Stitches

There are a lot of myths about stitches (the medical term for this is sutures) floating around so let me clear a few up.

First, dirty wounds cannot be sutured.  Such wounds will become infected and result in the sutures popping open.  Wounds must be properly cleaned out first.  We try hard not to suture bite wounds because the risk of infection is so high.  To this end, no wound older than 6-8 hours old can be stitched up.  If you think that your child needs stitches, seek immediate medical care.

We place skin sutures only to bring the skin together and to get a nice closure and to try to limit the size of the scar.  Deep or burried sutures provide any strength necessary to keep gaping wounds closed.  skin sutures are under little or no tension.

Sutures don't stop bleeding.  Cautery, direct pressure, ligation of bleeding vessles and vasoconstricting medications stop the bleeding.  If you suture up a seriously bleeding wound the bleeding will place the sutures under tension and they will pop open.

Sutures typically give better cosmetic closure than does superglue.  If it was my son's face we would be doing a running subcuticular suture not glue.  This is the type of suture used by most plastic surgeons for skin stitches for a reason.  You will note that plastic surgeons NEVER glue anything back together.

I hope that this demystifies some things for you.

Kevin M. Windisch MD, FAAP
Sparks Pediatric and Adolescent Medicine
775-359-7111
www.facebook.com/sparkspeds.nv

6 month old well child exam

Things start to ge complicated around 6 months of age.
We start as always, answering questions and watching the development of your child.  We are able to perform standardized screens of development at this age and have the parent complete this before we enter the room.  If your child shows delayed development we can address this early, while the child is still young enough to respond quickly.
Next we look at the growth of your child and perform our usual physical.  Special attention is paid to dental development at this time.
Finally we do our usual teaching.  This time we address upcoming mobility and the dangers that come with this.  We also talk about dental hygeine and, here in Nevada where we don't flouridate our water, prescribe vitamins with flouride to help keep the teeth strong.

We finish with vaccination pursuant with the CDC guidelines.

I hope that this helps to dispel many a myth for you.

Kevin M. Windisch MD, FAAP
www.facebook.com/sparkspeds.nv
Sparks pediatric and adolescent medicine
775-359-7111