Feeling anxiety about the possibility of an internal stitch tearing after surgery is understandable, especially since these sutures are not visible. Internal stitches are a standard part of many procedures, designed to hold tissue layers together beneath the skin while the body heals. While they are built to be strong and dissolve, complications can occasionally arise. This article provides general information to help you understand the healing process and identify signs that warrant immediate medical evaluation, but it is not a substitute for professional guidance from your surgical team.
Understanding Internal Sutures and Healing
Internal sutures, also known as absorbable stitches, are made from specialized materials that the body’s natural processes break down over time. Unlike external stitches that require removal, these materials, which include synthetic polymers like polyglycolic acid or polydioxanone, are designed to disappear on their own. Their primary function is to support the deep layers of tissue, such as muscle and fascia, during the earliest and most vulnerable phase of wound healing. The time it takes for these sutures to fully dissolve varies significantly based on the material type, size, and location in the body. Fast-absorbing sutures may dissolve within a few weeks, while those used in deeper tissues for prolonged support can take up to six months to fully absorb.
Distinguishing Normal Recovery from Expected Discomfort
The early post-operative period involves sensations that are a normal part of the body’s repair process. It is common to experience mild to moderate pain localized to the incision site, which should gradually improve and be manageable with prescribed pain medication. You may also feel occasional pulling, tightness, or slight itchiness as the underlying scar tissue begins to contract.
Depending on the type of surgery, minor drainage or spotting from the external incision can be expected. This discharge is often clear or a pale pink color and should decrease daily. Swelling and redness around the wound are typical signs of the initial inflammatory phase, but these symptoms should not spread or intensify after the first few days. Normal symptoms consistently lessen over the course of the recovery period.
Key Warning Signs of Internal Stitch Dehiscence
A tear in internal stitches is medically referred to as wound dehiscence. This occurs when the surgical incision separates before the tissue has gained enough strength to hold itself together. This separation can happen in the superficial layers or extend through all layers of tissue, most commonly within the first few weeks after the procedure. Recognizing these symptoms is important, as they indicate a potential complication that requires professional medical assessment.
A sudden, sharp, or worsening pain not relieved by prescribed medication is a major indicator of a potential issue. This pain may be described as a feeling of something “popping,” “ripping,” or shifting internally, which signals tissue separation. Increased or new bleeding from the incision, especially if bright red and heavy, is a serious warning sign.
Signs of infection frequently accompany a stitch failure, as the compromised tissue barrier allows bacteria to enter. These signs include a fever of 100.4°F (38°C) or higher, chills, or a foul-smelling, thick, or cloudy discharge, often yellow or green, draining from the wound. If the external incision begins to visibly separate, widen, or form a gap, this suggests the underlying internal support has failed.
Immediate Steps If a Tear is Suspected
If you suspect internal stitch failure or wound dehiscence, contact your surgeon’s office immediately. Your surgeon is familiar with your specific procedure and can provide the most accurate guidance on whether your symptoms require an urgent visit. It is helpful to document the specific symptoms you are experiencing, including the type of pain, the color and amount of any drainage, and your current temperature.
If you experience heavy, uncontrolled bleeding, a significant visible opening of the wound with tissue protruding, or severe, sudden pain coupled with a high fever, seek emergency medical care immediately. While awaiting professional medical advice, you should avoid strenuous activity, heavy lifting, or movements that put tension on the surgical site. Do not attempt to self-treat the wound, probe the area, or apply unapproved topical medications, as this can introduce infection or worsen the separation.