How do you know when a patient needs stitches?

[starfishlpn]

Especially if they are long term care or even hospice? Is there any surefire rule?

[AngelofLTC]

If I couldn't approximate the edges of the wound with steri-strips or stop the bleeing, I would send a resident for assessment. Hope this helps.

[Whispera, MSN, RN]

gushing blood, bone showing

(stifling myself and knowing I need sleep!)

[xtxrn, ASN, RN]

gushing blood, bone showing

(stifling myself and knowing I need sleep!)

ROFL :lol2: :lol2:

OK, I'm guessing you're kind of new at this and looking for some real answers-

1) know your facility policy

2) ask someone with more experience

2 1/4) if in doubt call the MD (to CYA, even if nothing else)

But wound edge approximation and hemostasis are good clues :)

[nola1202]

facial injuries in the ER, once u know u need stiches, call the plastic surgeon on call, they are the best at leaving a very small, difficult to notice scar. there's awindow of time a wound can remain open before it can't be sutured I think about 12 hours, but I can't remember for sure, time for bed, not gonna look it up. I know there's someone on this site who can tell you.

[akulahawkRN, ADN, RN, EMT-P]

The time limit is around 6 hours. That's basically to keep a closed wound from harboring a massive infection that makes itself known a couple/few days later. As to when to do sutures... it's basically if you need a minimal scar, if the wound edges can not be easily approximated with steri-strips, or uncontrolled hemorrhage.

Larger wounds also have another problem: swelling. Injured tissue will become edematous and this can make it difficult (at best) to keep the external wound edges approximated with just adhesive strips. Sutures will keep those edges approximated without too much fear of reopening the would.

The last wound I had that needed to be closed simply needed dermabond to keep it closed. Sutures would have likely resulted in a larger scar...

[GHGoonette, BSN, RN]

When the patient doesn't run in terror from the needle....

(Had that happen once in the ED, woman with a small cut almost wrecked the room when we approached her with the local anaesthetic)

[gentlegiver, ASN, LPN, RN]

Look closesly at the wound, if it looks deep, wont stop bleeding, send them out. You can tell a "normal" wound from a"stichable" wound from the depth. If you look and can see that it is so deep it has gone thru all the skin layers then it needs stiches. Temple wounds always win a ride to the ER.