Sutures, commonly known as stitches, are medical devices used to hold body tissues together following an injury or surgical incision. Their main purpose is to close the wound, keeping the edges aligned to allow the body to begin healing. The duration a suture remains in place varies significantly based on the material and the specific anatomical location of the wound. Premature removal risks the wound reopening, while delayed removal can increase the chance of scarring or infection.
Absorbable Versus Non-Absorbable Sutures
The fundamental difference between suture materials determines whether they need to be physically removed after the wound has closed. This distinction is based on the material’s ability to be broken down by the body’s natural processes. Absorbable sutures are designed to provide temporary support before dissolving harmlessly within the body.
These dissolving stitches are typically used for internal closures, such as repairing organs, muscle, or deep layers of tissue. Natural absorbable sutures, like catgut, are broken down through enzymatic degradation. Most modern synthetic types, such as polyglactin 910 (Vicryl) or polydioxanone (PDS), dissolve via hydrolysis. Since they degrade over time, absorbable stitches eliminate the need for a follow-up removal appointment.
Non-absorbable sutures are made from materials like nylon, silk, or polypropylene that resist the body’s breakdown processes. These materials are chosen when long-term tissue support is required, such as in high-stress areas or for securing external skin closures. Since the body cannot dissolve them, non-absorbable sutures must be manually removed once the underlying wound has achieved sufficient tensile strength. If left in place too long, they can cause a reaction in the skin or leave noticeable marks.
Typical Timelines for Non-Absorbable Suture Removal
The timeline for removing non-absorbable sutures is directly related to the rate of healing, which varies across the body. Wounds in areas with excellent blood supply and minimal tension heal faster, requiring a shorter duration for the stitches to remain in place. Conversely, areas subjected to frequent movement or high skin tension need more time to develop enough strength to prevent separation.
The quickest removal times are typically for the face, where sutures often come out within three to five days due to the rich blood supply. Early removal minimizes the risk of scarring since facial wounds achieve adequate strength quickly. The scalp, which also has a good blood supply but experiences moderate tension, generally requires sutures to remain in place for seven to ten days.
For the trunk and upper extremities (chest, abdomen, and arms), the standard removal window is usually between seven and fourteen days. This timeframe allows the wound edges to fuse securely in these moderately mobile areas. Exceeding this period in low-tension areas can sometimes lead to visible ‘railroad tracking’ marks along the incision line.
Wounds on the lower extremities, hands, feet, and over joints require the longest duration due to constant movement and high mechanical tension. Sutures in these areas are often left in for ten to fourteen days, and sometimes up to twenty-one days, particularly over joints or on the palms and soles. A healthcare provider makes the final determination for removal by assessing the wound for proper edge approximation and the formation of a healing ridge.
The Removal Procedure and Post-Stitch Care
The physical removal of non-absorbable stitches is a routine, quick procedure performed by a medical professional. The area is first cleaned with an antiseptic solution to minimize the risk of introducing bacteria into the healing wound. A small pair of sterile forceps is used to gently lift the suture knot away from the skin.
A sterile, sharp scissors is used to cut the thread on one side, as close to the skin surface as possible, ensuring only the external, unexposed part of the suture is pulled through the tissue. The knot is then gently pulled to slide the stitch out, which causes minimal discomfort, often described as a light tugging sensation. The wound is inspected to ensure all material has been removed and that the edges remain securely closed.
After removal, the healing site has only regained a fraction of its final strength, so careful post-stitch care is necessary for the following weeks. Adhesive strips known as Steri-Strips are often applied across the incision line to provide temporary support and reduce tension as the wound continues to strengthen. The wound should be kept clean and dry, and patients must watch for signs of infection, such as increasing redness, swelling, heat, or discharge.
To promote optimal healing and reduce the appearance of the scar, patients are often advised to apply a thin layer of petroleum jelly or an occlusive ointment. Once the wound is fully closed and the adhesive strips have naturally fallen off, gentle scar massage can be started to help break down early scar tissue. Protecting the new scar from the sun with clothing or a broad-spectrum sunscreen is necessary for many months, as ultraviolet light can cause the scar to darken and become more noticeable.