The Leeds Teaching Hospitals NHS Trust

Suturing of facial lacerations

This leaflet has been designed to improve your understanding of your forthcoming treatment and contains answers to many of the common questions. If you have any other questions that the leaflet does not answer or would like further explanation please ask a member of the medical or nursing staff.

The problem

You have a cut on your face which needs to be stitched. The doctor who has examined you has already decided that it is too big to be glued or taped. The treatment that is about to take place involves a general anaesthetic, ie: you are about to be put to sleep completely.

What does the operation involve?

Once you are asleep the wound will be cleaned before it is stitched. The wound is usually closed in several layers, ie: some stitches are placed underneath the skin to hold the deeper tissues together before the skin surface is stitched. The deeper stitches are made of a dissolvable material, and so they do not need to be removed since they disappear on their own.

At the end of the operation a dressing may be put over the wound.

What can I expect after the operation?

It is unlikely to be very sore but regular painkillers will be arranged for you. If any discomfort occurs it is usually worse for the first few days.

There is a variable amount of swelling and bruising that can occur depending on the site of your cut. It is usually most noticeable with wounds around the eyelids and can last 48 hours. Swelling and bruising can be improved by sleeping propped upright for the first few days after surgery.

Depending on the size of the cut that is stitched you may leave hospital on the day of surgery or need to stay overnight. It might be necessary to give you antibiotics to make sure that the wound heals without any infection. These may be given through a vein in your arm whilst you are in hospital. You will be sent home with painkillers and a course of antibiotics if necessary.

Before you leave hospital an appointment will be arranged to take out the skin stitches and review you in the outpatient department. It is important to keep any stitches or dressings dry until they are removed.

Do I need to take any time off work?

Depending on the nature of your work it may be necessary for you to take a week or so off and avoid strenuous exercise for this time. It is important to remember that you will not be able to drive or operate machinery for 48 hours after your general anaesthetic.

What are the possible problems?

• Bleeding from the wound is unlikely to be a problem but should it occur when you get home it can usually be stopped by applying pressure over the site for at least 10 minutes with a clean rolled up handkerchief or swab.

• The wound will appear red for several weeks after removal of the stitches. This is normal. Sometimes there is a little bit of discomfort from the scar when the deeper stitches dissolve a few months after they have been put in.

• A small number of people need revision of the scar if they are unhappy with its final appearance. This is not normally carried out until at least six months after the wound was first stitched since it can take this amount of time for the final appearance of the scar to be apparent.

• Occasionally people can have an excess of scar tissue (hypertrophic scar or keloid). This is very unusual but may require further treatment.