Spitting sutures are a common occurrence after surgery, where a piece of internal suture material emerges through the skin. While concerning, it’s generally not serious and often resolves without issues. Understanding why they happen and how to manage them can help alleviate anxiety during the post-operative recovery period.
What Spitting Sutures Are
Spitting sutures, also called “stitch migration” or “stitch rejection,” occur when the body expels suture material used to close an incision. This happens because the body’s immune system recognizes the suture as a foreign object, even if it’s designed to dissolve. Instead of fully breaking down internally, the body sometimes pushes the material to the surface of the skin. This can involve both dissolvable and non-dissolvable stitches.
These sutures typically appear as a small, red, and sometimes tender bump along the incision line, with a visible stitch end protruding. Spitting sutures are a common post-surgical event and do not necessarily indicate poor surgical technique or an infection. They can appear weeks to months after surgery, depending on the suture type and individual healing rates.
Managing Spitting Sutures at Home
If a spitting suture is observed, keeping the area clean and dry is important. Gently wash the affected area with mild soap and water, then pat it dry thoroughly. This helps to prevent irritation and maintain hygiene around the exposed suture.
Avoid picking, pulling, or forcefully removing the suture yourself. Doing so could introduce bacteria, cause further irritation, or disrupt the healing incision. If clothing or other items rub against the site, covering it with a sterile bandage can provide protection. Applying a warm, moist compress to the area might help encourage the stitch to emerge more fully, making it easier for a healthcare professional to manage.
When to Seek Medical Advice
While spitting sutures are often harmless, certain signs indicate a need for professional medical attention. Contact your surgeon or healthcare provider if you notice increased redness spreading beyond the immediate area of the suture. Significant swelling or warmth around the site also warrants evaluation.
Pus or unusual discharge requires prompt medical review. Worsening pain, a fever, or if the opening where the suture is emerging becomes large, are additional “red flags”. If in doubt, seek medical advice.
Medical Treatment Options
When a spitting suture requires medical intervention, a healthcare professional can perform a simple, quick procedure in the office. This usually involves removing the exposed stitch using sterile instruments, such as forceps. The doctor will typically clean the area thoroughly after removal to reduce the risk of complications.
In some cases, a small dressing may be applied to the site where the suture was removed. This procedure is generally minor and causes minimal discomfort, with some professionals opting for a local anesthetic if needed. If an infection or abscess is present, warm compresses may be recommended, and antibiotics might be prescribed after the suture is removed.
Aftercare and Healing
After a spitting suture has been treated, whether at home or by a medical professional, continued wound care for the small opening is important. Keep the area clean and dry, following any specific instructions provided by your surgeon. Regularly monitor the site for any new signs of irritation or potential infection, such as increasing redness or discharge.
The small opening created by the emerging or removed suture typically closes and heals quickly. In most cases, spitting sutures resolve without leading to significant scarring or long-term issues with the incision. Adhering to post-operative care instructions helps ensure proper healing of the affected area.