Why are my stitches coming out on their own? A definitive medical guide

September 28, 2025 •

5 min read

According to the Cleveland Clinic, a surgical wound infection is one of the most common causes of wound dehiscence, or wound separation. Whether planned or unexpected, discovering that your stitches are coming out on their own can be worrying, but understanding the underlying causes is key to a calm and controlled response. This guide explores the reasons behind this phenomenon.

Quick Summary

Stitches come out on their own for reasons ranging from normal healing with dissolvable sutures to complications like infection or excessive wound tension. The appropriate action depends on the type of suture and the state of the wound, often requiring medical assessment to ensure proper healing and prevent further issues.

Key Points

Absorbable vs. Non-Absorbable Stitches: Dissolvable sutures are meant to come out on their own, while non-absorbable types require professional removal.
Wound Dehiscence (Reopening): The premature separation of a wound can be caused by tension, infection, or other complications, requiring immediate medical attention.
Infection is a Major Risk: A surgical wound infection is a common cause for stitches to fail, often accompanied by pain, redness, and swelling.
Normal 'Spitting' with Dissolvable Stitches: The body can sometimes naturally reject small pieces of absorbable suture material as part of the healing process.
Activity Level is Crucial: Strenuous activity or heavy lifting can put too much tension on a healing wound, causing stitches to break or come loose.
When to Seek Medical Help: Signs like excessive bleeding, fever, pus, or significant wound reopening are indicators that immediate medical attention is necessary.

Understanding the Different Types of Stitches

Not all stitches are made to last forever. A crucial factor in determining why your stitches are coming out on their own is knowing whether they are absorbable or non-absorbable.

Absorbable (Dissolvable) Stitches

Absorbable stitches are made from special materials that the body can break down and absorb over time. They are commonly used for deep wounds, internal incisions, and closures in areas that heal quickly. It is perfectly normal for these to dissolve or be rejected by the body as the wound heals.

Non-Absorbable Stitches

Non-absorbable stitches, typically used for skin closure, are made from materials like silk or nylon. These are designed to be removed manually by a healthcare provider after the wound has healed sufficiently. If these stitches are coming out prematurely, it can indicate a problem.

Potential Reasons for Your Stitches Coming Out

Normal Healing Process with Dissolvable Stitches

As the wound underneath heals, absorbable sutures can sometimes be "spit" out by the body, particularly if they are near the surface. This is a natural rejection of the foreign material. It often presents as a small bump that may eventually open and expel the stitch fragment.

Wound Dehiscence: Incision Reopening

Wound dehiscence is the medical term for when a surgical incision reopens. This can be caused by a variety of factors and may result in stitches coming loose or breaking.

Excessive Tension: Wounds in areas of high mobility or under frequent tension, such as on joints, can pull apart. Coughing, sneezing, heavy lifting, or strenuous activity too soon after surgery can place undue stress on the incision.
Infection: A surgical wound infection is a common cause of dehiscence. Infection can weaken the tissue, delaying healing and causing the suture material to fail. Signs of infection include increased pain, swelling, redness, and pus.
Improper Surgical Technique: In rare cases, poor suture technique can cause complications. This can include knots that are tied too loosely or tightly, or stitches placed too close to the wound edge.

Your Body's Immune Response

Sometimes, the body's immune system identifies the absorbable stitch material as a foreign body. This can trigger a low-grade inflammatory reaction that can cause the material to be rejected, leading to the stitch working its way out of the wound.

Other Contributing Factors

Several health conditions and behaviors can impact wound healing and suture integrity:

Medical Conditions: Diabetes, obesity, and conditions affecting circulation or the immune system can slow healing. Malnutrition, particularly low protein levels, can also hinder the body's repair processes.
Medications: Chronic use of corticosteroids can affect wound healing.
Lifestyle: Smoking and excessive alcohol consumption negatively impact blood flow and the healing process.

What to Do When Your Stitches Come Out

The appropriate response depends heavily on the specific situation. For any concern, contacting your doctor is the safest and most recommended course of action.

