A surgical stitch, or suture, is a medical device used to hold body tissues together after an injury or operation. The primary function of a suture is to approximate the edges of a wound, closing the gap and providing support during the natural healing process. The duration sutures remain in place is precisely controlled to balance two needs: allowing the wound to gain enough tensile strength, and minimizing the risk of infection and scarring. Removing sutures too early risks the wound reopening, while leaving them in too long can lead to permanent marks or increased infection risk.
Understanding Absorbable and Non-Absorbable Sutures
Sutures are broadly categorized into two types based on their material composition, which determines whether manual removal is necessary. Absorbable sutures are made from materials like natural gut or synthetic polymers such as polyglycolic acid. They are designed to break down harmlessly within the body over time, degraded either through enzymatic activity or hydrolysis. These stitches are often used for internal closures or in areas where a follow-up removal appointment would be difficult.
Non-absorbable sutures are made from durable materials like nylon, silk, or polypropylene, and are resistant to the body’s natural breakdown processes. They are used when long-term tissue support is required or for external skin closures. These sutures must be manually removed once the initial healing is complete, requiring the patient to return for an appointment.
Specific Timelines for Different Body Areas
The amount of time non-absorbable stitches remain in place varies significantly depending on the area of the body. This variation is largely due to differences in blood supply, skin thickness, and the amount of tension the wound is under. The goal is to remove the stitches just after the wound has achieved sufficient strength to hold itself closed.
Face and Neck
Wounds on the face and neck benefit from an excellent blood supply, promoting faster healing. Sutures in these areas are typically removed very early, often within 3 to 5 days, to achieve the best cosmetic result and minimize scarring. Early removal is favored because the skin is thinner, and prolonged placement can lead to visible “railroad track” marks along the suture lines.
Scalp and Trunk
The scalp and the trunk, including the chest and abdomen, have a moderate healing rate compared to the face. Sutures in these locations generally remain in place for a slightly longer period to ensure the wound edges are firmly approximated. The standard removal window for the scalp and trunk is typically 7 to 10 days.
Arms and Legs
For the arms and legs, the skin is thicker and the wound may experience more movement or tension. Stitches require a longer duration here to allow for adequate healing. Sutures placed on the extremities are usually removed between 10 and 14 days after placement. This longer period helps prevent the wound from separating once the support is removed.
Joints and Areas of High Tension
Areas around major joints, such as the knees or elbows, and other high-tension areas like the palms or soles of the feet, are subject to constant stretching and movement. These sites require the longest support to prevent the wound from pulling apart under stress. Stitches in these locations may need to remain in for 14 days or longer, sometimes up to 21 days. It is necessary to follow the precise instructions given by the healthcare provider, as these timelines are general guidelines.
Proper Care While Stitches Are In Place
Proper wound care while the sutures are present is necessary for successful healing and infection prevention. Patients are usually instructed to keep the sutured area clean and dry for the first 24 to 48 hours to allow the initial wound seal to form. After this period, gentle cleansing with mild soap and water is recommended, followed by careful patting dry. Soaking the wound in a bath or pool must be avoided.
Patients must avoid activities that put excessive tension or stretching on the wound edges, as this strain can cause the stitches to pull out prematurely or the wound to separate. Monitor the site closely for signs of a developing infection, which requires immediate medical attention. Signs of infection include:
- Increasing pain.
- Spreading redness, warmth, or swelling.
- Thick, discolored discharge (pus).
- Fever, a bad smell, or red streaks extending from the wound site.
Adhering to these care instructions helps ensure the wound heals properly.
What Happens During Stitches Removal
The manual removal of non-absorbable stitches is a quick procedure typically performed by a nurse or doctor in a clinical setting. The healthcare provider first cleans the area with an antiseptic solution to minimize the introduction of bacteria. The standard tools used are sterile forceps and small, specialized suture scissors.
The provider uses the forceps to gently lift the suture knot away from the skin, creating a small loop of material. They then use the scissors to cut the thread close to the skin on one side, ensuring only the portion of the thread that was beneath the skin is pulled through. The suture is then gently pulled out in a smooth motion, which may feel like a slight tug or minor pressure.
After all stitches are removed, the healthcare provider may apply adhesive strips, commonly known as Steri-Strips, across the incision line. These strips act as a temporary supportive layer, providing additional tensile strength to the newly healed tissue for several more days. Initial scar care, such as sun protection and gentle massage, can begin once the wound is fully closed and approved by the provider.