Can Internal Stitches Burst? What You Need to Know About Wound Dehiscence

September 30, 2025 •

4 min read

According to research, wound dehiscence, the medical term for a surgical incision reopening, occurs in up to 3% of abdominal surgeries. This complication can cause anxiety, with many patients asking, 'can internal stitches burst?' as they recover. While they don't 'burst' in an explosive way, internal stitches can break or separate, compromising the healing process and potentially leading to serious complications.

Quick Summary

Internal sutures do not explode, but can separate in a complication called dehiscence. This occurs when an incision reopens, typically due to infection, strain, or poor healing. Recognizing symptoms like increased pain or swelling is vital for proper recovery and to prevent complications like evisceration.

Key Points

Not a 'Bursting' Event: The medical term for internal stitches coming apart is wound dehiscence, which is a gradual separation of wound edges, not an explosion.
Infection is a Key Culprit: A surgical wound infection is one of the most common causes of dehiscence, as it weakens the tissue and compromises the sutures.
Avoid Mechanical Strain: Heavy lifting, vigorous exercise, and even coughing or sneezing can put enough stress on a healing incision to cause internal sutures to break.
Recognize Warning Signs: Symptoms of dehiscence include a popping sensation, sudden increase in pain, unusual discharge, or new swelling near the incision.
Immediate Medical Attention: If you suspect your internal stitches have failed, contact your healthcare provider at once, as early intervention can prevent serious complications like evisceration.
Prevention is Key: Following all post-operative instructions, eating a healthy diet, and supporting your incision during movement are critical steps for safe healing.

Understanding Internal Sutures and the Healing Process

After surgery, internal sutures, or stitches, are placed by surgeons to hold tissue layers together while the body heals naturally. Unlike external stitches that are removed, internal sutures are typically made from absorbable materials that the body's natural processes break down over time. The success of these sutures depends on a strong and uninterrupted healing process, which unfolds in several phases:

Inflammatory Phase: The body sends fluids and immune cells to the incision site to clear debris and bacteria, causing initial swelling and redness.
Proliferative Phase: Fibroblast cells produce new tissue to rebuild the wound. This is a critical stage where the wound's strength increases.
Maturation Phase: The final stage, where the new tissue gains tensile strength and elasticity, continuing for months or even years.

During this time, the integrity of the sutures is crucial. They provide the necessary support until the new tissue is strong enough to bear the load on its own. While modern suture materials are designed to be strong and biocompatible, certain factors can disrupt this delicate process, leading to the stitches separating.

The Reality of "Bursting": What Is Wound Dehiscence?

The term “bursting stitches” is a common, though dramatic, way to describe a serious surgical complication known as wound dehiscence. This is when a surgical incision reopens, either partially or completely, before it has fully healed. The separation can occur in just the outer layers of skin or, more seriously, in the deeper, internal tissue layers. When internal sutures fail, the separation can lead to more severe outcomes, including evisceration, where internal organs protrude through the wound.

This separation is not a sudden, explosive event, but rather a process of wound failure. Most cases of dehiscence occur within the first week or two after surgery, when the wound is still in the early, fragile stages of healing.

Key Causes of Wound Dehiscence

Several factors can contribute to internal stitches coming apart. These can be broadly categorized into mechanical stress and physiological issues.

Mechanical Stress

Excessive Strain: Activities that put undue pressure on the incision site can cause stitches to break. This includes heavy lifting, strenuous exercise, and even intense coughing, sneezing, or vomiting.
Poor Surgical Technique: In rare cases, improperly placed sutures or the use of incorrect materials can increase the risk of wound separation.

Physiological Factors

Infection: A bacterial infection at the surgical site is one of the most common causes of wound dehiscence. The infection can weaken the surrounding tissue, causing the sutures to fail.
Underlying Medical Conditions: Certain health issues can impair the body's healing ability. These include obesity, diabetes, poor circulation, anemia, and certain respiratory diseases like COPD.
Malnutrition: The body requires specific nutrients, particularly protein, to rebuild tissue effectively. A lack of proper nutrition can delay healing and increase the risk of dehiscence.
Medication: The long-term use of corticosteroids can suppress the immune system and slow the healing process.

