Dissolvable stitches, also known as absorbable sutures, are an advancement in wound closure techniques. These specialized threads hold tissue together during initial healing, gradually breaking down and disappearing within the body. Unlike traditional stitches that require manual removal, dissolvable sutures eliminate the need for a follow-up procedure, offering convenience for patients. They are commonly employed in various surgical procedures, from closing internal incisions to managing skin wounds.
How Dissolvable Stitches Function
Dissolvable stitches are crafted from materials the body can naturally absorb and metabolize. These materials typically consist of synthetic polymers like polyglycolic acid, polylactic acid, polyglactin, and polydioxanone, or sometimes natural substances such as purified catgut. The breakdown process primarily occurs through two biological mechanisms: hydrolysis and enzymatic degradation. Hydrolysis involves water molecules chemically breaking down the suture material’s bonds, leading to its gradual disintegration.
Synthetic polymers primarily dissolve through hydrolysis, a predictable and consistent process allowing for reliable absorption timelines. Natural materials, such as catgut, are absorbed through enzymatic degradation, where the body’s enzymes attack the suture material. This enzymatic action can result in a less predictable absorption rate compared to hydrolysis, as it depends on individual enzyme levels and immune responses. The selection of specific stitch material depends on the wound type, location, and the required duration of support during healing.
What Normal Dissolving Looks Like
Initially, dissolvable stitches appear as thin threads holding wound edges together. These sutures can vary in color, appearing clear, white, blue, or green, depending on the specific material and manufacturer. In the days immediately following surgery, mild swelling and redness around the stitch site are typical as the body initiates its natural inflammatory healing response. The sutures remain firmly in place during this initial period, providing necessary support for the wound to begin closing.
As healing progresses over weeks, the appearance of the dissolvable stitches visibly changes. They may start to look looser, shorter, or even appear to be hanging as they begin to break down. The texture of the stitches can become softer, and their color might fade, becoming duller or more transparent. This change signifies the body’s successful absorption of the suture material. Some individuals may also experience a slight itching sensation around the wound as new skin forms and repairs.
Eventually, the stitches gradually shrink and either fall out or are completely absorbed into the surrounding tissue, leaving no visible trace. The exact timeline for absorption varies significantly based on factors such as the surgical procedure, the specific suture material used, the size of the stitches, and an individual’s unique healing capacity. For instance, some stitches might dissolve in a few weeks, while others, particularly those used in deeper tissues, could take several months to fully disappear.
Recognizing Potential Issues
While the body usually absorbs dissolvable stitches without incident, certain visual signs can indicate a potential problem with the stitches or the healing wound. Increased redness and swelling that spread beyond the immediate wound area, rather than improving, can signal an infection. The skin around the wound might also feel unusually warm to the touch, and pain may persist or worsen instead of subsiding. A clear sign of infection is the presence of pus-like discharge, which can be yellow, green, or have a foul odor.
In some instances, an allergic reaction to the suture material can occur. Symptoms may include persistent itching, a rash, or excessive redness extending beyond the wound edges. Bumps or blisters might also form around the stitch site. While mild discomfort is normal, an unusual increase in pain or tenderness could also point to an allergic response.
Another concern arises if the dissolvable stitches do not appear to be dissolving as expected. Stitches might remain intact and prominent long after their anticipated dissolution time, potentially causing irritation or discomfort. Sometimes, a knot from the stitch might protrude from the skin and dry out, preventing it from dissolving properly. Additionally, if the wound edges separate, a condition known as wound dehiscence, this indicates a failure of the stitches to hold the incision closed. This can manifest as broken stitches, a visible gap in the wound, or unusual drainage.
When to Contact Your Doctor
It is important to contact a healthcare provider if there are any signs suggesting a complication with your dissolvable stitches or wound healing. Seek medical attention if you observe worsening redness, swelling, or warmth around the wound, as these are common indicators of infection. The presence of any pus-like discharge, especially if it is thick, discolored, or foul-smelling, warrants immediate medical evaluation.
A doctor should also be consulted if you experience increasing or severe pain that does not improve, or if you develop a fever. If the dissolvable stitches do not appear to be dissolving within the timeframe your doctor provided, or if they are causing significant irritation, it is advisable to reach out. Furthermore, if any part of the wound opens up, if the stitches appear broken or loose, or if you feel a pulling sensation that suggests the wound is separating, prompt medical advice is necessary.