Sutures, commonly known as stitches, are medical devices used to hold body tissue together after an injury or surgery while the natural healing process occurs. Modern medicine frequently uses absorbable sutures, which are designed to gradually dissolve within the body over time, removing the need for follow-up removal. The core question for many patients is whether this dissolution process causes discomfort or pain. Generally, the answer is no; dissolving stitches should not cause sharp, severe, or worsening pain, though they can result in mild and temporary sensations as the wound heals. Understanding the science behind these threads and the typical sensations helps distinguish between a normal healing process and a complication that requires medical attention.
How Absorbable Sutures Work
Absorbable sutures are constructed from specialized materials that the body can safely break down and metabolize. These materials are either natural, such as purified collagen (catgut), or more commonly, synthetic polymers like polyglycolic acid (PGA) or polylactic acid (PLA). The primary mechanism for the breakdown of synthetic sutures is a chemical reaction called hydrolysis.
Hydrolysis involves water molecules penetrating the suture material and slowly breaking the long polymer chains. This gradual chemical process reduces the suture’s tensile strength until it completely disintegrates into smaller, absorbable fragments. Natural materials, conversely, are broken down through enzymatic degradation, where specific enzymes metabolize the material.
The timeframe for complete dissolution varies widely based on the material used, the size of the thread, and the location of the wound. Fast-absorbing sutures may disappear in a few weeks, while some synthetic options can maintain support for several months before full absorption. This predictable, gradual breakdown minimizes trauma to the healing tissue.
Normal Sensations During Dissolution
While the dissolution process is not painful, patients often report minor, expected sensations as the wound matures. The most common sensation is a mild itching around the wound site. This itching is often a sign of active healing, as the body reacts to the foreign material and the formation of new scar tissue.
A feeling of tightness or a slight pulling sensation can also be noticed, particularly as the healing incision contracts and the suture material loses integrity. As the threads break down, small fragments of the suture material may become visible on the skin surface or in wound dressings. These pieces may cause a momentary, minor stinging or tugging sensation just before they detach and fall away.
These minor sensations are temporary and should be manageable without strong pain medication. They are benign indicators that the body is successfully dissolving the sutures and the wound is closing effectively. If any part of the suture knot was placed on the skin’s surface, it will likely dry out and fall off within a few weeks.
Signs That Require Medical Attention
It is important to differentiate the expected mild discomfort of healing from signs of a complication, such as infection or an adverse reaction. Increasing or severe pain, especially if it worsens after the initial post-operative soreness has begun to subside, is a primary red flag. Pain that is disproportionate to the stage of healing should prompt a call to a healthcare provider.
Other warning signs include excessive redness or warmth that spreads beyond the edges of the incision. Swelling that increases rather than decreases, or the presence of thick, cloudy, or foul-smelling discharge (pus) coming from the wound, suggests a possible infection. A fever is another reason to seek immediate medical attention.
These symptoms indicate that the healing process has been interrupted and may require intervention, such as antibiotics or wound care adjustments. Patients should contact their healthcare provider immediately upon noticing any combination of these symptoms to prevent potential complications or a delay in wound closure.