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Wound care and suturing

Wound care and suturing — cleansing and surgical closure of cuts, lacerations and traumatic wounds.

Procedure that includes cleansing, suturing and tetanus protection to prevent infection and support tissue healing in cuts, lacerations and traumatic wounds where skin integrity is compromised.

Indication

  • Incision wounds caused by sharp instruments, glass or sharp objects
  • Lacerations following falls or impact
  • Skin wounds from animal bites or scratches
  • Postoperative wound dehiscence or surgical site care
  • Chronic wounds (diabetic foot, pressure ulcers) — specialized dressing
  • Healing-phase dressing for burn wounds

Preparation

  • The patient describes how, when and by what mechanism the wound occurred
  • Known allergies (local anesthetics, antibiotics) are reported
  • Tetanus immunization status is checked; booster or immunoglobulin is given if needed
  • Use of blood-thinning medications is reported

How it's performed

  1. The wound is irrigated thoroughly with saline or antiseptic solution
  2. Local anesthesia is administered for pain control
  3. Foreign bodies and tissue debris are removed; nonviable tissue is excised if needed (debridement)
  4. Wound edges are approximated with appropriate tension and sutured using absorbable or non-absorbable sutures
  5. A sterile dressing is applied; antibiotics or tetanus protection are administered per protocol
  6. In heavily contaminated, delayed-presentation or bite wounds, suturing may be deferred or the wound left open

Post-procedure

  • The dressing should not be moistened for the first 24-48 hours; bathing and pool use are not advised
  • Daily dressing changes or follow-up per physician's recommendation
  • Sutures are removed at 5-7 days on the face, 7-10 days on the trunk, and 10-14 days on extremities
  • Seek immediate care if redness, discharge, increasing pain or fever develops
  • Tetanus immunization schedule is completed if needed

Risks

  • Wound site infection (cellulitis, abscess)
  • Poor healing or thick scar (keloid) formation
  • Local anesthetic allergy or transient numbness
  • Missed nerve, vessel or tendon injury (especially in hand and wrist region)
  • Tetanus or rabies risk (if adequate prophylaxis was not given)

FAQ

Should the wound be sutured or will it heal on its own?

Wounds with gaping edges, depth, or longer than 1 cm usually need suturing. Superficial small abrasions do not require sutures. The decision is made by the physician after examination.

Is a tetanus vaccine needed for every wound?

If a vaccinated person has had a booster within the past 5-10 years, it is generally not needed. For unknown immunization status, contaminated or deep wounds, the vaccine and immunoglobulin if needed are administered.

Can I shower after my wound is sutured?

It should be kept dry for the first 24-48 hours. After that, brief showers are allowed and the dressing is changed. Bathing, pools and the sea are avoided until sutures are removed.

Will a permanent scar remain?

Some scarring may remain in any sutured wound. The appearance of the scar depends on the wound's location, depth and the patient's healing characteristics; sun protection and moisturizing help reduce the scar.