When do you need stitches - upper lip cut?

I had a bike accident this morning - hit a big piece of metal in the road - and am worried about this divet above my lip. I hit my chin, lips,spot between lips and nose, and of course the requisite elbow and hip (but those don't hurt as bad). I cleaned it with bactine and put some antibiotic on it. I got concerned that the divet/hole needed stitches - went to my internist, she said she doesn't "do stitches" but looked at it. She felt it didn't need stitches because it wasn't actively bleeding.

That's fair, but I see on the internet that stitches should be considered if there's a cosmetic concern, and there is -- I don't want a hole in my upper lip! The area is swollen and weeping, now about 10 hours after the accident.

Does anyone have any experience with this kind of wound, and how to judge when you should get stitches (and who do you see for this?).

Thank you; I've been lucky enough in 8 years of riding to have only this accident.

When I was a kid I hit the back of my leg, near my ankle, with one of those old metal spikey pedals that came on 10 speeds. It put a big gouge in my skin, which bled for a while but I was able to make it stop. In retrospect I should have gotten stitches, because I have this decent sized scar. It shrank some as it healed over time, but it's close to what it originally was. So if you're concerned about cosmetics, I'd swing by your local ER.

Generally speaking, a wound more than 4 or 5 hours old is considered contaminated and can't just be sutured. Maybe they will stretch that with some of the newer antibiotics. If you are concerned about the cosmetics, contact a plastic surgeon, some will see you on a same day basis for a small wound. Otherwise you go the the ER & request a referral to a plastic surgeon, if there is not one covering.

Thanks for the info. I went ahead and went to the ER last night, and I'm glad I did. They felt I didn't need stitches, but I had glass and junk in the cuts, so they numbed it and scrubbed it out, trimmed hanging skin, etc. Didn't take but an hour or so.