"Should I just put a Band-Aid on it?" is one of the most common phone calls our nurses take. Sometimes the answer is yes. Sometimes the answer is "come in now, before the wound dries out." Here is the simple framework we use, in language you can apply standing at the kitchen sink.
The five-test home check
Look at the wound under good light, after gently rinsing it under cold tap water for a minute. Then run through these five questions:
- Length — is it longer than 1.5 cm (about the width of a 10-cent coin)? Anything shorter than that on flat skin will usually close itself.
- Depth — can you see fat (yellow), muscle (red and fibrous), tendon (white and shiny), or bone? Any of those is an automatic yes.
- Gape — when you let go of the skin, does the wound stay open by more than a millimetre or two? A wound that gapes won't heal flat without help.
- Location — is it on a joint (knee, knuckle, elbow), the face, the lip, or the genitals? These sites either move a lot, scar visibly, or have functional implications. Lower threshold for closure.
- Bleeding — does it keep oozing after 10 minutes of firm direct pressure with a clean cloth? Brisk bleeding past 10 minutes means a vessel needs attention.
If you answered yes to any of these, you probably need to be seen tonight.
Why timing matters — the 6 to 12 hour window
Wounds close best when the edges are still moist and the tissue has not started to colonise with bacteria. The literature isn't dogmatic about exact numbers, but in practice we like to close clean wounds within 6 hours of injury, and we can usually still close most uncomplicated wounds up to 12 hours. After that the infection risk climbs and we often have to leave the wound to heal by secondary intention (open, slower, more scarring).
So if you cut yourself at 9 pm and the wound looks borderline, don't sit on it until morning — phone us, send a photo if you'd like, and we'll tell you whether you have time to wait until your GP opens or whether tonight is the moment.
Cuts that surprisingly don't need stitches
Plenty of cuts that look dramatic can be managed without sutures:
- Small superficial cuts on the scalp that are well-aligned — we can often use staples or even hair-knotting.
- Small clean cuts on the hands or fingers that are not deep — tissue glue or Steri-Strips work beautifully.
- Shallow cuts on flat skin under 1.5 cm — usually close with a non-stick dressing and time.
If you bring in a small cut and we can close it without a needle, we will. The five-test is for working out which way to lean — not a rule that says everyone needs sutures.
Always come in (or go to ED) for these
- Any bite from another person or an animal
- Any cut with visible tendon, bone, or muscle
- Any cut from glass that may have left fragments embedded
- Any cut where you've lost movement, sensation, or warmth distal to the wound
- Severe bleeding that won't stop with 10 minutes of pressure — go to ED, not us
Children — when to seek same-night assessment
Children's wounds are easier to over-treat and easier to under-treat. Two rules: any cut on a child's face should be reviewed the same night, because the scar will be there a long time. And any cut on a child that needs glue or sutures is much easier to do tonight while you can still hold them calmly than tomorrow when they have anticipated the visit.
What to do in the 20 minutes before you walk in
- Rinse the wound under cool running water for 60 seconds. Tap water is fine.
- Cover with a clean cloth or sterile gauze and apply firm direct pressure if bleeding.
- Elevate the limb above heart level.
- Do not use hydrogen peroxide, iodine, alcohol or table salt to clean — they all delay healing.
- Take a paracetamol or ibuprofen on the way if you can swallow tablets.
- Bring any tetanus records you have (or just tell us your best guess of your last booster).
What a sutured wound looks like at day 1, 3, 7 and 14
Most people see redness for 3 days, mild itching from days 5–10, and a pink scar at 14 days that fades over months. We have a separate article on caring for sutures at home if you'd like the day-by-day version.