be filled in with scar tissue. Scar tissue is a different colour than your skin and will be visible. If the edges of the wound can be connected through stitches then only the small line of the laceration will be visitable and these have a higher chance of fading. In addition, without treatment, you may have complications such as an infection which will require longer care.
Some people have a fear that the hospital will force them to stay there or get them in trouble. Medical professionals see a lot of self harm injuries and it is up to you what you want to disclose to them. Medical professionals are more concerned about injuries if injuries are connected to a suicide attempt rather than non-suicidal self harm injuries. You can also have a chat with a local crisis line, children's help line, or other help lines in your area about what a visit to the hospital will look like so you can prepare yourself for it.
It is always worth it to be seen for larger wounds and you can go to the hospital by yourself or with a friend if you have a safe way to get there. You can also Google smaller clinics and health centres that may be near your house as any doctor can do stitches - it does not have to be an emergency department.
Tetanus vaccine
If you cut yourself or created an open wound and it's been longer than 5 years since your tetanus shot, you should consider getting one. Routinely the vaccine is recommended every 10 years. You are at higher risk if it's an unclean object or outside.
"Adults who were immunized against tetanus and diphtheria when they were younger should get a booster dose of the Td vaccine every 10 years. This strengthens or boosts the immune system to give better protection against these diseases.
Adults who have not been immunized or do not have a record of prior immunization should also get the vaccine. The vaccine may also be given to people with serious cuts or deep wounds if their last tetanus vaccine was given more than 5 years ago."
This subreddit can be a great resource in helping to unburden an already heavily burdened medical system. Users often come here to enquire whether or not their injuries require medical attention, and our userbase is normally very helpful in supporting and answering them. Please keep in mind though:
All medical related answers here are OPINIONS--some from laymen, some from flaired medical professionals. Either way, please use your own best judgement and seek treatment if you believe you need it.
Even if a comment is from a flaired medical professional, they are not able to diagnose and prescribe treatments over the internet. This is simply because they do not have all the information; no matter how detailed you post may be. Anyone who claims otherwise goes against Rule 6.
That said, many users post about their ailments and are informed that time and basic care is all that is needed. This is a fantastic resource for someone who might otherwise have shown up to Emergency just to be sent home. Please just be judicial in your acceptance of medical advice and if in doubt, seek qualified medical treatment.
Additionally:
If anyone ever needs support or is feeling hopeless and like they have no other alternatives, the Suicide Prevention Hotline is available for free 24/7 at 800-273-8255 in the US. Just DM me for other countries' numbers if you reside elsewhere.
Further, If you or someone you know needs help, please call the National Domestic Violence Hotline at 800-799-7233 in the US. Again, DM me for international numbers. You are not alone.
This dead toe has been dead for quite a while and it did get worse recently (turn the whole toe purple) but everyone was saying to simply wait for it to all off but then I noticed that there’s more discoloration now which I find concerning. Earlier, I stubbed it pretty badly on the bed frame and it started bleeding and is extremely painful right now. I’m worried if I should get this checked already or if it’s okay to simply wait for it to fall off (which it hasn’t for months). It’s like kinda moist and sticky from the blood I think. I don’t have the capacity right now to have it checked because it’s my midterms and I need to study but I also have no idea how severe this is.
Is this infected or is this normal for a dead toe that’s about to fall off.
He got me! I’ve been a vet tech a long time, but this is my first bite that has broken skin. There are two TINY punctures on my index finger. One is in the crease when I bend my finger, the other slightly below. The dog was not up to date on rabies, but I have been vaccinated against. Our DVM told us I should go to urgent care for antibiotics, however I feel like minor bites like this often get ignored (people in my field often “tough it out” and avoid medical care for bites this tiny) where I’m at. I feel like I should just monitor it, but I am a little nervous bc it’s closer to a joint. I have full mobility of the finger and it is not red or swollen. I’m not sure if going to urgent care is worth all the hassle because it is very minor. Is it safe to just monitor?
I scraped my knee two weeks ago and, despite careful wound care, the deep scrape continues to be painful, has mucus-like discharge on every bandage, is warm to the touch, has a reddish/purple ring around it, and has not scabbed over or significantly healed.
Went to an urgent care today and nurse practitioner prescribed antibiotics and then formed and, with bare hands, cut and molded a small piece of Gelfoam and pushed it onto the scrape (again, without gloves) and then covered it with a large bandage. (note: I was pretty surprised/shocked by the NP not wearing gloves when handling the Gelfoam piece and when applying it to the wound and regret not stopping her to ask her to keep things sterile).
I just read that Gelfoam should not be used on potentially infected/older wounds. Again, after two weeks, the wound is discharging yellowish pus, is warm to the touch and continues to be painful and quite itchy, and has a red/purple border. I have no fever or red streaks from the wound.
Below is an image of the wound from today after showering and just before applying a fresh bandage (before going to urgent care). I am concerned about the use of Gelfoam given the age/condition but would appreciate any thoughts/advice.
