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When A Child Needs Stitches

by Sue Hubbard, M.D.

Well, I thought it would be a good time to write about stitches and give a follow-up to my Thanksgiving Day. I get numerous calls at both home and office asking if a child might need stitches. Sometimes it is terribly obvious, but other times you just have to look and decide. This is especially true on the face.

My Son's Thanksgiving Accident

My Son's Thanksgiving Accident

There is nothing more precious than your child’s face, so I am especially careful about looking at facial lacerations. This often means a trip to the office (or my house) to actually decide if the laceration warrants suturing, and if so to determine if a plastic surgeon should be involved. With that being said, I often get phone calls from a parent who is already in the ER and has been told that their child needs suturing on their face, but not sure if they need plastic surgeon.

In the case if my son’s injury last week, because the laceration involved not only his brow but also the inner corner of his eye, a plastic surgeon sutured him. The same plastic surgeon that sutured him (27 stitches) about 8 years ago after a dog bite to his face he received while he was spending the night at a friend’s house. That is not a good phone call either. The good news is that none of these injuries are life threatening, and despite the few tears of a mother who sees her child’s face bloodied, he is just fine and scars do “fade” with time. He reminds me that these are just part of being a boy, I guess so?

The most common injury I see to a child’s face is either a “busted” chin from a fall, or a laceration to the brow from the nightstand or corner of fireplace or coffee table. In many instances these are easily closed by an ER doctor or any doctor who is “used” to suturing. These are rarely seen as the child grows and the scar on my chin from many years ago is only noticeable when I lift my chin to show a parent the long old line that was sutured by a “resident” in the ER when I was about six. It is amazing to see how many adults have the same scar. In many cases if the laceration is not too deep and in a less visible area on the face, it can be closed with “glue” in the office rather than having to use sutures.  When “glue” (dermabond) was developed it really changed the way we can deal with smaller lacerations and it is easily applied and no pain!! The results are amazing and may even be preferable to suturing. But if a facial laceration is deep, jagged etc. a plastic surgeon should be called and most ER doctors will tell you the same thing. ER doctors are used to suturing but they too are very aware of cosmetic results to a child’s face and will call in plastics when necessary.

But remember, as upsetting as it may be to have to stitch your child’s face, they will be just fine!!!  Just break out the sunscreen to help the scarring.

That’s your daily dose, we’ll chat again tomorrow.

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