Dissolvable stitches are a common medical tool used to close wounds and surgical incisions. Designed to be absorbed by the body over time, they eliminate the need for manual removal. This absorption process is often misunderstood, leading to questions about whether these stitches truly dissolve or simply fall out.
Understanding Dissolvable Stitches
Dissolvable stitches, also known as absorbable sutures, are crafted from specialized materials the body can naturally break down. These include natural polymers, such as purified catgut, and synthetic polymers like polyglycolic acid (PGA), polylactic acid (PLA), polyglactin 910 (Vicryl), and polydioxanone (PDS). Their primary function is to hold wound edges together, providing temporary support until the body’s natural healing processes create sufficient tissue strength. Unlike non-dissolvable stitches, which require removal, absorbable sutures gradually lose integrity and are absorbed, leaving no foreign material behind.
The Dissolution Process
Dissolvable stitches generally dissolve within the body rather than falling out as complete strands. While small fragments might occasionally become visible or expelled, the primary mechanism involves a controlled biological breakdown. Synthetic dissolvable stitches break down through hydrolysis. During this process, water molecules penetrate the suture material, chemically breaking its bonds into smaller, harmless components. These components are then absorbed and processed by the body.
Natural dissolvable stitches, such as catgut, are absorbed differently, primarily through enzymatic degradation. The body’s enzymes, specifically proteolytic enzymes, attack and break down the suture material’s protein structures. This action reduces the stitch into smaller molecules, which the body then metabolizes and eliminates. Both hydrolysis and enzymatic degradation ensure sutures are gradually and safely integrated back into the body.
Expected Timelines for Disappearance
The timeline for dissolvable stitches to disappear varies significantly, influenced by several factors. The material type is a primary determinant, as different polymers have distinct degradation rates. For instance, polyglycolic acid (PGA) sutures typically dissolve within 60 to 90 days, while polylactic acid (PLA) can take 90 to 120 days. Natural catgut sutures dissolve much faster, usually within 10 to 21 days, and polyglactin 910 (Vicryl) takes approximately 56 to 70 days. Polydioxanone (PDS) is a slower-dissolving material, often taking 180 to 210 days to be fully absorbed.
Beyond the material, wound location also plays a role; stitches in areas with higher movement or moisture, such as the mouth, may dissolve more quickly. The specific surgical procedure, wound size and depth, and an individual’s overall health and healing rate also affect the dissolution timeline. While some stitches may be gone in a few weeks, others, especially those in deeper tissues, can take several months to fully disappear.
What to Expect During Dissolution and When to Call a Doctor
As dissolvable stitches break down, individuals may notice a few common signs. The wound might feel less tight as sutures lose strength, and small fragments of stitch material may sometimes appear on the skin surface. Mild itching or discomfort around the wound is also a normal part of the healing process as stitches dissolve. These observations generally indicate the body is successfully absorbing the sutures.
It is important to monitor the wound for any signs of complication. Increased pain, persistent or spreading redness, swelling, or warmth around the incision site are concerning symptoms. Pus, unusual discharge, or fever also warrant immediate medical attention, as these can be signs of infection. If stitches take an unusually long time to disappear without healing, or if the wound reopens, consult a healthcare professional.