The decision to seek medical attention for a physical injury can be challenging, especially when the wound is the result of self-injury. The primary concern is always immediate safety, both physical and mental. If you are struggling with thoughts of self-harm or suicide, help is available.
Immediate Assessment: When to Seek Emergency Care
Wound assessment begins by identifying signs that require an immediate call to 911 or a trip to the emergency room. Uncontrolled bleeding is a primary indicator of danger. If the wound is gushing or spurting blood (suggesting arterial involvement), or if bleeding does not stop after 10 to 15 minutes of firm, continuous direct pressure, professional help is necessary. Maintaining pressure for the full time is important, as checking the wound disrupts the natural clotting process.
Immediate medical attention is necessary if you can see deeper structures within the wound, such as yellowish fatty tissue, muscle, bone, or tendon. This indicates the injury has penetrated beyond the skin’s surface layers and carries a high risk of severe infection and structural damage.
If the wound results in a loss of sensation (numbness or tingling below the injury site), possible nerve damage requires urgent evaluation. Emergency care is also needed if you cannot move a limb normally, or if the wound is located on a sensitive area like the neck, chest, abdomen, or near the eyes. Signs of shock, including cold, clammy skin, a rapid pulse, or feeling faint, demand immediate emergency services.
Practical Criteria for Determining the Need for Stitches
Even if the wound does not require emergency care, several characteristics indicate a need for professional closure. Wounds that penetrate through the full thickness of the skin to expose the underlying fat layer typically require stitches for proper healing. A wound longer than half an inch that cannot be easily held closed by pressing the edges together also needs closure.
Gapping is a primary determinant; wounds where the edges pull apart widely will result in a significantly wider and more noticeable scar if left unclosed. Wounds over areas of high skin tension, such as joints like the elbow or knee, frequently require stitches because movement constantly pulls the edges apart. Cuts on the face or hands are almost always stitched, both for cosmetic reasons and due to the density of underlying structures.
The time elapsed since the injury is known as the “golden period” for wound closure. Most wounds must be closed within six to eight hours to minimize the risk of trapping bacteria and causing infection. If a wound is older, a professional may choose delayed closure or allow it to heal naturally after meticulous cleaning. Puncture wounds, which are deep but have a small surface opening, are often left unstitched because closing them can seal bacteria inside, increasing the infection risk.
Essential Wound Care Before Professional Treatment
Once professional medical treatment is determined necessary, immediate care steps should be taken. The first concern is controlling the bleeding, achieved by applying firm, consistent pressure directly to the wound using a clean cloth or sterile dressing. Elevating the injured area above the level of the heart, if possible, can help slow blood flow.
After bleeding is controlled, gently clean the wound to remove debris and reduce infection risk. Rinse the area with cool or lukewarm running tap water and mild soap, avoiding scrubbing the wound itself. Avoid harsh chemicals like hydrogen peroxide or rubbing alcohol, as these substances can damage healthy tissue and impair healing.
If a foreign object is embedded, do not attempt to remove it, as this could cause further damage or severe bleeding. Pad around the object and secure it to prevent movement. Cover the wound with a clean, non-stick sterile dressing until a healthcare professional can perform examination and treatment.
Addressing the Root Cause: Seeking Mental Health Support
The physical healing of the wound is only the first part of recovery; addressing the underlying emotional distress is the necessary next step. Self-injury is often a coping mechanism for overwhelming feelings like anxiety, depression, or emotional numbness, and medical treatment does not resolve the root cause. Seeking support from a mental health professional experienced in treating self-injury is highly recommended.
Therapy, such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT), can help you identify self-harm triggers and develop safer, healthier coping skills to manage intense emotions. A professional can conduct an assessment to determine if underlying conditions like depression or a personality disorder are present, which may be addressed with therapy, medication, or a combination of treatments. Support groups and peer-led services offer a valuable space to connect with others who understand the struggle, reducing feelings of isolation.
If you are currently experiencing a mental health crisis, immediate, confidential support is available 24/7. You can call or text the 988 Suicide & Crisis Lifeline anytime in the United States and Canada, or text HOME to 741741 to connect with the Crisis Text Line.