Dissolvable stitches, also known as absorbable sutures, are medical materials designed to temporarily hold wound edges together during healing. They are commonly used for internal closures, such as after abdominal surgery, or for deep layers of tissue beneath the skin. They are also used externally in areas where follow-up removal would be difficult, such as in the mouth or in children’s wounds. Using these materials eliminates the need for a return visit for manual removal, providing a more convenient recovery.
Why Absorbable Stitches Do Not Need Removal
Absorbable stitches do not require removal because their unique chemical structure allows the body to safely break them down over time. Unlike non-absorbable sutures (like silk or nylon), dissolvable stitches are composed of biocompatible synthetic polymers or purified animal proteins. These materials are engineered to maintain sufficient strength during the initial healing phase, typically the first one to two weeks, before dissolving.
The primary mechanism for the breakdown of synthetic absorbable sutures is hydrolysis. This process involves water molecules penetrating the suture material and cleaving its long polymer chains into smaller, harmless components. The body’s natural metabolic processes then safely absorb and eliminate these fragments. Natural materials, such as catgut, dissolve through a different mechanism involving the body’s proteolytic enzymes, which digest the suture protein.
As the suture loses structural integrity, the body gradually absorbs the material, minimizing the risk of a foreign body reaction or infection. This predictable degradation ensures the stitch supports the healing tissue long enough but disappears once the wound has gained sufficient strength. Suture material selection is based on the tissue type and required healing time.
Factors Influencing Dissolution Time
The time required for absorbable stitches to fully disappear varies widely, ranging from a few days to several months, depending on multiple factors. The type of material used is a significant variable, as synthetic polymers offer different absorption profiles. For example, fast-absorbing gut sutures may lose strength within days and be fully absorbed in about two weeks. Conversely, materials like Polydioxanone (PDS) can provide support for up to six weeks and take up to six months to fully dissolve in deeper tissues.
The location where the stitch is placed also influences the dissolution rate. Stitches in areas with high moisture and blood flow, such such as the mouth or highly vascularized tissues, tend to dissolve faster than those in areas with less circulation. Oral sutures, for instance, break down quicker due to constant exposure to saliva. Conversely, internal stitches placed in low-vascular areas may take longer to fully absorb.
The patient’s overall health and metabolic rate also play a role in the absorption timeline. Factors like infection, which can accelerate the breakdown of some natural sutures, or underlying health conditions such as diabetes, can affect the healing process. Additionally, the physical characteristics of the stitch, including its thickness (gauge) and the tension applied by the surgeon, influence how quickly the material degrades.
Recognizing and Addressing Complications
You should monitor the wound site for signs that healing is not progressing as expected. Contact a healthcare provider immediately if you develop signs of infection, including increasing redness, spreading swelling, or warmth around the wound. Other warning signs are worsening pain, a foul odor, or any unusual discharge, such as pus.
Sometimes, the ends of a dissolvable stitch may become visible or poke through the skin before the suture has fully dissolved, causing mild irritation. If a stitch end is irritating the skin, a healthcare professional can safely trim it. Never attempt to cut or manually remove a stitch yourself, as this can introduce bacteria, lead to infection, or cause the wound to reopen prematurely.
Delayed dissolution occurs when stitches remain intact long past the expected timeframe provided by your doctor. If sutures are still present and causing irritation after the estimated date, seek medical evaluation. A medical professional may need to assess the wound and, if appropriate, manually remove the remaining portion of the suture to ensure proper healing.