Sutures, commonly known as stitches, are medical devices used to hold tissue edges together following an injury or surgical incision. They provide mechanical support, allowing the body’s natural healing process to bridge the gap between severed tissues. This closure minimizes the risk of infection and helps reduce scarring by keeping the wound edges properly aligned. Sutures are temporary, meant to last only until the wound has established enough strength to hold itself closed. Once the tissue has healed sufficiently, non-absorbable sutures must be removed to prevent complications like infection or scarring.
Qualified Healthcare Providers
The removal of non-absorbable sutures is performed by a range of licensed healthcare professionals to ensure safety and proper wound evaluation. Physicians (MDs and DOs) often oversee the decision to remove and may perform the procedure themselves. Advanced practice providers, such as Nurse Practitioners (NPs) and Physician Assistants (PAs), are also authorized to assess the healing site and remove sutures.
Registered Nurses (RNs) frequently perform the physical removal under the direction of a licensed physician or advanced practitioner. Depending on state regulations, certified Medical Assistants (MAs) or Licensed Practical Nurses (LPNs) may also be delegated this task in outpatient clinics. Regardless of who performs the physical action, a licensed provider must conduct a comprehensive assessment to confirm adequate healing before removal begins. This procedure typically takes place in a doctor’s office, urgent care center, or outpatient clinic, which provides the necessary sterile environment and tools.
Understanding Different Suture Types
Professional removal depends on the type of material used for the closure, which falls into two categories.
Non-Absorbable Sutures
Non-absorbable sutures are made from materials like nylon or polypropylene that the body cannot break down. These are used for external skin closures or areas requiring long-term support and must be manually removed, usually within 7 to 14 days. Leaving them in place too long increases the risk of infection, scarring, or tissue reaction.
Absorbable Sutures
Absorbable sutures are designed to break down naturally within the body, eliminating the need for a follow-up removal procedure. Made from materials such as polyglactin, they are often used for internal tissues or layers beneath the skin. The body gradually dissolves these materials over a period ranging from a few weeks to several months.
Other common skin closures also require professional attention, such as surgical staples and adhesive strips like Steri-Strips. Surgical staples, similar to non-absorbable sutures, require a specialized removal tool and professional handling to prevent wound separation.
The Risks of Attempting Removal at Home
Attempting to remove non-absorbable sutures without professional supervision carries severe risks that compromise the healing process. The primary danger is introducing bacteria into the wound, leading to infection due to non-sterile instruments or an unclean environment. Professional settings use antiseptic solutions and sterile tools to minimize this risk to the vulnerable open wound.
Without clinical training, an individual may not fully remove a suture, leaving a fragment embedded in the skin. This incomplete removal can cause a foreign body reaction or localized infection, requiring further medical intervention. A trained provider assesses the wound for proper closure, checking for signs of infection like pus, redness, or swelling.
Removing sutures too early, a common risk with do-it-yourself attempts, can cause wound dehiscence—the reopening of the wound edges. This separation may require re-stitching or result in a slower healing wound and a more prominent scar.
What Happens During Professional Removal
The professional suture removal procedure is standardized to minimize pain and ensure the integrity of the newly healed tissue. The process begins with the healthcare professional inspecting the wound to confirm the edges are closed, drainage is minimal, and the area is sufficiently healed. The site is then thoroughly cleaned with an antiseptic solution to reduce the bacterial load and loosen any crusted material.
Using a sterile suture removal kit, the provider uses forceps to gently grasp the knot and lift it away from the skin. Specialized suture scissors cut the thread close to the skin, typically on the side opposite the knot. The provider then uses the forceps to pull the short segment of thread out of the skin, pulling toward the incision line to minimize tension. After removal, the wound is inspected again, and adhesive strips may be applied for extra support before aftercare instructions are given.