Spitting sutures, also known as “spitting stitches,” frequently occur after surgery involving absorbable internal sutures. This happens when the body recognizes the suture material as a foreign entity, triggering a localized reaction. Although seeing a stitch protrude from a healing incision can be alarming, it is generally a minor complication of the recovery process. Proper care for the site is important for ensuring optimal healing and preventing secondary issues.
The Mechanism of Spitting Sutures
Surgical wounds are closed in layers, often using both non-absorbable and absorbable sutures. Deep, internal layers are typically closed with absorbable sutures, which are designed to break down gradually over weeks or months. Sometimes, the body’s immune system mounts a localized inflammatory response against this buried material. This foreign body reaction attempts to isolate or expel the unrecognized material.
The resulting inflammation and pressure push the suture filament toward the path of least resistance, usually the incision line. The suture then protrudes through the skin’s surface, which is the event known as “spitting.” This process most commonly occurs within the first three months post-operatively, though it can happen later with long-lasting materials. Spitting sutures are a sign of the body’s natural rejection process.
Safe Home Management and Care
The first step in managing a spitting suture is maintaining strict wound hygiene to prevent bacteria from entering the small opening. Gently wash the area daily with mild, unscented soap and clean water, avoiding vigorous scrubbing or high-pressure water streams. After cleaning, pat the incision dry with a clean cloth or gauze, ensuring the area remains moisture-free.
If the exposed material is short and not causing irritation, the best approach is to let it fall out naturally as the body continues to expel it. If the exposed suture is long, causes discomfort, or catches on clothing, you may consider trimming it after consulting your surgeon. Trimming should be done with sterilized, sharp scissors, cutting the thread as close to the skin’s surface as possible. Never attempt to forcefully pull out a suture that resists gentle traction, as this can damage the healing wound.
Applying a thin layer of plain petrolatum or an antibiotic ointment, if recommended by your healthcare provider, can help keep the exposed area protected. Cover the site with a sterile, non-adhesive dressing or bandage to shield it from external contaminants and friction.
Recognizing When to Seek Medical Help
While a spitting suture is usually an expected part of healing, certain signs indicate a complication requiring professional medical attention.
Signs of Infection
- Increasing pain, warmth, or redness that spreads outward from the incision line.
- The presence of thick, yellow, or green discharge, especially if it has a foul odor.
- Systemic symptoms, such as a fever above 100.4°F (38°C) or chills.
Another serious complication is wound dehiscence, which occurs if the wound edges separate or open up. If you notice any significant gapping or separation along the incision, contact your surgeon right away.