When does a cut need stitches?
Answered by Zachary Bauman, DO, Critical Care Surgeon:
This question is really hard to answer because there are so many variables. In my practice, if the wound edges come together easily, I may elect to glue or skin closure strip as opposed to using stitches. However, this also depends on the location of the laceration (i.e., if the laceration is in a high-tension area, I may elect to put stitches), if it's pretty dirty, etc. The problem is this is very patient dependent and provider dependent.
Depth is difficult to assess. I would say, if the cut does not go through the dermis (last layer of the skin) with underlying structures exposed, the patient may not need stitches. But I cannot say that is the case for every patient as not all cuts are the same.
The problem with urgent care versus an emergency room is that it is all provider dependent. If I were staffed at an urgent care, I would be very comfortable repairing a very complex wound because I do that all the time. If the provider at the urgent care is not very comfortable with the wound, they may either provide a poor repair or send the patient elsewhere. I think it is fairly safe that complex wounds should probably go to the emergency department and less complex wounds can likely be handled at urgent care, but again, this is all relevant. What I may consider a complex wound, another provider or patient may consider simple.
I think all I can really say for certain is that a tertiary hospital (like Nebraska Medical Center) has all the resources and physician specialists needed to handle any wound. That is not the case for urgent care clinics.