Internal stitches are medical tools used to close wounds and hold tissues together beneath the skin. They support the body’s natural healing process after injury or surgery. A common question is whether these internal stitches can become visible or ‘come out’ of the skin. Understanding this can help alleviate concerns during recovery.
Understanding Internal Stitches
Internal stitches serve to hold body tissues together, facilitating proper healing. These sutures are broadly categorized into two types: absorbable and non-absorbable. Absorbable stitches are crafted from materials the body can naturally break down over time, eliminating the need for manual removal. They are made from various biocompatible substances, including animal proteins like catgut or synthetic polymers such as polyglycolic acid (PGA) and polylactic acid (PLA).
The dissolution process for absorbable sutures occurs through hydrolysis or enzymatic degradation. The time frame for this dissolution varies, ranging from a few days to several months, depending on the material, its size, and the surgical site. Non-absorbable stitches, conversely, are made from materials like nylon or silk that do not degrade in the body. They either remain permanently or are removed by a healthcare professional if accessible, often used for external closures or when long-term tissue support is necessary.
Why Internal Stitches Can Emerge
Internal stitches can occasionally emerge to the skin’s surface, a phenomenon often referred to as ‘spitting a stitch.’ This typically involves absorbable sutures. The body may perceive the suture material, even if biocompatible, as a foreign substance and initiate an inflammatory response to expel it. This natural rejection mechanism is common during healing.
Emergence can happen weeks to months after surgery, often appearing as small pieces or knots of the suture material, rather than the entire stitch. The timing can vary, with some instances occurring 2 to 3 weeks post-operation. Factors contributing to this include the volume of suture material placed superficially, minor localized inflammation, or the body’s efficient healing pushing the material outwards. This process is a normal part of healing.
Recognizing and Responding to an Emerging Stitch
When an internal stitch emerges, it typically appears as a small piece of thread or a knot protruding from the incision line. It might be accompanied by a small, pimple-like bump, localized redness, or a slight feeling of irritation. Some individuals may feel a small prick or a faint sensation, while others might not experience any discomfort. The color of the emerging suture is often clear or white, reflecting the materials used in many absorbable stitches.
It is important to avoid pulling on the stitch, as this can cause further irritation, potentially reopen the wound, or introduce infection. Instead, gently clean the affected area with mild soap and water to maintain hygiene and prevent bacterial buildup. If there is any minor discharge or irritation, covering the site with a sterile bandage can provide protection. In many instances, the emerging stitch will eventually work its way out or dissolve completely.
When to Seek Professional Medical Advice
While an emerging stitch can be a normal part of healing, certain signs indicate the need for professional medical evaluation. Consult a healthcare provider if you notice increasing redness, warmth, or swelling around the wound site. The presence of pus, a foul odor, or persistent and worsening pain are also indicators of a possible infection. These symptoms suggest intervention may be necessary to prevent complications.
Another serious concern is wound dehiscence, which occurs when the surgical incision reopens or separates. Signs of this include significant gapping of the wound edges, broken sutures, or a feeling of something pulling or ripping. Systemic symptoms such as fever or chills also warrant immediate medical attention, as they can signal a broader infection. Excessive bleeding from the site, or if the emerging stitch is causing significant discomfort, are also reasons to seek advice. If you have any unusual symptoms during your recovery, contact your doctor for proper care and to prevent potential issues.