Surgical sutures, commonly called stitches, are threads used to hold tissue edges together after an injury or operation, allowing the body to heal. Their purpose is to close a laceration or incision, which stops bleeding, reduces infection risk, and minimizes scarring. When a patient receives a count like 14 stitches, this number reflects the required closure technique, not the wound’s severity. The focus should be on the characteristics of the wound being closed, not the quantity of sutures.
What Determines the Number of Stitches
The length of the laceration is the most direct factor influencing the stitch count. Each stitch is typically spaced a uniform distance apart to distribute tension evenly along the wound line. A long cut closed with a single layer of sutures will require more individual stitches than a shorter one. However, the technique aims to use the fewest number of stitches possible while still closing the wound without excessive tension.
Wound depth also significantly impacts the overall closure, often necessitating a layered closure. This technique involves placing dissolvable sutures deep below the skin’s surface to bring underlying tissues, such as the dermis or subcutaneous fat, back together. These internal sutures reduce tension on the outermost layer of skin. A deep, complex wound may require many internal stitches that are never counted in the final tally given to the patient.
The location on the body also plays a significant part in the number of sutures used. Areas that experience high movement, like joints, or areas with high cosmetic importance, like the face, require more meticulous and often closer-spaced sutures. This technique achieves a better aesthetic outcome and prevents the wound from pulling apart. On the face, sutures may be placed closer together to precisely align the skin edges, promoting minimal scarring, which increases the total count for a relatively short length. Minimizing tension on the skin edges is crucial to prevent dehiscence and thickened scarring.
Standard Healing Timeline and Care
The timeline for removing non-absorbable sutures varies greatly depending on the wound location, reflecting different rates of blood flow and skin regeneration. Wounds on the face, which has a rich blood supply, typically heal quickly, and stitches are removed between five and seven days. Conversely, areas on the trunk, arms, and legs usually require sutures to remain in place for ten to fourteen days to ensure adequate healing strength.
Joints and areas under constant movement, where the skin is stretched, may require sutures to stay in for a longer period, sometimes up to fourteen to twenty-one days, to prevent the wound from reopening. After the initial twenty-four hours, most surgical wounds can be gently washed with mild soap and water, then patted dry with a clean cloth, unless otherwise instructed. Proper post-operative care, including keeping the area clean and dry, supports the body’s healing process.
Some mild pain, swelling, and redness are expected during the first few days as the body initiates its inflammatory response. The wound should not be pulled, rubbed, or tugged, and dressings should be changed according to instructions. A physician determines the best time for suture removal by assessing the wound’s healing progress and the patient’s overall health.
Recognizing Potential Complications and Scarring
Any signs of worsening pain, increasing redness spreading outward from the incision line, or a feeling of warmth around the stitches can indicate a potential complication. Immediate medical attention is required for thick, cloudy discharge (yellow or green), a foul odor emanating from the wound, or a fever greater than 100.4°F. Fever or chills can signal a systemic infection, meaning the bacteria have spread beyond the wound site.
Scar formation is a natural part of healing, but two types of abnormal scars can occur: hypertrophic and keloid scars. A hypertrophic scar is a raised, thickened scar that remains within the boundaries of the original injury. A keloid is a more aggressive type of scar tissue that grows beyond the edges of the original wound, sometimes expanding over time.
The number of stitches does not directly determine the final appearance of the scar; proper wound closure and post-suture care are more important. Once the wound is fully closed, scar management techniques such as applying silicone sheets or gel can help flatten and soften the tissue. Protecting the healing area from sun exposure with sunscreen is highly recommended, as ultraviolet light can cause the scar to become permanently darker.