Internal sutures (stitches) are placed beneath the skin’s surface to hold deeper tissue layers together, providing temporary support while the body repairs itself. Worrying about the integrity of these hidden supports is natural during recovery. Understanding the difference between normal healing sensations and the signs of a complication, known as wound dehiscence, is important for a safe recovery and requires knowing the specific symptoms that need immediate medical attention.
The Role of Internal Sutures in Recovery
Internal sutures are specialized materials used by surgeons to bring together tissues beneath the visible incision line. They secure muscles, fascia, and other internal structures, initiating the body’s natural healing process. Sutures are categorized as either absorbable or non-absorbable, though absorbable types are most common internally.
Absorbable sutures are designed to lose tensile strength and break down within the body over time. Materials like polyglycolic acid are dissolved through hydrolysis, a process where water molecules slowly break down the material. The time required for a suture to lose strength and fully dissolve varies widely based on the material, location, and the patient’s health.
Fast-absorbing sutures may break down within a week, while long-absorbing materials like polydioxanone can maintain support for up to six months. The suture provides adequate support until the tissue has regained strength on its own. This initial support prevents the wound from separating, making the early post-operative period the most vulnerable time for complications.
Recognizing Warning Signs and Serious Symptoms
The most concerning complication is wound dehiscence, the separation or reopening of the surgical incision, often starting with internal suture failure. Normal post-operative discomfort includes mild pain that gradually improves, a sensation of mild pulling or itching, and localized swelling that slowly subsides. These feelings are manageable with prescribed medication and indicate the inflammatory phase of healing.
A significant warning sign is a sudden, sharp spike in pain, especially a tearing or popping sensation within the wound area. This feeling suggests the internal stitching has failed, allowing underlying tissues to separate. Pain that suddenly worsens or becomes disproportionately severe, rather than steadily improving, also suggests a potential problem.
Visual and physical changes at the surgical site are important indicators of complications. Look for new or excessive bleeding that quickly saturates the dressing. A sudden increase in discharge, particularly if it is thick, cloudy, foul-smelling, or pus-like, can signal infection, which often contributes to dehiscence.
A noticeable change in the wound’s appearance, such as new bulging beneath the skin or a visible separation of the outer incision edges, indicates that deeper layers are no longer held together. Systemic signs of infection, such as persistent fever, chills, or a general feeling of being unwell, also require immediate evaluation.
When to Seek Emergency Medical Attention
If you suspect a complication, contact your surgeon’s office immediately for guidance. However, certain symptoms require bypassing the office and heading directly to an emergency room. Immediate action is necessary for life-threatening situations where a delay could compromise recovery.
An emergency room visit is required for heavy or uncontrolled bleeding that does not stop with light pressure. A sudden, complete separation of the wound, especially if tissue or organs are protruding (evisceration), is a severe emergency. Do not attempt to push tissue back; cover the area with a clean, moist cloth and seek emergency care immediately.
Other urgent symptoms include signs of shock, such as lightheadedness, rapid heartbeat, or confusion, which may indicate significant blood loss or severe systemic infection. Emergency medical professionals will perform a physical examination and may order imaging tests, such as an ultrasound or CT scan, to assess internal tissues. Prompt diagnosis and intervention are essential, as complications like dehiscence can quickly worsen without proper management.