Surgical stitches, also known as sutures, are medical devices used to hold the edges of a wound or incision together, providing temporary support until the body’s tissues form a stable connection. Sutures are classified as absorbable (which break down naturally) or non-absorbable. The focus here is exclusively on the consequences of leaving non-absorbable stitches in place beyond their recommended removal date.
Why Non-Absorbable Stitches Require Removal
Non-absorbable sutures, made from synthetic materials like nylon, are not dissolved by the body’s enzymes. They require removal when used to close the skin, as their primary function—approximating wound edges—is typically complete within seven to fourteen days, depending on the injury location. Retention beyond this period serves no medical purpose and introduces risk. The body recognizes the stitch material as a foreign body, triggering an inflammatory reaction at the site. This persistent irritation interferes with the final stages of the healing process.
Acute Consequences: Infection and Inflammation
The most immediate risk of retaining non-absorbable stitches is the increased likelihood of infection. The suture material acts as a physical niche for microbial growth, allowing bacteria to colonize and form a protective biofilm. This is concerning because the external portion of the stitch is exposed to bacteria on the skin’s surface.
The “wick effect” further compounds this risk, particularly with braided sutures. This capillary action allows fluids containing bacteria to travel along the suture thread from the skin’s surface into the deeper layers of the wound. The stitch creates a direct pathway for microbes to infiltrate the incision site, bypassing the skin’s natural barrier.
If infection occurs, it can manifest as cellulitis or a stitch abscess. Common symptoms include redness, swelling, warmth, and persistent pain around the wound. Severe cases may involve pus or fluid drainage, indicating the body is attempting to expel the foreign material. Untreated infections can lead to prolonged recovery and may require antibiotics or further medical intervention, such as draining an abscess.
Missing the Deadline: What to Do Next
If stitches are left in place for weeks or months, the skin begins to grow around and over the suture material. This process, known as embedding, causes the stitch to become partially or fully covered by new tissue. Simple removal then becomes significantly more complex, often requiring the provider to gently cut the skin to expose the buried thread. Embedding makes the procedure more uncomfortable and increases the chance of incomplete removal, leaving fragments trapped beneath the skin.
Prolonged inflammation from the retained foreign body has detrimental long-term cosmetic effects. Persistent irritation stimulates excessive collagen production, leading to the formation of raised, thicker scars, such as hypertrophic scars or keloids. The tension created by the stitches over an extended period can produce permanent, visible “track marks” along the incision line.
Individuals who realize their non-absorbable stitches have been missed should immediately contact their healthcare provider or the clinic responsible. Avoid attempting to remove the stitches at home, especially if they appear embedded or the wound shows signs of infection. Self-removal risks introducing new bacteria, causing tissue damage, or leaving behind fragments. A medical professional can safely assess the wound, use sterile tools, and ensure complete removal.