TLDR: hit by kid's e-bike. Right leg swelling, but minor pain. Didn't pursue further action.
This is my first post ever and it's not a fun one. At least, I'm open to others opinions on the matter. On Oct. 9th of this year, I (29F) attended the first day of a haunted maze of a popular amusement park a bit far from my home. I went alone because I knew some friends couldn't handle it and I wasn't gonna wait around for anybody. I had fun, reacted with the actors because I wanted to be entertained, and even lead a family of four through the whole maze because they couldn't handle it!🤣
After it was done, I was about to leave and saw a stall just setting up to sell apple cider donuts. So, I went over to buy some. Seconds after I got there, two kids with their e-bikes came up to ask questions about their stall and the haunted maze. Then, it happened all so fast! As one of them got off their bike, the "sensory" went haywire and it went loose and turn my right leg into a traffic cone.
I went down gently and the pain was excruciating and burning. Everyone asked me if I was okay, the 15-yr old kid started crying, and the amusement park's police checked on me. The officer asked me and him questions, and I lifted my pant leg to see my right shin with a flesh wound and swelling. Then, EMT checked on me, gave me an ice pack, and checked my vitals. They asked if I needed to go to the hospital, and I said no. One, I don't have health insurance. Two, because nothing was broken when I was limping around.
To round it out, the police got everyone's information, and the kid came over to apologize profusely. I said, "This was an accident, thank you for staying to comply, and we'll both be fine." I took an expensive ride home, took a large dose of Ibuprofen, took pictures, and called my friends about it.
Today, I'm debating if I should've done more since my leg is still swollen and in slight pain. What other steps should I have taken? Should I have sued the kid? Is it worth suing at all? Could I still get help for my leg?
I've never been in this predicament before. What do you guys think?
On Saturday night (10/10) I touched a metal peice i didn't realize was hot. The skin/blister is completely intact. It is not painful at all. Wouldnt say numb as i can feel if i touch things. I'm keeping it covered and using ointment.
I am not worried about scaring. I just am wondering will it heal with no medical intervention. I don't want to pay an arm and a leg to be told just keep doing what I'm doing.
Got a small cut on this damn broken handle. Its looks kind of rusted as you can see. I sprayed it with lysol (it was all I could find) and rubbed hand sanitizer on it shortly after. I gotta go see a Doctor anyways it’s been a while… Should I really be worried?
About a month ago, I got a tattoo done on my forearm. It's a half-sleeve. The artist I had didn't do a great job, to say the least. She obviously overworked it, and then after, gave me improper after care instructions. So now I'm left with marks on my skin where the pigment isn't as melonated as the rest.
Over the month it has been healing, it has gotten a LITTLE more melonated. But it still looks pink for the most part. It's itching, but it's a healthy kind of itching. I know it's healing, but I'm worried how far it can go. Is there some kind of ointment I can use to get my pigment back? Or some kind of procedure that needs to be done? It feels like it'll never return back to my normal skin color.
This may be the wrong subreddit for this, and it is, I apologize in advance. I'll also say in advance I'm not a professional nor claim to be. I have basic first-aid training through my employer (construction) and through a local CERT (Community Emergency Response Team) group.
Recently, I had to help my SO with her elderly father. Without too many details, he ended up witha cut on his foot. He didn't have any kind of bandages at his house, but I remembered I had a small FAK in my truck (A little JJ Keller kit that I took from a previous company vehicle before it was traded in... https://a.co/d/0fHtrPfN ). Everything was still sealed but some of the stuff had expired by a few years. I was able to get his foot fixed up and taken care of.
Which brings me to my new issue. I've been looking into getting a new FAK for my truck. I know Walmart and other places carry general kits which would probably be fine, but one thing is I drive roughly 90 minutes each way for work, usually early mornings or late nights. I also work construction, so there is that addition. I also do off-road trips (nothing wild).
I had a discussion with AI about a good, multi-purpose kit, and it was pointing me to something that almost seemed like an ambulance in a bag! The first one it recommended was something from Scherber - a Basic First Responder Trauma Kit! I'm not a paramedic! Sometimes AI can run away with itself...
I spoke with my sister, who used to be a paramedic. She told me that my brother-in-law recommended one of the marine FAK's, and he recommended one of Adventure Medical Kit's Marine 450 kit. I like the idea of it being waterproof, as this would be store under the back seat of my truck, or possibly in my Jeep (when off-roading), but $230 is a bit much!
My idea was to have something that can basically treat myself or someone else until professional help can arrive/take over. The cases I was using were either rendering aid for an auto accident, or something happens while out off-roading, or a natural disaster (hurricane, tornado, etc).
Thanks for reading and providing any constructive advice!
TL:DR - Looking for an upgraded first-aid kit (FAK) for my truck/home/Jeep that's more than just bandaids and tape...
