A retained suture is a piece of surgical thread or material that remains in the body after a wound has healed or after a scheduled removal. Finding unexpected material can cause alarm, but this occurrence is often a minor issue requiring simple medical attention. The material is typically non-absorbable thread that was not completely removed, or occasionally a fragment of absorbable material the body is attempting to expel. Recognizing the presence of this material and knowing the next steps is important for proper wound healing and preventing irritation.
Recognizing a Retained Suture
Identifying a retained suture usually involves spotting a small piece of foreign material near or on the healed incision line. Non-absorbable sutures must be manually removed, and a retained piece may look like a small loop or knot of thread protruding directly from the skin. This material can sometimes be covered by a scab or thin layer of scar tissue, only to become exposed later as the area matures.
Absorbable sutures, which are meant to dissolve internally, can occasionally be retained and appear on the surface. When the body attempts to expel an internal fragment, the process is sometimes called a “spitting suture.” This often presents as a localized bump or a firm area that eventually opens to reveal the thread fragment. The material’s color can vary, including black, blue, or clear, depending on the type of suture used.
Immediate Patient Action Steps
Do not pull on or attempt to remove the visible stitch yourself. Pulling the thread can cause trauma to the healing tissue, introduce bacteria deeper into the wound tract, or lead to the separation of the wound edges. Even if the material appears loose, it may still be anchored internally and require precise technique for safe extraction.
The area should be kept clean by gently washing it with mild soap and water, which helps prevent surface bacteria from traveling along the suture material into the deeper tissue. If the protruding thread causes irritation by rubbing against clothing, covering it loosely with a clean, dry bandage offers temporary protection. However, direct manipulation of the stitch should be avoided.
The next step is contacting the surgeon or primary care provider who managed the wound closure for advice. Providing a clear description of the appearance and location of the retained material allows the medical team to triage the situation. This contact is necessary regardless of whether the area shows signs of infection, such as redness, swelling, warmth, or drainage. A healthcare professional needs to determine the material type, assess the healing progress, and schedule the removal.
The Professional Removal Process
Once you see a healthcare provider, the process begins with a close examination of the healed wound and the protruding material to confirm it is a suture fragment. In most cases, removal is a swift, simple in-office procedure requiring no significant preparation. The area around the stitch will be cleaned with an antiseptic solution to minimize the risk of introducing surface bacteria during extraction.
The provider will use sterile instruments, typically forceps and small scissors, for the removal. They will gently grasp the knot or loop of the material with the forceps, cut the thread cleanly near the skin surface, and pull the remaining fragment out. This is usually painless, though a slight tugging sensation may be felt as the material is extracted. The goal is to remove the thread without pulling the contaminated, exposed portion through the underlying tissue.
If the suture fragment is slightly buried, a foreign body reaction may have occurred, sometimes forming a lump called a granuloma around the material. In these instances, local anesthetic may be used to numb the area before a tiny incision allows for complete retrieval. Complete removal typically resolves any associated inflammation or irritation quickly, allowing the remaining small opening to heal without further complication.