By Jackie Hutcherson, St. Louis Post-Dispatch, December 10, 2007

Q: When does a child’s cut require stitches and a trip to the emergency room?

A: A child rides his bicycle, then takes a spill. A wobbly toddler hits her head on the sharp corner of a table. Both are candidates for stitches. Jumping off the top bunk bed is also a prescription for splitting open the skin of a kid’s head.

Dr. Rob Poirier, chief of emergency medicine at Barnes-Jewish Hospital and Washington University School of Medicine, has seen all of the above and has also stitched up dog bites and the occasional incident with an unruly bagel slicer.

These are the events that typically have parents going to the ER, but what are the signs? Poirier says the quick answer is if you cannot stop the bleeding by holding pressure on the wound in five to 10 minutes, and if you can see inside the cut and can’t close it with a bandage, see a doctor as soon as possible.

"If the cut is in an area on the face, such as a lip cut that goes into the face or an eyelid cut. Basically any kind of cut on the face could leave a scar, so it needs stitches," Poirier said.

Some other injuries that would need stitches include:

— Puncture wounds, like a large piece of glass that goes an inch into the skin.

— A cut from a rusty nail would also include the patient receiving a tetanus shot, if her shot were not current.

— A hand going through a glass window. Shards of glass still inside the wound would definitely require an ER visit.

Before heading to the doctor, Poirier recommends cleaning the wound with warm, soapy water, not alcohol or peroxide.

"Alcohol and peroxide will delay the healing and cause bigger scars if it gets into the wound," he said. "Swath around the wound with warm, soapy water, then get to the hospital."