Recognizing the Symptoms

Knowing the signs of a potential problem is critical for timely medical intervention. If you experience any of the following, contact your doctor immediately:

Sudden or Increased Pain: A sharp or persistent pain that worsens at the incision site, which may feel like a ripping or pulling sensation.
Unusual Swelling or Bulging: A noticeable or excessive swelling, or a new bulge, near the wound may indicate tissue separation underneath.
Bleeding or Discharge: Any unusual bleeding, or drainage of pus or fluid with a foul odor, could signal an infection or dehiscence.
Fever and Chills: Systemic symptoms like fever, chills, and fatigue are common indicators of an infection.

Normal Healing vs. Wound Dehiscence

Understanding the differences between normal post-operative recovery and signs of dehiscence is vital for patients.


Aspect of Recovery	Normal Healing	Wound Dehiscence
Pain	Mild to moderate pain, gradually improves over time.	Sudden, severe, or worsening pain, often with a "popping" feeling.
Swelling	Initial swelling that decreases as healing progresses.	New or increased swelling or a bulge near the incision site.
Discharge	Minimal, clear, or slightly bloody discharge in the first few days.	Unusual, foul-smelling, or colored (yellow/green) discharge.
Appearance	Incision edges are well-approximated and a clean line of healing.	Incision looks open, separated, or gaping.
Systemic Symptoms	No fever or chills after the initial post-op period.	Persistent fever, chills, and general malaise.

Treatment and Prevention

If wound dehiscence is suspected, prompt medical attention is crucial. Depending on the severity, treatment can range from local wound care and antibiotics to further surgical intervention. In severe cases of evisceration, emergency surgery is required.

To minimize your risk of complications, adhere strictly to your doctor’s post-operative instructions. Key preventative measures include:

Avoiding heavy lifting and strenuous activity.
Supporting the incision with a pillow or towel when coughing, sneezing, or laughing.
Maintaining good nutrition and hydration to support healing.
Keeping the incision site clean and dry as instructed by your healthcare team.
Managing underlying health conditions like diabetes effectively.

Conclusion

While the prospect of internal stitches coming undone is frightening, understanding the medical reality can alleviate some anxiety. The concept of internal stitches bursting is better understood as wound dehiscence, a complication caused by factors such as infection or excessive strain. By following your surgeon's instructions, taking preventative measures, and being vigilant for warning signs like sudden pain or unusual discharge, you can significantly reduce your risk. Always remember that open communication with your healthcare provider is the best way to ensure a safe and successful recovery from any surgery.

For more information on wound healing and care, you can refer to authoritative medical sources, such as the Cleveland Clinic website.

Frequently Asked Questions

Wound dehiscence, the separation of a surgical wound, typically occurs within the first 3 to 10 days post-surgery, when the wound is still in its most fragile healing stages.

Patients often report a distinct 'popping' or 'ripping' sensation at the incision site, followed by a sudden increase in pain. This can be accompanied by new or worsening swelling, bleeding, or fluid discharge.

Yes, in a phenomenon known as a 'spitting suture,' the body can reject and expel internal stitches through the skin. This appears as a pimple-like bump with a thread emerging, but is usually not a cause for alarm unless infected.

While light walking is encouraged for recovery, overexertion can place excessive strain on the wound. Strenuous activities, rather than gentle walking, increase the risk of dehiscence.

Treatment depends on the severity. Minor separations can be managed with local wound care and rest, while larger or deeper dehiscence may require antibiotics for infection and possibly further surgery to re-close the wound.

Evisceration is a rare but severe complication of complete wound dehiscence. It occurs when internal organs protrude through the reopened incision, and it is a medical emergency requiring immediate surgery.

Prevention involves following all post-operative care instructions, including avoiding heavy lifting, supporting the incision during physical strain (like coughing), and practicing good hygiene to prevent infection.