All About Stitches

How can I tell if my dog’s wound needs stitches?

If your dog suffers an injury resulting in a fresh wound, one of the first questions likely to cross your mind is “Does this need stitches?” It is a natural and important question, but one that does not always have an easy answer. Many factors help a veterinarian determine which wounds benefit from suturing and which are best left to heal naturally.

Size – The smaller the wound, the less likely it is to need stitches. Exceptions to this might include cuts around sensitive areas such as the eyes, which may be sutured to ensure they heal without impairing the function of the eyelids. Cuts measuring longer than an inch generally need to be closed with stitches.

Depth – Deep cuts, especially those that penetrate the skin completely, often require stitches. Large wounds need to be cleaned and disinfected completely before being closed.

Exposed tissue – If you can see muscle, bone or other underlying structures, the wound likely needs stitches.

Heavy bleeding – Uncontrollable bleeding or a wound that does not stop bleeding within a few minutes requires immediate veterinary care.

Infection – Signs of infection include redness, swelling, heat, discharge and odor. The presence of some or all of these symptoms can indicate a need for veterinary treatment, potentially including stitches.

Location – Wounds on joints, where there is more tension and motion, or on the face (especially if it is a bite wound) may require stitches to prevent issues with healing and proper function. Wounds where the skin is taut, such as the lower legs, are questionable candidates for stitches, since bringing the edges of the wound together may restrict blood circulation.

Bite wounds – These wounds, from dogs or other animals, are prone to infection and should always be checked by a vet to see if sutures are required. Suturing puncture wounds, which are deeper than they are wide, can trap bacteria and other contaminants, resulting in an abscess. Stitches are not usually recommended for puncture wounds.

Extent – Wounds surrounded by bruising, ragged tissue and missing skin can be difficult to close with sutures. These need to be evaluated by your veterinarian to determine the best plan for healing.

What types of suture material are used to stitch up my dog?

Veterinary sutures are classified as either absorbable or non-absorbable, depending on their material and intended use.

Absorbable, or dissolvable, sutures are designed to break down and be absorbed by the body over a period of time. This eliminates the need for them to be removed. They are commonly used for internal stitches, such as closing muscle layers and internal tissues or tying off blood vessels. Examples of dissolvable sutures are natural sutures like catgut and synthetic options like polyglycolic acid (PGA) and polyglactin 910.

Non-absorbable sutures do not dissolve and need to be removed after the wound or incision has healed. They are used for external wounds, where the sutures provide long-term support until the skin has healed sufficiently. Examples are nylon, silk and stainless steel.

The choice of suture material depends on several factors, including the location and type of wound, the tissue being repaired, and the desired healing outcome. A veterinarian will assess these factors to determine the most appropriate suture for the specific situation.

How are wounds or surgical incisions closed?

The surface or skin layer of your dog’s wound or incision may be closed with stitches, surgical glue or staples. The suture pattern that is used to close the skin depends on the length of the wound and how much tension is present across the incision. The sutures may be tied on the surface of the skin (non-absorbable) or they may be buried beneath the skin surface using absorbable suture material.

If a wound or surgical incision extends through several layers of tissue, each layer will be closed separately. This means there may be multiple rows of sutures in a single incision site. The pattern of stitches used depends on the preference of the surgeon closing the wound, as well as the size and location of the wound.

What are the post-operative instructions when stitches have been placed?

Do not allow your dog to jump, play with other dogs, or engage in any strenuous activity that could cause excessive stretching of the suture site, especially during the first few days. Too much activity may cause the sutures to break apart or the incision to bleed.

Do not bathe your dog or allow the incision to get wet. Never apply any cream, ointment, disinfectant or other substance to the incision unless specifically instructed to do so by your veterinarian. NEVER clean the incision with hydrogen peroxide or alcohol, as these products will damage the cells and delay healing.

Do not allow your dog to lick or scratch at the incision, as he may pull the sutures out and could introduce an infection into the incision. Inspect the stitches at least twice daily. The incision should be clean and the edges should be touching each other. It is not unusual for the incision to be slightly redder during the first few days while healing begins.

How can I prevent my dog from licking at the stitches?

The best way to prevent licking at the stitches is to get an Elizabethan collar, also known as an “E” collar, “lampshade” or “cone of shame.” Although awkward, and sometimes a danger to owners’ legs and household objects, they are an effective way to prevent the dog from getting to the stitches. Fit is important, so it is best to take your dog where you plan to purchase the collar so it can be sized correctly.

Inflatable or stuffed “donut” collars are a softer alternative to E-collars. They have a similar shape to the travel neck pillows we use to sleep on planes. These limit the dog’s ability to turn his head and lick. For determined dogs, owners may stack the collars, placing both a donut (or two) and an E-collar.

Recovery suits are garments designed to cover the entire body and prevent access to the wound. For some sutures, a T-shirt or other garment can be used to cover the wound.

Another option is to apply something around the incision to discourage licking. There are many products on the market. Two of the more common are Bitter Apple and Yuk. These are applied to unbroken skin AROUND the incision. Before you apply these products, it helps to give your dog a good full-strength taste of it so he will know how bad the stuff you are painting on him will be.

Solid deodorant will sometimes work to stop licking when applied around the incision. Too much of this is not good for your dog, so if he continues to lick, you will need to find another solution.

Wound dressings can be used to cover the wound, but they should be secured with medical tape. Even the most secure bandages are at risk of being ripped off and eaten by the dog.

Extreme cases may require prescription medications to calm the dog. Ask your veterinarian to prescribe mild sedative drugs to ensure the wounds or incisions are allowed to heal.