Surgical stitches, also known as sutures, hold wound edges together, providing mechanical support for healing. This approximation allows the body to regenerate, reducing infection risk and minimizing scarring. While designed for durability, stitches can sometimes come undone, which can be concerning.
Immediate Actions
Discovering that stitches have come undone requires prompt and calm action to protect the wound. Begin by washing your hands thoroughly with soap and warm water to prevent the introduction of bacteria. Gently clean the wound area with sterile saline solution or mild soap and clean water, avoiding harsh chemicals like hydrogen peroxide or alcohol, which can impede healing. After cleaning, carefully pat the area dry with a clean, sterile gauze pad.
If any bleeding is present, apply gentle, direct pressure to the wound using a clean, sterile dressing until the bleeding subsides. Once bleeding is controlled and the wound is clean and dry, cover it with a fresh, sterile bandage to create a barrier against contaminants. Avoid probing the wound or attempting to re-close it yourself, as this can cause further damage or introduce infection.
Assessing the Severity
After immediate steps, assess the wound’s condition. Observe its appearance: is it gaping wide, exposing underlying tissues, or is there slight separation? Note the depth, as deeper separations indicate more significant issues.
Consider the location, especially over joints like knees or elbows, which are under more tension. Look for infection signs: spreading redness, increased swelling, warmth, pus, or foul-smelling discharge. Note any persistent bleeding despite pressure, or increased pain.
When Professional Help is Needed
Certain signs indicate the necessity of professional medical attention following stitch separation. If the wound is gaping wide open, is deep, or exposes underlying fat, muscle, or bone, immediate medical evaluation is advised. Significant bleeding that soaks through dressings or does not stop after sustained pressure warrants urgent care. Signs of infection, such as fever, increasing redness or warmth spreading from the wound, pus or foul-smelling discharge, or severe and worsening pain, require prompt medical assessment.
If the stitches came undone from a critical area like the face, over a joint, or near a major artery, contact a healthcare provider without delay. When in doubt or experiencing significant concern, it is always advisable to contact the surgeon’s office, visit an urgent care center, or go to an emergency department for guidance.
Preventing Stitches from Coming Undone
Proactive measures can reduce the likelihood of stitches coming undone. Always adhere to your healthcare provider’s post-operative instructions. Keep the wound clean and dry, following specific instructions on washing, often with mild soap and water after the initial 24-48 hours.
Avoid strenuous activities, heavy lifting, or movements that place tension on the wound site. Excessive physical activity can stress healing tissues, potentially causing stitches to break or the wound to reopen. Protect the wound from accidental bumps, friction, or other physical trauma.
Regularly inspect the wound for early signs of issues, such as slight separation or unusual discharge, and report concerns to your doctor. Attend all scheduled follow-up appointments for proper stitch removal, as attempting to remove them yourself can cause complications.