Stitches vs. Glue - which one?

Cuts and scrapes go hand-in-hand with kids. Sometimes, they require a trip to the emergency department for further evaluation. There are several options if the cut requires medical intervention - stitches, glue or staples. We talked to Dr. Jonathon Jacobs, an emergency medicine physician at Le Bonheur Children's Hospital, about these options and best treatments. Here's what he had to say:

Glue is best used for cuts or wounds that meet the following criteria:

• small (less than 4 cm)
• clean (not contaminated with dirt/debris or have a risk for infection)
• linear/straight (no jagged edges, multiple edges or complex cuts)
• low tension wounds (a wound over a joint or a cut on the forehead that goes up and down is under high tension.)

Glue cannot be used near the eyes or mouth and is also not good on the hands due to hand-washing wearing it away.

Neither glue nor stitches is necessarily a better method than the other; stitches and glue have the same cosmetic result as long as you follow the criteria above.

When applying stitches or glue, some doctors will use numbing to wash out the wound. The application is usually not painful if numbing is used, and a local anesthesia shot in the wound is very effective. While it is briefly painful, it works in just a few minutes. Sometimes a combination of numbing solution and shot works best; the solution will make the shot much less painful. When a child receives stitches, some form of numbing is necessary.

We still use staples in select situations. The most common being a laceration or cut of the scalp where, cosmetically, it's not as much of an issue. It's fast, easy and very effective.

Glue goes away by itself. Some stitches are absorbable and also go away by themselves. Those are usually used for the lips, mouth and in young children. With younger children, we use absorbable stitches to avoid sedation for suture removal.

I think it's always worth asking if glue is appropriate with the understanding that it's used in very specific and limited situations. Most often, when some form of closure is needed, stitches are used. As always, good wound care and follow up is important to ensure the wound heals appropriately.