Dissolvable stitches are a common medical tool used to close wounds, providing support during healing without requiring removal. These specialized sutures are designed to be safely broken down and absorbed by the body over time, making them useful for internal tissues or areas where stitch removal would be difficult.
Understanding Dissolvable Stitches
Dissolvable stitches, also known as absorbable sutures, are made from materials the body can naturally metabolize. These materials can be natural, such as purified collagen derived from animal intestines, or synthetic polymers like polyglycolic acid (PGA), polylactic acid (PLA), polyglactin 910 (Vicryl), polydioxanone (PDS), and poliglecaprone 25 (Monocryl). The way these stitches dissolve depends on their composition.
Synthetic sutures primarily break down through hydrolysis, where water molecules in the body gradually penetrate and break chemical bonds within the suture material. Natural sutures are degraded by the body’s own enzymes, which metabolize the material into smaller components that can be absorbed. This controlled breakdown ensures the wound remains supported until it gains sufficient strength to hold itself together.
Factors Influencing Dissolution Time
The time it takes for dissolvable stitches to disappear varies considerably based on several factors, primarily the type of material used. Different suture materials are engineered with specific degradation rates to match the healing time needed for various tissues. For instance, fast-absorbing catgut sutures dissolve within 10 to 21 days, though chromic catgut, treated to slow absorption, can last up to 90 days.
Synthetic sutures generally have more predictable dissolution times. Polyglycolic acid (PGA) stitches usually dissolve within 60 to 90 days. Polyglactin 910 (Vicryl) sutures typically absorb within 56 to 70 days, while a faster-absorbing variant, Vicryl Rapide, fully dissolves in about 42 days. Poliglecaprone 25 (Monocryl) sutures take approximately 90 to 120 days for complete absorption. The slowest-absorbing synthetic sutures, such as polydioxanone (PDS), can take 180 to 210 days for complete absorption.
The location of the stitches also plays a role. Areas with a rich blood supply, such as the face or inside the mouth, dissolve stitches faster due to increased metabolic activity and moisture. Oral stitches, for instance, often dissolve within 7 to 14 days due to the moist environment and enzymes in saliva. Stitches in areas of high tension or movement may also have different dissolution rates.
An individual’s overall health and healing capacity influence how quickly stitches dissolve. Factors like age, nutritional status, immune response, and metabolic rate affect the body’s ability to break down and absorb the suture material. The type and size of the wound can also influence the local environment.
What to Expect During Dissolution
As dissolvable stitches begin to break down, individuals may notice changes around the wound site. The stitches might feel less tight, and small fragments of the suture material may become visible on the surface of the wound or in dressings. This indicates the body is actively absorbing the material.
It is common to experience itching or discomfort as the stitches dissolve and the wound heals. These sensations are usually a normal part of the healing process as new tissue forms. While some stitches may loosen or even poke out from under the skin, this is typically not a cause for concern unless accompanied by other worrying signs.
When to Seek Medical Advice
While stitch dissolution is generally a smooth process, it is important to monitor the wound for signs of complication. Certain symptoms warrant immediate medical attention, including increased pain, redness, or swelling around the wound that worsens over time.
The presence of pus or a foul-smelling discharge from the wound is a warning sign of infection. A fever or chills can also indicate a spreading infection and should prompt medical consultation.
If the stitches do not dissolve within the expected timeframe, or if the wound edges begin to re-open or separate, seek medical advice.