Sutures, or stitches, are medical materials used by surgeons to close surgical incisions and help the body heal. The deeper layers of a wound are often closed using absorbable sutures, which are designed to naturally dissolve within the body over time. Spitting stitches occurs when the body expels this buried, absorbable suture material to the skin’s surface instead of breaking it down completely. This phenomenon is a common, benign post-surgical occurrence because the body views the suture as a foreign object and attempts to push it out.
Identifying Spitting Stitches
Spitting stitches exclusively involves absorbable sutures placed beneath the skin to hold deeper tissue layers together. Unlike non-absorbable sutures, which must be manually removed, absorbable materials are meant to be metabolized by the body. In some cases, the body’s natural inflammatory response, known as a foreign body reaction, acts to isolate and expel the material instead of fully dissolving it.
The appearance of a spitting stitch is typically subtle and can be easily mistaken for a minor skin irritation. Patients often notice a small, raised bump along the incision line, which may have slight redness or feel like a sharp spot. Sometimes, the material presents as a small white or clear thread protruding from a tiny opening in the skin, resembling a persistent pimple.
The underlying mechanism of this rejection involves a cellular effort to push the material through the path of least resistance, which is often the incision line itself. While the suture is designed to break down through hydrolysis or enzymatic processes, the body’s localized reaction can interrupt this process.
The Typical Healing Timeline
The process of a suture becoming a spitting stitch does not usually begin immediately after surgery. This event typically occurs weeks or even months after the initial procedure, often when the body is actively breaking down the deep sutures. Depending on the specific type of absorbable material used, the spitting process commonly starts anywhere from three weeks to three months post-operation.
The duration of the spitting event itself is variable, depending on how much material the body needs to expel. Once the suture material has fully surfaced and been removed or shed, the small opening it created will heal quickly. Healing of this specific site is usually rapid, often closing completely within a few days to a couple of weeks.
The process of the body pushing out the material is self-limiting and will stop once all the rejected suture is expelled from that particular site. The timeframe for the entire process, from the first sign of a bump to the final closure of the small wound, is generally short once the material is visible.
Recognizing Signs of Complication
While a spitting stitch is a normal occurrence, it is important to distinguish this process from an actual infection or a more significant wound problem. Normal spitting is usually accompanied only by mild, localized irritation and a small amount of clear or light fluid discharge. The surrounding redness should remain confined to a small area immediately around the protruding stitch.
Red flags that suggest a true infection or complication necessitate immediate contact with a healthcare provider. Signs such as redness that rapidly spreads away from the incision line or a pronounced feeling of warmth in the area are concerning. An increase in pain that is disproportionate to the small site of irritation should also be reported.
Other signs of a developing infection include a discharge that is thick, pus-filled, or foul-smelling, which is distinctly different from the thin, clear fluid sometimes seen with simple suture rejection. A fever or general feeling of illness indicates that the infection may be spreading. Any instance where a large section of the wound reopens or the edges separate, a condition called dehiscence, requires urgent medical evaluation.