Understanding the Dissolution Process
Internal, or absorbable, stitches are a modern marvel of surgical technology, allowing wounds to be closed beneath the skin's surface without the need for future removal. The process is a gradual, natural one, orchestrated by your body's internal systems.
How Your Body Breaks Down Sutures
The dissolution of internal stitches depends on the material they are made from.
- Natural Sutures: Materials like 'catgut' (derived from purified animal intestines) are broken down by the body's own enzymes, a process known as enzymatic degradation. While less common today, it's the original form of absorbable suture.
- Synthetic Sutures: Modern dissolvable stitches are most often made from synthetic polymers, such as polyglycolic acid (PGA) or polydioxanone (PDS). These materials are broken down through hydrolysis, a chemical reaction with water. This reaction is more predictable and causes less inflammatory reaction than older, natural alternatives.
The Healing Timeline
The timeframe for internal stitches to dissolve varies significantly based on the suture material, the size of the stitch, and the location of the wound. A surgeon will choose a material with a dissolution rate appropriate for the specific tissue and healing time required.
- Some stitches used for superficial layers may dissolve in just a few weeks.
- Deeper or more load-bearing internal repairs, like those for ligaments or deep fascia, may require stitches that remain for several months.
- Your surgeon should provide a specific timeline for your recovery, but a general range can be from several weeks to many months.
What to Expect During Dissolution
For most people, the dissolution of internal stitches is an uneventful process. The wound heals from the inside out as the stitches lose their tensile strength and are eventually absorbed.
Normal Sensations
As the healing progresses, you may experience some minor sensations that are part of the normal process.
- Mild Itching: Itching around the incision site is a common sign of healing. It indicates that new tissue is forming.
- Tugging or Pulling Sensation: As the body absorbs the stitches, you might feel a mild, fleeting tugging or pulling, especially with movement. This is usually not cause for concern unless it's accompanied by severe pain.
- Small Bumps: Sometimes, a small, hard lump can form along the incision line. This is often just the stitch knot dissolving and can take some time to disappear completely.
The 'Spitting Stitch' Phenomenon
In some cases, the body's immune system may treat the absorbable stitch as a foreign object, causing it to push the small piece of suture material to the surface of the skin. This is known as a 'spitting stitch.'
- What it looks like: A small, thread-like piece of material may emerge from the incision. It may be accompanied by a small pimple-like bump.
- What to do: Do not pull on or try to remove the stitch yourself. Gently clean the area and let your body continue to expel it. If it is easily removable with sterilized tweezers, your doctor may approve gentle removal, but always consult them first.
When to Seek Medical Attention
While most post-operative experiences are smooth, certain signs can indicate a potential complication that requires medical attention.
- Increased pain, swelling, or redness around the incision.
- Warmth to the touch at or around the wound site.
- Discharge of pus or a foul odor from the incision.
- Fever.
- The wound reopening (dehiscence).
Internal vs. Non-Dissolvable Stitches
To better understand the function of absorbable sutures, comparing them to their non-dissolvable counterparts is helpful.
| Feature | Internal (Dissolvable) Stitches | External (Non-Dissolvable) Stitches |
|---|---|---|
| Material | Natural (e.g., catgut) or Synthetic Polymers (e.g., Vicryl, PDS) | Silk, Nylon, Polypropylene, etc. |
| Removal | Absorbed by the body; no removal needed | Must be manually removed by a healthcare provider |
| Healing Time | Varies widely, from weeks to months, depending on material | Generally stay in place for 7-14 days until surface wound heals |
| Use Case | Internal procedures, deep wounds, areas hard to access | Surface wounds where easy access for removal is possible |
| Inflammatory Response | Can cause a localized, mild inflammatory reaction as they dissolve | Generally cause less tissue reaction |
Conclusion
What happens when internal stitches dissolve? Your body systematically and safely breaks down the suture material over time as your wound heals. The process is a testament to the body's natural healing capabilities, aided by specialized surgical materials. While most people will not notice the dissolution process, being aware of the normal signs and potential complications is crucial for a healthy recovery. Always follow your surgeon's specific post-operative care instructions, and never hesitate to contact them if you have concerns about your healing progress. Further details on types of sutures and their uses can be found through authoritative medical sources, such as the National Institutes of Health.
