Getting stitches involves numbing the area around a wound, then using a curved needle and thread to pull the skin edges together so the wound can heal cleanly. The whole process typically takes 10 to 30 minutes depending on the size and location of the cut. Here’s what actually happens at each stage.
Cleaning and Numbing the Wound
Before any needle touches your skin, the wound needs to be cleaned. The provider flushes the cut with a sterile solution to remove dirt, debris, and bacteria that could cause infection. This step matters as much as the stitching itself, because closing a contaminated wound traps bacteria inside.
Next comes numbing. For most cuts, the doctor injects a local anesthetic directly into the exposed tissue along the wound edge, not through the outer skin surface. This reduces the sting considerably. The anesthetic takes several minutes to fully kick in, so there’s usually a short wait before stitching begins. For children or for small cuts on the face and scalp, doctors often use a topical numbing solution instead. A soaked cotton pad is placed inside the wound for about 30 minutes, which avoids the needle entirely. Topical options work best on lacerations shorter than about 5 centimeters.
You’ll feel pressure during the injection but shouldn’t feel sharp pain once the area is numb. If you do feel pain during stitching, more anesthetic can be added.
How the Stitches Are Placed
The doctor holds a small curved needle with a locking tool called a needle holder, gripping it about halfway to three quarters of the way from the tip. With the other hand, they gently stabilize the skin near the wound using fine forceps or a small hook. This keeps the tissue steady so the needle passes through cleanly.
The needle enters the skin at a 90-degree angle, typically 1 to 3 millimeters from the wound edge depending on how thick the skin is in that area. Entering straight down rather than at a slant makes a smaller puncture and helps the skin edges sit up slightly rather than folding inward, which promotes better healing. The needle curves through the tissue under the wound and exits on the opposite side at the same distance from the edge.
Once the thread is pulled through, the doctor ties a knot to hold that single stitch in place. The knot is tightened just enough to bring the wound edges together without squeezing the tissue. Sometimes a small loop of slack is left intentionally, because swelling over the next day or two increases tension on the thread. A stitch tied too tight can cut into swollen skin. One or two additional knot throws are added to keep the stitch secure, and the excess thread is trimmed short.
This process repeats along the length of the wound, spacing each stitch evenly until the entire cut is closed.
Common Stitch Patterns
Not all stitches look the same. The pattern your doctor chooses depends on where the wound is, how much tension the skin is under, and how important the cosmetic result is.
- Simple interrupted stitches are the most common type. Each stitch is tied independently, making them ideal for low-tension wounds. If one stitch loosens or needs to be removed early, the rest stay intact.
- Vertical mattress stitches take a wider and deeper bite of tissue, making them stronger and less likely to pull through. They’re useful on areas where the skin is thin or where the wound edges need extra support to stay aligned.
- Horizontal mattress stitches spread tension across a wider area and work well on wounds that are harder to pull together. They’re typically reserved for less visible areas because they can leave more noticeable marks.
- Continuous subcuticular stitches run just beneath the skin surface in a single unbroken line. Because the thread is buried and invisible, this technique produces the best cosmetic result. It’s used on clean, straight surgical incisions where infection risk is low.
Absorbable vs. Non-Absorbable Thread
Stitches fall into two broad categories based on the thread material. Absorbable sutures break down naturally inside the body over weeks to months and don’t need to be removed. They’re made from materials that dissolve through chemical reactions with your body’s enzymes and water. Doctors use these for internal tissue layers, for areas that are hard to access for removal, and in children where a follow-up visit for removal may be difficult.
Non-absorbable sutures are made from synthetic materials like nylon or polypropylene. They provide stronger, longer-lasting tension, which can improve how tightly the wound edges stay together during healing. The trade-off is that they require a removal appointment. When used internally, such as in heart surgery or hernia repair, they stay in the body permanently.
Suture Sizing
Suture thread comes in a range of thicknesses, measured on a scale that can seem counterintuitive. The numbering runs from size 7 (the thickest) down to 11-0 (the thinnest, finer than a human hair). The more zeros in the number, the thinner the thread. A 2-0 suture is thinner than a 0 suture, and a 6-0 is thinner still. Delicate areas like the face typically get very fine thread (5-0 or 6-0) to minimize scarring, while areas under more stress, like the scalp or over joints, get thicker thread that can handle greater tension.
Alternatives: Glue and Staples
Traditional stitches aren’t always necessary. Skin glue is a liquid adhesive applied over the wound surface that bonds the edges together as it dries. It causes less pain than sutures, produces good cosmetic results, and is cost-effective. It works best on small, clean cuts that aren’t under much tension.
Staples are metal clips pressed into the skin with a device similar to a desktop stapler. They’re significantly faster to place than sutures, which makes them practical for long incisions or scalp wounds where cosmetic appearance is less of a concern. Adhesive strips (butterfly bandages) are another option for very minor, shallow cuts that just need help staying closed.
Caring for Your Stitches
Keep the area clean and completely dry for the first 24 to 48 hours. After that, gently wash around the site once or twice a day with cool water and soap. Clean close to the stitches but avoid rubbing directly on them. Pat the area dry with a clean towel rather than rubbing, and replace the bandage with a fresh one each time.
Avoid submerging stitches in water (baths, pools, hot tubs) until they’re removed or your provider clears you. Moisture softens the surrounding skin and can increase infection risk.
When Stitches Come Out
Removal timing depends on where the wound is. Areas with good blood supply and thin skin heal faster, while areas that move a lot or bear weight need more time. As a general guide:
- Face: 3 to 5 days
- Scalp: 7 to 10 days
- Arms and hands: 7 to 10 days
- Trunk and abdomen: 7 to 10 days
- Legs and feet: 10 to 14 days
- Over joints: 10 to 14 days
Leaving stitches in too long increases scarring because the stitch holes themselves start to heal and leave permanent marks. Removing them too early risks the wound reopening. Your provider will give you a specific timeline based on your wound.
Removal itself is quick. The doctor snips one side of each stitch near the skin and pulls the thread out. It feels like a light tugging sensation but is rarely painful.
Signs of Infection to Watch For
Some redness and mild swelling around fresh stitches is normal. What isn’t normal: redness that spreads beyond the wound edge, thick white or cream-colored discharge, a noticeable odor from the wound, increasing pain rather than decreasing pain, or the wound feeling warm or hot to the touch. A fever above 101°F (38.4°C) with chills or sweating alongside a healing wound is a clear signal that something needs medical attention. An opening developing along the incision line, where the wound appears to be getting deeper or wider, also warrants a prompt call to your provider.