A spitting stitch is a common event that occurs after a surgical procedure involving internal, dissolvable sutures. This phenomenon is a sign that your body is reacting to the surgical material, which can be unsettling when it happens on a healing incision line. If you notice a piece of thread or a small bump, understanding the underlying process is the first step toward safe management.
Understanding Spitting Stitches
Spitting stitches result from the body’s immune response to internal, absorbable suture material, which it perceives as a foreign object. Instead of dissolving completely, the body attempts to expel the suture by pushing it through the skin’s surface. This reaction is more common with absorbable sutures (like Vicryl or PDS) designed to break down over weeks or months, unlike non-absorbable stitches meant to stay in place or be removed manually.
A spitting stitch can appear as a small, red bump resembling a pimple or a fine piece of thread protruding from the scar line. This process typically begins weeks to several months after surgery, often long after the initial wound seems healed, around the time the sutures should be dissolving. Although the sight of a stitch emerging can be alarming, it is generally an ordinary part of the body’s healing mechanism.
Immediate Action and Self-Removal Risks
You should not attempt to forcefully remove a spitting stitch yourself. Even if the stitch appears loose, pulling it could introduce bacteria deep into the healing tissue, significantly increasing the risk of infection. A more serious concern is that a portion of the suture may still be securely anchored internally, and pulling could tear delicate, newly formed tissue beneath the skin.
Pulling the stitch can create a larger wound or cause the incision to reopen, a complication known as wound dehiscence. If you only manage to pull out a small segment, the remaining embedded material could continue to irritate the wound, leading to chronic inflammation or a stitch abscess. The goal is to allow the body to work the stitch out passively or have it safely removed by a medical professional.
Proper Management and Care
If you identify a spitting stitch, the safest home management involves supportive care and monitoring. Gently cleanse the area daily with mild soap and water to keep the site clean and prevent bacterial buildup. If the exposed thread is long enough to catch on clothing, cover it with a small, sterile, non-stick bandage to protect the area from friction.
Avoid excessive manipulation, rubbing, or squeezing the bump, as this can worsen irritation and inflammation. Applying a warm, moist compress a few times a day may help encourage the suture material to move closer to the skin’s surface. If the stitch is ready to come out, it often does so naturally within a few days or weeks with this passive care, and the small opening will then close and heal.
When Professional Medical Intervention is Necessary
While a spitting stitch is usually a minor issue, certain signs require immediate professional attention. Contact your surgeon or primary care provider if you notice increasing redness that spreads outward from the site, or if the area becomes noticeably warm and swollen.
The presence of thick, yellow, or foul-smelling pus or discharge strongly indicates a localized infection that needs assessment and possible antibiotic treatment. Other serious symptoms include a persistent or increasing fever, or pain disproportionate to the size of the irritation. A healthcare professional can safely remove the stitch using sterile tools, ensuring the entire piece is extracted to prevent further complications.