Closing a wound is a fundamental aspect of healing, designed to bring tissue edges together to minimize infection and promote optimal repair. This procedure, known medically as suturing, involves placing specialized materials across a laceration or incision to hold the edges in close alignment. While most people understand the goal is to close the injury, confusion often exists between the terms used to describe the materials and the action itself. Understanding the precise language used in a clinical setting helps clarify the steps involved in wound management.
Clarifying the Terminology
The distinction between “sutures” and “stitches” is primarily one of technical definition versus common usage. In medical practice, a suture refers to the sterile material—the thread or strand—used by the practitioner to close the wound. Sutures are specialized tools, ranging from synthetic polymers to natural fibers, designed to hold tissue together temporarily or permanently. The term stitch, in a clinical context, describes the actual physical loop, knot, or bite of material placed into the tissue. While a patient may say they are “getting stitches,” the medical professional is performing a suturing procedure using suture material, with the resulting loops being the stitches.
The Materials Used in Suturing
Sutures are broadly classified into two main categories based on how the body interacts with them over time: absorbable and non-absorbable. The choice between these types depends on the location of the wound and the required duration of support for the healing tissue.
Absorbable sutures are designed to lose their tensile strength within 60 days and are eventually broken down and digested by the body, typically through hydrolysis or enzymatic reactions. These materials, which include synthetic polymers like Polyglycolic Acid or Polydioxanone, are used for internal wounds and deep tissue layers where manual removal is impractical. They provide temporary support until the underlying tissue has sufficient strength.
Non-absorbable sutures resist degradation by the body’s tissues, utilizing materials such as nylon, polypropylene, or silk. These sutures maintain their structural integrity and are used for skin closures, areas under high tension, or tissues that heal slowly, like fascia or tendons. If placed externally on the skin, these materials must be manually removed once the wound edges are sufficiently healed.
Different Methods of Wound Closure
The manner in which suture material is applied is known as the suturing technique, which varies based on the wound’s depth, tension, and the desired cosmetic outcome. Interrupted sutures involve placing and individually knotting each stitch, providing excellent wound security because if one knot fails, the others remain intact. In contrast, a continuous or running suture uses a single strand of material to create a series of stitches, allowing for faster closure of the wound. Clinicians may choose a subcuticular technique, which places a continuous stitch just beneath the skin’s surface, to achieve a more favorable cosmetic result.
Beyond traditional suturing, several alternative methods exist for wound closure. Surgical staples are often used for scalp or long incisions, offering rapid closure and high tensile strength. For small, low-tension lacerations, tissue adhesives (surgical glue) or sterile skin tapes can provide adequate closure while avoiding the need for a needle.
Post-Suture Care and Removal
Proper care of the sutured wound is necessary to prevent infection and promote the best possible healing outcome. Patients are typically instructed to keep the wound clean and dry for the first 24 to 48 hours to allow the initial seal to form. After this period, gentle cleaning and the application of an antibiotic ointment may be recommended to keep the area moist and reduce scab formation.
Non-absorbable sutures placed on the skin surface must be removed once the wound is stable, a process performed by a healthcare professional. The timing for removal is dependent on the body location, reflecting the different healing rates of various tissues. For instance, sutures on the face, which has a rich blood supply, are often removed relatively early, typically between three and five days. Sutures on the extremities or over joints, which experience more movement and tension, may remain in place for a longer duration, often between 10 and 14 days, to ensure adequate strength has developed. Since absorbable sutures are designed to dissolve, they do not require a separate removal appointment.