What happens if dissolvable stitches don't dissolve internally?

September 23, 2025 •

4 min read

While most dissolvable stitches absorb without a hitch, it is not uncommon for a delay or issue to occur, impacting approximately 10% of patients. Understanding what happens if dissolvable stitches don't dissolve internally is key to managing your recovery with confidence and safety.

Quick Summary

If internal dissolvable stitches fail to absorb as expected, it can lead to delayed healing, inflammation, infection, or the formation of granulomas, where the body walls off the foreign material. Often, the body simply 'spits' or extrudes the excess suture material from the wound site.

Key Points

Normal Dissolution: Dissolvable stitches are designed to be absorbed by the body over weeks or months, depending on the material and location.
Common Causes of Issues: Problems can stem from poor blood flow, infection, improper suture placement, or the body's natural foreign body response.
Suture Extrusion: It's common for the body to push out undissolved stitch material, a process known as 'spitting sutures'.
Signs of Complications: Be vigilant for persistent or increasing pain, swelling, redness, discharge, or fever, which could indicate infection.
When to Call Your Doctor: Contact your healthcare provider immediately if you experience significant irritation, signs of infection, or if the wound reopens.
Avoid DIY Removal: Never attempt to pull out protruding stitches yourself, as this can lead to serious complications and infection.

The Purpose of Dissolvable Stitches

Dissolvable sutures, also known as absorbable stitches, are designed to hold tissue together internally while the wound heals. They are gradually broken down by the body's natural processes, typically through hydrolysis, which involves water. The rate at which this occurs depends on several factors, including the material used, the stitch's location, and the patient's individual health. For example, faster-absorbing stitches might be used in the mouth, while slower-absorbing ones are reserved for deeper fascial layers that require longer support.

Why Stitches Might Not Dissolve

When the natural process of absorption is interrupted, internal dissolvable stitches may linger longer than anticipated. Several factors contribute to this:

Poor Blood Circulation: Areas with less blood flow, such as the lower extremities or wounds in individuals with diabetes, may have a slower enzymatic activity required for suture breakdown.
Suture Encapsulation: The body can sometimes treat the stitch as a foreign object and encapsulate it in scar tissue, forming a hard lump or knot.
Infection or Inflammation: A chronic inflammatory response or infection at the wound site can interfere with the body's ability to properly break down the suture material.
Superficial Placement: If a stitch or knot is placed too close to the skin's surface, it may not be fully covered by tissue and can dry out, preventing it from dissolving effectively.
Suture Material Type: Some synthetic absorbable materials take longer than others to fully disappear. While most dissolve in weeks, some can take months.
Allergic Reaction: In rare cases, a patient may have a sensitivity or allergic reaction to the suture material, leading to persistent inflammation.

Signs of Non-Dissolving Internal Stitches

Knowing what to look for can help you identify a potential problem. It's crucial to differentiate between a normal healing process and a complication.

Common signs of issues include:

Suture Extrusion or 'Spitting': This is a very common occurrence where a portion of the stitch gets pushed out of the incision site as the body rejects it. It might look like a small red bump or a piece of white or clear thread poking through the skin.
Persistent Discomfort: While some discomfort is normal during recovery, increasing or persistent pain beyond the expected healing timeline could signal an embedded suture causing irritation.
Inflammation or Swelling: Some inflammation is normal, but persistent redness, warmth, or swelling that worsens over time could indicate an infection or foreign body reaction.
Discharge or Pus: Any yellow or green discharge, pus, or a foul odor coming from the wound is a significant sign of infection and requires immediate medical attention.
Fever or Chills: Systemic symptoms like fever or chills, accompanied by wound symptoms, suggest a more serious infection.
Formation of Granulomas: If the body encapsulates the stitch, a small, firm, and often benign lump can form under the skin.

When to Seek Medical Attention

While some minor issues resolve on their own, certain symptoms warrant a call to your doctor. You should contact your healthcare provider if:

You experience persistent or worsening pain.
There is increasing redness, swelling, warmth, or discharge from the wound site.
You develop a fever or feel generally unwell.
A large portion of a suture protrudes or causes significant irritation.
The wound edges pull apart or reopen.
Your stitches have not dissolved within the timeframe your doctor initially provided.

What to Do If You Spot a Problem

First and foremost, do not try to pull out any protruding stitches yourself. This can cause the wound to reopen or introduce bacteria, leading to infection. If a stitch is poking out and not causing problems, your doctor may advise you to leave it. If it is bothersome, they may clip it for you during a quick, sterile office visit. For signs of infection, follow your doctor's specific care instructions, which may include antibiotics or further assessment.

Normal vs. Complicated Dissolvable Stitch Healing


Feature	Normal Healing	Complicated Healing
Dissolution Time	Gradually disappears within expected timeframe (e.g., weeks to months)	Lingers beyond expected timeframe, or never fully dissolves
Inflammation	Mild, decreases over time	Persistent, worsening redness, warmth, or swelling
Pain Level	Decreases steadily post-surgery	Increases or remains consistently painful
Appearance	Wound edges stay approximated; may form a slight bump or knot that subsides	Protruding 'spitting sutures', pus, or abscess formation
Scar Formation	Minimal, fades over time	Poor healing, potential for more prominent scarring, or granuloma formation
Systemic Symptoms	None	Fever, chills, or malaise

Conclusion

While the sight of a lingering internal stitch can be concerning, it is not always a sign of a major problem. Many issues are minor and can be managed effectively with proper medical guidance. A key takeaway is that you should never attempt to remove internal stitches on your own. It is essential to monitor your incision for any signs of infection or complications and to consult with your healthcare provider if you have any concerns. They can provide an accurate diagnosis and recommend the appropriate course of action, ensuring a smooth and healthy recovery.

For more detailed information on wound care and healing, you can visit a reputable source like the Cleveland Clinic, which offers comprehensive guides on post-operative recovery.

Frequently Asked Questions

The timeframe varies widely, from a couple of weeks to several months, based on the material, stitch size, and surgical site. For many common sutures, it's typically a few weeks, but your doctor can give you a more specific timeline for your procedure.

Yes, it is common for a piece of the stitch or a knot to protrude from the incision line. This is often called a 'spitting suture' and happens when the body pushes out the material it views as foreign.

Sometimes, the body can encapsulate the stitch material with scar tissue, forming a small, hard lump or 'granuloma'. While this is usually benign, you should have your doctor examine any new lumps or bumps, especially if they are painful or inflamed.

While most should be gone sooner, some types of sutures used for deeper layers of tissue can take longer to dissolve. If it is not causing any symptoms, it may be harmless, but it is best to check with your surgeon if the stitches persist well beyond the expected timeframe.

Signs of infection include increased pain, persistent redness, swelling, warmth around the wound, pus or other discharge, a foul odor, or fever.

No, you should never pull out a stitch yourself. This can pull on unhealed tissue, increase the risk of infection, and cause the wound to reopen. It is safest to let a healthcare professional handle it.

If a non-dissolving internal stitch remains, it can cause chronic irritation, inflammation, or infection. In severe cases, it could lead to the formation of an abscess or a more pronounced foreign body reaction, requiring medical removal.