The terms “sutures” and “stitches” are frequently used interchangeably by the general public, leading to common confusion about wound closure procedures. In a medical context, however, these words refer to two distinct components of the healing process. While both are related to closing a wound, one describes the physical device used and the other describes the resulting action or placement. Understanding this distinction provides a clearer picture of how medical professionals manage an injury or surgical incision.
Understanding the Terminology
A suture is the material used to hold tissue edges together, functioning as the medical thread or filament. This sterile device is pre-attached to a curved surgical needle, used to pass the material through the skin and underlying layers. The suture material provides the necessary tensile strength to keep the wound edges approximated while the body heals.
A stitch is the specific loop, knot, or pattern created by a medical professional using the suture material. It represents the action or result of sewing the tissue together. When a patient says they are “getting stitches,” they refer to the entire procedure of having their wound closed. The placement of a single loop of thread secured by a knot is considered one stitch.
Absorbable and Non-Absorbable Materials
Suture materials are categorized based on what happens to them within the body, which dictates where and how they are used. Absorbable sutures break down over time, eliminating the need for manual removal. The body digests these materials, typically through hydrolysis or enzymatic reactions, with absorption times varying from a few weeks to several months.
These dissolving sutures are used for closing internal incisions, deep tissue layers, or where removal would be impractical. Examples include synthetic polymers (Polyglycolic Acid or Polydioxanone) and natural materials like catgut, derived from purified animal intestines. Absorbable sutures allow temporary support to disappear once the tissue has regained strength.
Non-absorbable sutures are made from materials the body cannot break down, retaining their tensile strength indefinitely. These materials (nylon, polypropylene, or silk) must be manually removed after healing or remain permanently within the body. They are preferred for external skin closure, especially on the face to minimize scarring, or in areas of high tension like tendons or fascia.
The choice between a monofilament (single-strand) and a braided (multifilament) material impacts healing. Monofilaments cause less tissue reaction and are less likely to harbor bacteria. Multifilament sutures are easier to handle and offer greater knot security. The surgeon selects the appropriate material based on the wound’s location, depth, and required duration of support.
Common Wound Closure Techniques
The way a surgeon places the stitches depends on the wound’s size, location, and desired cosmetic outcome. The simple interrupted stitch is a common and versatile technique, involving individual stitches tied off separately along the wound line. If one stitch fails, the remaining stitches continue to secure the wound, offering high security and precise tension control.
A continuous or running stitch involves a single strand of suture material used to create a series of connected stitches without cutting the thread between passes. This method is faster to apply and distributes tension evenly across the wound, suitable for long incisions with minimal tension. If the suture material breaks, the closure is at risk of separating.
For optimal cosmetic results, a subcuticular stitch is used, where the suture material is placed just beneath the skin surface within the dermal layer. This technique is applied as a continuous pattern and eliminates external stitch marks, leaving a cleaner scar line. Deep placement allows the knot to be buried, improving the final appearance of the healed wound.
Caring for Stitches and the Removal Process
Proper aftercare for stitches is crucial for minimizing scarring and preventing infection. Patients are instructed to keep the wound site clean and dry, especially during the first 24 to 48 hours. Soaking the wound in water is discouraged until the stitches are removed or fully dissolved.
Signs of infection (redness, swelling, warmth, or discharge) should be reported to a healthcare provider promptly. Non-absorbable stitches require manual removal, and the timeline varies significantly depending on the body part due to differences in blood supply and skin tension.
Sutures on the face, which heals quickly, are often removed as early as three to five days to reduce visible scarring. Stitches on the trunk or scalp typically remain in place for seven to ten days. Areas of high movement or tension (hands, feet, or joints) may need ten to fourteen days to ensure adequate wound strength. Removing stitches too early risks the wound re-opening, while leaving them in too long can lead to “railroad tracking” marks on the skin.
Common Wound Closure Techniques
The choice between a monofilament (single-strand) and a braided (multifilament) material impacts the healing process. Monofilaments cause less tissue reaction and are less likely to harbor bacteria. Multifilament sutures are easier to handle and offer greater knot security. The surgeon selects the appropriate material based on the wound’s needs.
The way a surgeon places the stitches depends on the wound’s size, location, and the desired cosmetic outcome. The simple interrupted stitch is a common and versatile technique, involving individual stitches that are tied off separately along the wound line. If one stitch fails or becomes infected, the remaining stitches continue to secure the wound, offering high security and precise tension control.
A continuous or running stitch involves a single strand of suture material used to create a series of connected stitches without cutting the thread between passes. This method is faster to apply and distributes tension evenly across the wound, making it suitable for long incisions with minimal tension. However, if the suture material breaks at any point, the closure is at risk of separating.
For optimal cosmetic results, a subcuticular stitch is often used, where the suture material is placed just beneath the skin surface within the dermal layer. This technique can be applied as a continuous pattern and eliminates the external stitch marks on the skin, leaving a cleaner scar line. The deep placement allows the knot to be buried, further improving the final appearance of the healed wound.
Caring for Stitches and the Removal Process
Proper aftercare for stitches is crucial for minimizing scarring and preventing infection. Patients are typically instructed to keep the wound site clean and dry, especially during the first 24 to 48 hours following the procedure. Soaking the wound in water, such as in a bath or swimming pool, is discouraged until the stitches are removed or fully dissolved.
Signs of infection, including increasing redness, swelling, warmth, or discharge from the wound, should be reported to a healthcare provider promptly. Non-absorbable stitches require manual removal, and the timeline for this procedure varies significantly depending on the body part due to differences in blood supply and skin tension.
Sutures on the face, which has a rich blood supply and heals quickly, are often removed as early as three to five days to reduce visible scarring. Stitches on the trunk or scalp typically remain in place for seven to ten days, while those on areas of high movement or tension, such as the hands, feet, or over joints, may need to stay for ten to fourteen days to ensure adequate wound strength. Removing stitches too early risks the wound re-opening, while leaving them in too long can lead to “railroad tracking” marks on the skin.