Mohs micrographic surgery precisely removes cancerous tissue while preserving the maximum amount of healthy skin. After the cancerous cells are cleared, the resulting surgical wound is closed using stitches, or sutures, to hold the skin edges together and minimize scarring. The duration these stitches remain in place is not uniform, depending on several physiological and surgical variables unique to each patient and procedure.
Factors Influencing Stitch Duration
The stitch removal timeline is primarily determined by the anatomical location, which affects the skin’s thickness, blood supply, and tension. Areas with excellent blood flow and minimal movement heal faster, allowing for earlier suture removal. The size and depth of the wound also play a role, as deeper defects require more time for underlying tissues to establish strength.
The type of surgical repair is another major consideration. Complex reconstructions, such as skin flaps or grafts, require longer support from stitches compared to a simple side-to-side closure. This extended duration ensures the transferred tissue remains securely fixed and viable while new blood vessels establish themselves. Patient health and lifestyle, including smoking or certain medical conditions, can also impair healing and extend the required stitch duration.
Typical Timelines Based on Surgical Site
Stitches on the face or scalp are removed sooner due to the rich blood supply, which accelerates healing. For facial sites, including the nose, eyelids, and forehead, sutures are often removed within five to seven days. This shorter duration minimizes the appearance of “track marks,” which are small stitch scars along the incision line. Wounds on the ears or neck, where skin tension is slightly higher, typically require stitches to remain for seven to ten days.
Surgical sites on the trunk, chest, back, upper arms, or thighs have an intermediate healing time because the skin is thicker and experiences more movement. Stitches in these locations are kept for ten to fourteen days to allow the deeper layers of the wound to gain strength. Removing them too early increases the risk of the wound separating or stretching, leading to a wider scar.
The longest duration for stitches is reserved for the lower legs, feet, and areas subject to constant motion, such as the shoulder or knee. Due to poorer circulation and the effects of gravity and movement, wounds on the lower legs may require stitches to remain for fourteen to twenty-one days. This extended period ensures the skin edges are fully approximated and the newly formed collagen fibers develop a stable bond against mechanical strain.
Caring for the Wound After Stitch Removal
Once sutures are removed, the newly closed incision remains vulnerable and requires diligent care for the best cosmetic outcome. Surgeons often apply adhesive strips, called Steri-Strips, immediately afterward to provide continued support to the incision line. These strips should be kept dry for the first day, and they usually fall off on their own within one week.
Patients should avoid strenuous activity that causes pulling or stretching of the surgical area for several weeks while the incision’s internal strength develops. Scar management begins about one month after surgery, once the initial healing phase is complete. Gentle massage of the scar with a moisturizing ointment or silicone product helps soften the tissue and encourage flattening. Protecting the healing skin from ultraviolet radiation is necessary, as sun exposure can cause the developing scar to become permanently darkened. Applying a broad-spectrum sunscreen with an SPF of 30 or higher daily is recommended once the wound is fully closed.