Management of Itching at Laceration Repair Sites with Stitches
For itching at a laceration repair site with stitches, apply hydrocortisone cream (0.5-1%) to the affected area up to 3-4 times daily to provide relief. 1
First-Line Interventions
- Topical hydrocortisone (0.5-1%): Apply thinly to the area around (not directly on) the stitches 3-4 times daily as needed 1
- Cool compresses: Apply for 10-15 minutes several times daily to reduce inflammation and itching
- Sitz baths: If appropriate for the location, twice daily until the first wound check 2
- Avoid scratching: Prevent wound disruption and potential infection
Wound Care Considerations
For Mild Itching
- Keep the wound clean and dry
- Avoid using alcohol-containing lotions or gels which can increase dryness and itching
- Use oil-in-water creams or ointments for moisturizing the surrounding skin 2
For Moderate to Severe Itching
- Consider oral antihistamines such as cetirizine, loratadine, or fexofenadine for more significant pruritus 2
- For persistent symptoms, urea- or polidocanol-containing lotions may provide additional relief 2
Special Considerations
Timing of Interventions
- Itching often increases as healing progresses, particularly 3-5 days after suturing
- Most intense itching occurs during the proliferative phase of wound healing
- Facial sutures should be removed after 5-7 days to minimize scarring while ensuring adequate wound healing 3
Warning Signs
- Monitor for signs of infection that may accompany itching:
- Increasing redness extending beyond wound edges
- Increased pain
- Purulent discharge
- Fever
- Wound dehiscence
Wound Characteristics Associated with Increased Itching
- Larger wounds tend to itch more 4
- Wounds with moderate amounts of exudate 4
- Wounds with tissue edema 4
- Wounds with granulation tissue in the base 4
Pitfalls to Avoid
- Do not apply hydrocortisone directly on open wounds - only on intact skin around the wound
- Do not scratch the wound - this can disrupt healing, introduce infection, and worsen scarring
- Avoid alcohol-based products near the wound as they can cause drying and increase itching 2
- Do not remove sutures early due to itching - this can lead to wound dehiscence
Long-Term Management
- After suture removal, continue moisturizing the area to prevent dryness
- Protect healing wounds from sun exposure with SPF 30+ for at least 6 months to prevent darkening 3
- Consider gentle massage with moisturizer after complete healing (2-4 weeks) to help with scar remodeling 3
Remember that while itching can be uncomfortable, it's often a sign of normal healing. Proper management can significantly improve comfort while allowing the wound to heal optimally.