When Should Stitches or Sutures Be Removed?
While there are numerous methods used to close wounds of the skin, the most common form of repairing the skin is by using stitches or sutures. Other methods for closing wounds can include surgical staples, skin closure tapes, and special adhesives. The removal of stitches or other types of skin closing devices is a procedure which many people want to avoid. It can be helpful and assuring to understand the various methods used to close the skin in addition to the methods used for removal.
Stitches are commonly used to close and secure cuts or wounds on the skin. They can be used on virtually every part of the body, including both internally and externally. A doctors will sew the skin together using individual sutures and securely tie a knot. Once they are placed, stitches allow the skin to naturally heal when it may not come together on its own. It is common to close accidental cuts or lacerations with stitches. Surgeons also use stitches during an operation to secure the ends of a bleeding blood vessel and close the incision.
Sutures are classified as absorbable and nonabsorbable. Sutures which are absorbable quickly break down in the tissues within about 60 days. Absorbable sutures do not need to be removed as they absorb on their own. They are used to close the skin and for other internal uses when a permanent stitch is not required. In comparison, nonabsorbable sutures maintain their strength for more than 60 days. This type of suture is often used to close skin, external wounds, or to repair blood vessels. In most cases, nonabsorbable stitches require removal.
The technique for placing stitches is quite simple. The thread or suture is attached to a needle. The wound is cleaned, and an antiseptic solution, betadine is then used. The area is then numbed with a local anesthetic. The needle and thread are then used to sew the skin back together. Depending on the severity of the wound, sever stitches may be required. Once the wound is closed, a topical antibiotic gel is often used and a bandage is placed to protect the wound. While all wounds which require stitches will have some form of scaring, it is usually minimal and sometimes quite difficult to see.
Based on the location of the wound, the sutures should be removed within a few days to two weeks. The prompt removal of the stitches aids in reducing the risk for marks, infection, and visible scarring. It is important to minimize the risk of complications by following the doctor’s recommendation for removal.
As a general rule, the greater the tension is across a wound, the longer the stitches need to remain. The following is a guideline for the recommended removal times based on the location of the sutures:
- Face: 5-7 days
- Neck: 7 days
- Scalp: 10 days
- Trunk or upper extremities: 10-14 days
- Lower extremities: 14-21 days
Sutures placed in wounds which are under a greater amount of tension may need to remain in place for a bit longer.
In order to promote optimal healing and reduce the risk of complications or scarring, it is important to use the proper technique to remove stitches. Sutures are gently elevated using forceps or tweezers to allow the suture to be cut. The suture is then gently pulled through the skin and removed. Following the removal of the sutures, Steri-Strips can be applied for additional support during the healing process.