Usually we just hold the kid down and do the sutures. A topical numbing medicine and then local numbing medication is usually used on kids. If the kid is uncooperative and it's really important that the kid be completely still, then occasionally I will try using ketamine to help calm the kid.

Good luck getting a plastic surgeon to come to a community ED. If you really want a plastic surgeon to see your kid, then go to a big childrens center (and even then you are most likely going to get a surgery resident in the middle of the night). I do find it amusing when parents demand a plastic surgeon in the middle of the night though. My hospital has no pediatricians or plastic surgeons.

DD got them at about 1.5 years old and it was similar to what OP heard. I forget if it was a papoose or if they swaddled her with a blanket, but she had to be restrained. Someone held the body, someone held the head, I entertained and calmed (tried), someone did the stitches. It was overwhelming, but she was completely fine as soon as everyone dispersed and she didn't feel crowded. The stitches were for her forehead.

Ditto plastic surgeon, if you have the option. I cut my knee open as a child at a friend's house. This being the dark ages of the late 70s, they took me back in the ER and started sewing me up before my mother even arrived. Several grownups were holding me down -- very traumatic. Did a terrible job - looks horrible 30+ years later.

Recently my daughter had to have a hemangioma removed from her arm. The dermatologist wanted to remove it in an outpatient procedure but we ended up going to Children's and a pediatric plastic surgeon removed it and put her under. Went very well and scar is truly minimal.

Totally depends on the kid. We have five kids and have plenty of experience in the stitches department. When my oldest was 9, they had to put him in a papoose to put stitches in his foot. He was too big and too strong for anyone to try to hold.

On the flip side, when my youngest was 4 he had to get stitches in his shin. No drama at all. They told him that he had to be very still. And he was.

It is called a papoose, it is like making the kid into a burrito. I believe they only use it for stitches and staples, but not the glue. My kids have had the papoose and it is necessary, esp for a facial injury. For the more extreme stitches one of my kids, he was wrapped in the papoose, the wound was cleaned (mainly flushing it out), the stitches were put in (10), a dressing put on, all done.

If the wound is to the face, you want the steady hands to minimize the scarring. A papoose helps that.