Dissolvable stitches are also known as dissolvable sutures or absorbable sutures and are one of the ways to hold a wound, cut or surgical incision closed so that it can heal properly, minimizing scars, bleeding and the risk of infections.
The main types of surgical sutures are:
- Dissolvable (absorbable) stitches, which are resorbed by the body over time
- Regular (non-absorbable) stitches, which need to be removed by a medical professional
- Metal staples
- Adhesive stitches (steri-strips)
- Cyanoacrilate glue, a special non-toxic glue suitable for the skin
Dissolvable stitches are mainly used for deep tissues and tissues that heal rapidly such as the skin, the subcutaneous tissues and the muscles.
What are dissolvable stitches made of?
Dissolvable sutures can be made of many different materials. Nowadays most stitches are made of synthetic polymer materials such as polyglycolic acid or as polylactic acid, which is also used as biodegradable dermal and facial filler (Sculptra®) for cosmetic applications.
All materials used to manufacture dissolvable stitches are biocompatible and safe to use although in rare cases they may be rejected by the organism causing an inflammatory response.
How long does it take for stitches to dissolve?
The time it takes for sutures to dissolve varies depending on multiple factors:
- The material the dissolvable suture is made of
- The size of the dissolvable stitches used
- The location of the body and the type of tissue where the dissolvable sutures have been used
- The patient’s unique metabolism and characteristics
Dissolvable stitches are engineered to hold the wound for a set amount of time before losing their strength because of the dissolution process. This time varies between few days and over 8 weeks.
Complete absorption times vary between 40 days and 200 days, after which the material used for suturing is completely metabolized by the body and replaced by connective tissue.
My internal dissolvable stitches are sticking out of the wound (“spitting silks”)
In some cases, internal dissolvable stitches can be pushed to the surface and break through the skin. These are known as spitting silks, spitting stitches or spitting sutures.
Sometimes after starting to dissolve small parts of the stitches are pushed out of the body by the organism. Other times there is an inflammatory response to the stitches recognized as foreign object by the body: this leads to a fluid buildup and to the pushing of the stitches to the skin surface; in this case you may see something that looks like a pimple or small wound. There may be some blood or fluid discharge that can range in color from brown to green and yellow.
If this happens there is nothing to worry about:
- Disinfect the wound
- Keep the wound clean and dry
- Go see your surgeon or GP and have it removed.
The removal of a spitting stitch is an easy, quick and painless procedure. Sometimes more experienced patients just remove them by themselves with a pair of tweezers and a gentle pull. Once the stitch is removed the pimple-like small wound will heal rapidly and disappear.
Spitting stitches have no effect on the outcome of the procedure.
Dissolvable stitches inside the mouth
Dissolvable stitches inside the mouth are the same that can be used in any other body part. They are sometimes called dental stitches or oral stitches and are often used in dental and oral surgery such as after wisdom tooth extraction or other tooth removal or gum surgery.
Because of the materials and thickness chosen for such stitches and due to the characteristic of the tissues, dissolvable stitches when placed in the mouth often fall within 2-7 days following surgery and generally don’t last more than 14 days.
How to remove dissolvable stitches
As a general rule, there is no need to remove dissolvable stitches as they are made to disappear on their own. If the wound healed and the stitches are bothering you, you may consider removing them after getting your doctor’s approval. Never remove stitches without consulting you physician first.
To remove the sutures, you’ll need a set of two hands so if you can’t reach the stitches with both hands due to the location of the closed wound you will need some help from another person. You will also need a pair of tweezers and one pair of surgical scissors. If you don’t have surgical scissors, other types of small sharp scissors or a nail clipper should do the work too. To sterilize the equipment put it in boiling water for 10 minutes, then dry it with a clean paper towel. Find a location with good lighting where you can rest in a comfortable position while removing the stitches.
- Wash your hands thoroughly.
- Sterilize the area where the stitches are located, not just the closed wound, but also the surrounding area.
- Pull the knot with the tweezers and cut right below it.
- Gently pull out the thread from the skin.
- Repeat the process for each knot.
- Wipe again the area with a disinfectant.
You may feel the skin being pulled, but removing stitches is generally not painful. If there is minor bleeding, cover the wound with a bandage after finishing. If you have doubts or complications arise ask your doctor for directions.
How do I know if my stitches are infected?
The signs of infection for any wound are the following:
- Redness around the stitches
- The area is warm to the touch
- The area is swollen
- Increasing pain.
Keep in mind the pink-reddish skin is normal around the stitches while the wound heals, as well as minor pain or discomfort.
The presence of pus or colored and foul-smelling discharge, fever and/or swollen glands are other signs of infection.
If you think your wound is infected, call your doctor for directions and a proper evaluation.
How do you treat infected stitches? (Stitch abscess)
You should always consult your physician if you suspect your wound or stitches have become infected.
Your doctor may prescribe warm compresses, a wound culture, topical antibiotic ointment, a course of oral antibiotics or other medications. Minor infections may be treated by simply wiping the wound twice a day with a disinfectant and keeping it clean, dry and covered. More serious infections may require additional surgery or procedures to treat it.
How do I stop my stitches from bleeding?
Some oozing or minor bleeding may be normal and expected depending on the wound. If there is minor bleeding, replace the bandage with a clean, dry new one and apply pressure on it for a couple of minutes to stop the bleeding. If it doesn’t stop or if it keeps happening, consult your doctor.
- United Kingdom National Health Service
- Mayo Foundation for Medical Education and Research