Dissolvable stitches, also known as absorbable sutures, are a common medical tool for closing wounds and surgical incisions. Designed to gradually break down within the body, they eliminate the need for manual removal. While convenient and aiding healing, concerns arise if they don’t dissolve as anticipated. This article explores how dissolvable stitches work and what happens if their absorption is delayed.
How Dissolvable Stitches Work
Dissolvable stitches are made from biodegradable materials the body naturally breaks down. These often include synthetic polymers like polyglycolic acid (PGA), polylactic acid (PLA), polyglactin 910 (Vicryl), and polydioxanone (PDS). Natural materials like catgut, from animal intestines, are less common now.
Sutures break down through two primary mechanisms. Synthetic materials dissolve via hydrolysis, where water molecules break chemical bonds. Natural materials, like catgut, are absorbed through enzymatic degradation by the body’s enzymes. Dissolution timelines vary significantly by material, from 10 days for some catgut to several months for polydioxanone.
Reasons for Delayed Dissolution
Several factors can delay stitch dissolution. Suture type and size play a role; thicker stitches or polymers like polydioxanone last longer than thinner ones or materials such as polyglycolic acid. For instance, PDS can take 180-210 days to dissolve, while PGA typically dissolves within 60-90 days.
Wound location also affects dissolution; areas with less moisture or blood flow might slow the process, while high movement or moisture (e.g., mouth) may see faster dissolution. An individual’s healing rate, influenced by metabolism and immune response, causes variations. Wound infection can interfere with breakdown, prolonging presence or causing premature surfacing.
An inflammatory reaction to the suture material, especially natural ones like catgut, can also slow dissolution. Sometimes, the body’s immune system encapsulates stitches in scar tissue, preventing breakdown. External factors like inadequate wound care, rubbing, or pressure can also impede dissolution.
Signs of Potential Problems
If dissolvable stitches don’t dissolve as expected or cause issues, certain signs may appear. Stitches remaining visible or palpable long after their anticipated dissolution time is a direct indication. Redness, swelling, or increasing pain around the stitch site, especially if worsening, can signal a problem.
Pus or abnormal discharge from the wound, sometimes with an unpleasant smell, strongly indicates infection. Fever or general unwellness can also point to a spreading infection. Persistent itching or irritation may suggest an allergic reaction or prolonged inflammation. Stitches may protrude from the skin or form a small knot, causing irritation or snagging.
When to Consult a Healthcare Professional
Seek medical advice if you observe any concerning signs related to your dissolvable stitches. Prompt evaluation is advised for signs of infection (e.g., increased redness, warmth, swelling, pus), significant or worsening pain, or if stitches remain visible or cause irritation beyond their typical dissolution period. Also seek advice if stitches are causing irritation, snagging, or forming a bothersome knot. Any general concerns about healing, or if the wound appears to be reopening, should prompt a consultation. A healthcare professional can determine if observation is sufficient, if stitches need manual removal, or if treatment for infection or other complications is necessary.