A suture, commonly known as a stitch, is a medical device used to hold body tissues together after an injury or surgical incision. These threads keep the wound edges close, allowing natural healing to occur without tension. When a scheduled removal is missed, the outcome depends entirely on the stitch material and the duration of the delay. Some sutures disappear on their own, but non-removable types left in place can lead to complications.
Understanding Absorbable Versus Non-Absorbable Sutures
The difference between suture types determines the severity of delayed removal. Absorbable sutures are constructed from materials the body can naturally break down and dissolve over time. These materials include natural substances like purified collagen (catgut) or synthetic polymers such as polyglycolic acid (PGA) and polydioxanone (PDO).
The body absorbs these sutures through enzymatic activity or hydrolysis. Because these stitches degrade, they are often used for internal tissues or where follow-up removal is impractical. Delayed removal is generally not a concern, though the body may rarely react negatively during absorption, causing irritation.
Non-absorbable sutures, in contrast, are made from materials like nylon, polypropylene, or silk, which the body cannot metabolize. These stitches provide long-term support for wounds under high tension or for closing the skin’s surface. Since they do not dissolve, they must be manually removed by a healthcare professional, typically within 5 to 14 days. If non-absorbable stitches are not removed, they remain indefinitely, leading to complications.
Short-Term Localized Reactions
When non-absorbable stitches remain past the recommended removal window, localized adverse reactions can begin to appear. The foreign material creates a pathway for external bacteria to colonize the wound site. This increases the risk of localized infection, which may manifest as spreading redness, swelling, or the discharge of pus.
The suture material acts as a constant irritant to the delicate, newly formed tissue, causing inflammation and discomfort. This sustained irritation interferes with the final stages of the healing process. Patients may experience increased tenderness and pain as the skin reacts to the continued foreign body presence.
Risks of Long-Term Retention and Embedding
Leaving non-absorbable stitches in for weeks or months elevates the risk of lasting consequences. The most common issue is embedding, where newly formed skin tissue grows over the suture material. Once the skin encapsulates the stitch, removal becomes substantially more difficult and may require minor surgical intervention and local anesthetic.
Prolonged retention increases the likelihood of noticeable scarring, often described as “suture track scarring” or “railroad tracking.” This pattern occurs because skin cells migrate down the suture material into the deeper tissue, leaving permanent, visible marks along the stitch line. The body may also attempt to isolate the foreign material, leading to the formation of a granuloma—a small mass of inflamed tissue that forms around the stitch.
This chronic foreign body reaction causes persistent inflammation that is difficult to resolve until the suture is completely removed. The longer the stitch is retained, the more prominent the resulting scar is likely to be, compromising the cosmetic outcome of the original wound closure. In rare instances, the prolonged presence of the material can trigger a hypersensitivity or allergic reaction to the specific suture components or dyes.
What To Do If Your Stitches Are Overdue
If your non-absorbable stitches are past their scheduled removal date, the immediate action is to contact the medical office or clinic that placed them. A healthcare professional needs to assess the wound to determine the degree of embedding and check for infection. This assessment decides the safest and most effective method for removal.
Avoid any attempt at self-removal, as this carries a high risk of incomplete removal, introducing bacteria, or damaging the fragile healing tissue. If the stitches have started to embed, professional removal is necessary to minimize pain and prevent further tissue trauma. The healthcare provider can remove the sutures safely and provide guidance on post-removal wound care.