Sutures, commonly known as stitches, are medical devices used to temporarily hold the edges of a wound together, allowing the natural healing process to bridge the gap. They provide support until the body generates enough new tissue strength to keep the wound closed. Whether these supports need manual removal depends entirely on the type of material used by the medical provider.
Identifying Stitches That Require Removal
The need for a follow-up appointment to remove stitches is determined by whether the suture material is absorbable or non-absorbable. Absorbable sutures are constructed from materials the body can naturally break down and dissolve over time, meaning they do not require manual removal. These materials, such as catgut or synthetic polymers, gradually lose strength as the wound heals and are typically used for internal closures or beneath the skin’s surface.
Non-absorbable sutures are made from durable materials like nylon, silk, or stainless steel, which the body cannot metabolize. These sutures are designed to provide reliable support and must be manually removed once the skin has sufficiently healed. They are often used for external skin closures where they can be easily accessed.
If a wound is closed with non-absorbable material, the surface stitches remain visible until a healthcare professional removes them. Leaving them in for too long can lead to complications, such as increased risk of infection or the material becoming embedded in the skin. The provider will inform the patient which type was used.
The Critical Timing for Suture Removal
For non-absorbable stitches, removal timing is calculated based on the wound’s location and the tension in that area. Removing them too early risks wound dehiscence, where incision edges separate because the new tissue lacks sufficient strength. Delaying removal can cause the material to become embedded in the skin, increasing infection risk and potentially leaving permanent scars.
Wounds on the face, which have excellent blood supply and low tension, heal quickly and typically require removal within three to five days. The scalp and trunk areas, with moderate tension, generally need sutures to remain in place for seven to ten days. Extremities like the arms and legs, which experience more movement and greater tension, require ten to fourteen days.
Areas subjected to high mechanical stress, such as joints or the back, require the longest support time, often needing stitches to stay in for fourteen to twenty-one days. Following the schedule provided by the healthcare provider is important for ensuring adequate healing and minimizing cosmetic impact.
Understanding the Removal Procedure
The process of removing non-absorbable sutures is a quick, generally painless procedure performed by a healthcare professional. The necessary tools are typically a sterile suture removal kit containing specialized scissors and forceps. Before starting, the area is cleaned with an antiseptic solution to reduce the risk of introducing surface bacteria into the healing wound.
The technique involves using forceps to gently lift the knot away from the skin surface, exposing the small loop of suture material closest to the skin. The provider then slips the specialized scissors under this loop and cuts the thread close to the skin. Cutting close to the knot ensures that the contaminated, exposed portion of the suture is not pulled through the underlying healing tissue.
Once the cut is made, the knot is grasped again and gently pulled with the forceps, sliding the remainder of the suture out of the skin. Patients often describe the sensation as a slight tugging, but it is typically not painful since the superficial wound has healed. Afterward, the site is cleaned, and adhesive strips, such as Steri-Strips, may be applied for a few days to provide additional support.