Absorbable sutures, commonly known as dissolvable stitches, are specialized threads designed to hold tissue together during the initial healing phase before the body naturally breaks them down and absorbs them over time, thus eliminating the need for a follow-up procedure to remove them. This self-dissolving property makes them highly useful for internal surgical sites and external closures, particularly in pediatric or cosmetic surgery. The body’s process of degrading the material involves enzymatic action or hydrolysis, depending on the suture type. While these materials are selected for their compatibility with human tissue, the introduction of any foreign substance carries a small potential for an immune response. An allergic reaction to dissolvable stitches is a documented complication, though such events are generally infrequent.
The Materials Used in Dissolvable Stitches
Absorbable sutures are broadly categorized into two types based on their source: natural and synthetic. Natural sutures, such as catgut, are derived from purified collagen, often taken from the intestines of cows or sheep. These materials are broken down by the body’s proteolytic enzymes, and because they are animal-derived, they are historically more likely to elicit a stronger inflammatory response or an allergic reaction. Modern medicine favors synthetic absorbable sutures, which are manufactured from polymers designed to degrade through hydrolysis, where water gradually breaks the chemical bonds.
Common examples of these polymers include polyglycolic acid (PGA), polylactic acid (PLA), and polydioxanone (PDO). These synthetic materials are associated with a lower risk of immune system overreaction compared to natural options. The immune system’s reaction is often triggered not by the initial suture material itself, but by specific components released as the polymer breaks down.
As the synthetic suture hydrolyzes, it releases smaller chemical byproducts that the body may identify as foreign antigens. Furthermore, reactions can sometimes be attributed to additives in the thread, such as coatings or the dyes used to make the suture material visible during surgery.
Telling the Difference Between Allergy, Infection, and Normal Healing
Distinguishing between a true allergic reaction, a localized infection, and the expected inflammatory response of normal healing is important for post-operative care. Normal healing involves mild, localized symptoms. Initially, slight redness, a small amount of swelling directly at the incision site, and some gentle tightness or itching are expected. These symptoms tend to peak within the first few days post-surgery and then gradually improve as the wound closes.
A localized surgical site infection, however, presents with symptoms that worsen over time and often include systemic signs. Redness and warmth will spread beyond the incision’s margins, and the area will typically be painful to the touch. The most defining signs of infection are the presence of purulent discharge, commonly known as pus, which may have a foul odor, and the potential for a fever or chills.
A true hypersensitivity reaction to a dissolvable suture often presents differently, usually manifesting several days after the procedure when the suture material begins to degrade. Symptoms of an allergy include persistent, severe itching that may extend far from the wound edges and does not respond to typical wound care. The skin around the incision may appear dry, flaky, or develop a rash, resembling contact dermatitis. Unlike an infection, an allergic reaction often produces a clear, thin, and watery fluid discharge that is sterile, meaning it contains no bacteria. Swelling caused by an allergy tends to linger or even worsen over time, but it will typically not be accompanied by the high fever or intense, spreading warmth associated with bacterial infection.
What to Do If You Suspect an Allergy
If you recognize symptoms that align with a hypersensitivity reaction, contact your surgeon or healthcare provider promptly. Professional medical assessment is necessary to confirm the cause of the reaction and prevent complications. Applying a cool, damp compress to the area can provide temporary relief from the intense itching. Medical management typically begins with non-invasive treatments, such as a topical corticosteroid cream to reduce local inflammation and itching, and oral antihistamines to relieve systemic symptoms. In cases where the reaction is severe or significantly impedes the healing process, the medical team may consider removing any remaining external suture material. This action physically eliminates the source of the immune trigger, allowing the inflammation to subside. For patients with a documented sensitivity, this information is recorded to guide the selection of materials for any future procedures.