Understanding the Two Types of Stitches
When a healthcare provider closes a wound, they use one of two main types of sutures: absorbable or non-absorbable. The first step in determining what to do is to know which type was used. If you are unsure, you must contact the medical professional who treated you. If you were given dissolvable sutures, you may not need to worry, as your body will absorb them over time. However, if you received non-absorbable sutures, which are made from materials like nylon or silk, they must be removed.
Absorbable Sutures
- Material: Made from natural materials like catgut or synthetic polymers like Vicryl and Monocryl.
- Function: Used for internal layers of tissue that heal quickly, such as muscles. They are also used for external wounds where follow-up visits might be difficult.
- Absorption: Dissolve naturally within the body through hydrolysis or enzymatic action over several weeks or months.
Non-Absorbable Sutures
- Material: Made from permanent materials like nylon, silk, or polypropylene.
- Function: Used for skin closures, high-tension areas (like joints), or cardiovascular repairs.
- Removal: Must be manually removed by a healthcare professional at the appropriate time to prevent complications.
Why a Stitch Can Become Stuck
There are several reasons why a non-absorbable stitch might become difficult or impossible to remove at home, necessitating professional intervention. Over time, the body's natural healing process can cause skin and tissue to grow over the suture. This can happen if the stitches are left in too long past their recommended removal date. When the suture is embedded, a simple pull may not be enough, and the risk of infection or tissue damage increases with attempted self-removal.
Sometimes, the body perceives the suture as a foreign object, triggering an inflammatory immune response. This can lead to the formation of a fluid-filled pocket, or abscess, around the stitch. Another possibility is a suture granuloma, a small, hard lump that forms as the body walls off the foreign material. Both of these conditions make simple removal impossible and require medical treatment.
Risks of Not Removing Stitches
Leaving non-absorbable stitches in for too long or indefinitely can lead to a variety of health problems. The foreign material can become a breeding ground for bacteria, increasing the risk of a local or widespread infection. This can cause delayed or complicated healing and could require antibiotics or surgical drainage. Furthermore, prolonged contact with the suture can cause excessive inflammation, leading to a more pronounced and noticeable scar. In cosmetically sensitive areas like the face, this can result in permanent “track marks”. Chronic inflammation can cause pain, irritation, and itching at the wound site.
Professional Removal of Stubborn Stitches
If you have a stitch that is difficult to remove, a healthcare professional is the best and safest option. They can assess the wound and use proper sterile techniques and tools to remove the suture without causing further damage or infection. If the stitch has become embedded or caused an abscess, the procedure may be slightly more involved. The doctor might need to numb the area and make a small incision to free the encased suture. In cases of infection, they may drain the pus and prescribe a course of antibiotics.
Comparison: Absorbable vs. Non-Absorbable Sutures
| Feature | Absorbable Sutures | Non-Absorbable Sutures |
|---|---|---|
| Material | Natural (e.g., catgut) or synthetic (e.g., Vicryl, PDS) | Synthetic (e.g., nylon, prolene) or natural (e.g., silk) |
| Removal | Not required; dissolves naturally | Requires manual removal by a professional |
| Timeframe | Dissolves over weeks to months | Removed within days to weeks, depending on location |
| Uses | Internal tissues, fast-healing areas, internal layers of skin | Skin closures, high-tension areas like joints, long-term support |
| Tissue Reaction | Moderate inflammatory response during absorption | Minimal long-term tissue reaction once removed |
| Primary Risk | May cause more inflammation if used superficially | Risk of infection, increased scarring, and irritation if left in too long |
When to Seek Immediate Medical Attention
While a stuck stitch can be frustrating, some symptoms warrant immediate medical care. These signs may indicate an infection or other complication that requires urgent treatment:
- Fever: A sign of a more widespread infection.
- Increased pain or tenderness: Especially if it worsens after the first couple of days.
- Swelling and redness: Beyond the expected amount for healing.
- Pus or discharge: Oozing from the wound, which may have an unpleasant odor.
- Warmth to the touch: The area around the incision feels hot.
- Wound gaping: The wound starts to reopen.
If you experience any of these symptoms, contact your doctor or visit an urgent care clinic. They can properly diagnose the issue and provide the necessary treatment to prevent further complications.
Conclusion: Prioritize Professional Care for Retained Sutures
If you have a stitch that is stubbornly stuck, the most important takeaway is to avoid self-removal. Attempting to dig out or force out a retained suture can cause significant damage, introduce bacteria, and lead to serious infection or more noticeable scarring. Distinguishing between absorbable and non-absorbable stitches is the first step, but even with non-absorbable sutures, an embedded or complicated situation requires a professional's touch. Always consult with your healthcare provider for the safest and most effective resolution to prevent long-term complications and ensure proper healing.
