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There is virtually no one who has never had a cut or scrape in their lifetime!One or the other time,all of us would have visited a hospital for a wound care.A good majority would have undergone stitches for their wounds as well.In this article,I would touch upon some of the important principles of wound care,of stitches,and of novel modalities of wound closure.

First aid in wound care

Your wound may be just a mild abrasion where only the superficial layer of skin is injured ;or can be a lacerated wound with deeper injuries often with irregular margins or a bruise where there is only contusion.Whatever be the wound type(skin wounds),certain first aid measures need to be done to prevent infection:

  1. Wash thoroughly with soap and water.

  2. Apply minimal pressure over the wound if bleeding has occured and oozing still.

  3. Cover the wound with a light dresSing or fabric taking care to avoid contact with dirty surfaces.

  4. If a lacerated wound has occured,visit your nearby clinic or hospital for wound care.

  5. Tetanus shot is often required if you haven’t taken a shot in the recent past or if there is high risk of contamination.

  6. Wound closure if required.

What are the different means by which wound is closed?

There are different techniques of which the most commonly employed means is by suturing-stitching-of the wound.All the available modalities of wound closures are briefly as under:

  • Sutures or Stitches : Sutures are pieces of threads made from different materials which aim at approximating the wound.The type of suture used is dependent upon the site,nature,depth and contamination of the wound.Usually,skin wound suturing is done under local anaesthesia at the casualty or outpatient basis unless in the case of paediatric age group.

  • Staples : Skin staples work in the same way as sutures.Here it takes lesser time and the wound may look neater but usually employed only when the wound is clean as in a surgically incised wound.

  • Steri-strips: these are set of strips as the name indicates which are applied across the sound perpendicular to it.These are applicable only in clean shallow wounds where there is not much gaping.Ideal in small cuts in children.

  • Tissue glue: Adhesives which helps in holding the cut ends together.Not applicable for all types of wounds.

When are the stitches removed?

The number of days after which the stitches are removed depends on the site of wound as well as the type of suture material used.Sutures can be absorbable(need not be removed manually) or non-absorbable(needs to removed after the stipulated time period).Generally,sutures over the face can be removed after 3-5 days while those on the back are usually removed after 10-14 days.All other skin stitches are removed around 7-10 days.However several other factors come into play too.For instance,in the presence of infection,sutures may have to be removed earlier than intended.

Some common misconceptions seen in clinical practice

1) "The number of sutures indicate the severity of the wound".

Absolutely NOT! The number of stitches in any means do not dictate the severity of wound.Basically it is the surgeon's preference! Naturally,if the wound is long,you need more number of stitches to be put.

2) "You should not take bath until all stitches are removed!"

You can't be more misinformed than this! Traditionally,it has been believed that stitches should be kept dry and free from water.This is wrong.After 3-4 days,clean wounds should be considered like normal skin only and can be washed with soap and water until your doctor specifically asks you not to.Further,wounds never cleansed with water would accumulate dirt in them and can be a cause of secondary infection.

3)"It is okay to take the stitches at any time past the day of review"

No! The sutures should be removed at the exact time advised by your doctor.Stitches kept past the stipulated time period can lead to scarring and disfigurement.

4)"You need not pay attention to the stitches once you have been discharged.They would heal eventually."

Not really.Always pay attention to the natural course of healing once you have been stitched up.If you see any redness or discharges between the sutures often with fever or increased warmth in the surrounding skin,always visit your doctor to ensure your wound is not getting infected.

Remember, timely stitching up of wounds help in cosmetically amiable healing.Always adhere to your doctor's advices regarding wound care.

As the saying goes,"A stitch in time saves nine!".

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