If Dissolvable Stitches Fall Out

Assess the wound: A stitch coming out after the wound has closed and healed over is less concerning than one from an open wound.
Monitor for signs of infection: Look for redness, swelling, warmth, or pus. If these appear, contact your doctor immediately.
Keep the area clean: Gentle cleaning with soap and water can help prevent infection.

If Non-Dissolvable Stitches Fall Out Prematurely

Contact your doctor immediately: This is often a sign of a problem and should not be ignored. The wound may need to be re-stitched.
Apply gentle pressure: If the wound is bleeding, apply light, clean pressure with a sterile gauze pad.
Cleanse the wound: If directed by a healthcare professional, gently clean the area. Do not attempt to stitch the wound yourself.

A Comparison of Suture Issues


Issue	Type of Suture	Wound Appearance	What to Do
Normal Dissolving	Absorbable	Wound appears closed and healed; small piece of suture may emerge.	Monitor for infection, keep clean. Contact doctor with concerns.
Stitch Spitting	Absorbable	Small bump or opening where suture is rejected; wound otherwise stable.	Clean the area gently, don't pull on the stitch. Contact doctor.
Minor Dehiscence	Any	Small area of wound margin reopens; may be shallow.	Contact doctor. May heal on its own or need minor attention.
Major Dehiscence	Any	Large area of wound reopens, exposing deeper tissue.	Contact a doctor immediately or seek emergency care.
Premature Non-Absorbable Loss	Non-absorbable	One or more stitches missing before scheduled removal.	Contact doctor immediately for assessment and possible restitching.

Proper Post-Operative Care to Prevent Problems

Following your surgeon's instructions precisely is the best way to prevent issues with your stitches. This includes:

Rest and activity limitations: Avoid strenuous activities, heavy lifting, or any movements that put strain on the incision site.
Diet and hydration: A healthy, balanced diet rich in protein supports tissue repair. Staying hydrated is also crucial for overall health and healing.
Wound hygiene: Keep the incision clean and dry as instructed. This is often the most important step in preventing infection.
Monitoring: Regularly check the wound for signs of infection or other complications. Early detection can prevent serious issues.

When to Seek Immediate Medical Attention

While some minor issues can be managed at home, certain signs warrant immediate medical intervention. These include:

Excessive bleeding from the wound.
Fever or chills, which can indicate a systemic infection.
Significant swelling, warmth, or redness spreading from the incision.
A large portion of the wound reopening, especially if internal organs or tissues are visible.
Severe, persistent pain that does not improve.

Conclusion: Prioritize Communication with Your Provider

Seeing your stitches fall out can be concerning, but it's important to differentiate between a normal, planned process (for absorbable stitches) and a potential complication. The key is to know what type of sutures you have and to monitor the wound closely. Always follow your medical provider's post-operative instructions carefully and don't hesitate to reach out to them if you have any questions or concerns about your stitches. For general health information, authoritative sources like the National Institutes of Health can offer educational insights, but your specific wound care concerns should always be directed to a healthcare professional. Prompt and clear communication with your doctor ensures the safest and most effective recovery.

Frequently Asked Questions

Yes, it is entirely normal for absorbable, or dissolvable, stitches to fall out or be absorbed by the body over time. This happens as the wound heals and no longer needs the sutures to hold it together.

If a non-dissolvable stitch comes out before it's manually removed by a doctor, it can be a sign of a problem, such as excessive wound tension or potential dehiscence (reopening). You should contact your healthcare provider immediately.

Key signs of an infection include increased redness, swelling, warmth, or persistent pain around the wound. The presence of pus or a fever and chills are also serious indicators that you should contact your doctor.

Yes, excessive physical activity, particularly anything that puts significant tension or strain on the wound, such as heavy lifting, coughing, or bending, can cause stitches to come loose or break.

You should never attempt to pull out a stitch yourself, even if it appears loose. This can increase the risk of infection and cause damage to the healing wound. A healthcare provider should assess the situation.

To prevent premature stitch removal, you should strictly follow your doctor's post-operative care instructions, limit strenuous activity, keep the wound clean and dry, and attend all follow-up appointments.

A 'spitting stitch' occurs when the body's immune system naturally rejects a fragment of an absorbable suture, pushing it out through the skin. This can cause a small bump or a pimple-like opening but is usually a normal part of the healing process for this type of stitch.