Will a stitch push itself out? What to know about spitting sutures

Many people experience their body rejecting internal stitches during recovery, a common phenomenon known as "spitting a suture." Understanding if and why will a stitch push itself out is key to proper wound care and identifying potential issues during the healing process.

Quick Summary

A stitch can indeed push itself out, a common occurrence during the healing process, particularly with dissolvable sutures. This happens when the body recognizes the suture as a foreign object and attempts to expel it, an event known as suture extrusion or "spitting a stitch."

Key Points

• Spitting is common: During healing, the body may expel dissolvable sutures it recognizes as foreign, a normal process called suture extrusion.

• Spitting vs. Infection: A spitting stitch is localized and often resolves itself, whereas an infection involves widespread redness, swelling, and potential pus, requiring medical attention.

• Proper Care is Key: Keep the area clean, apply warm compresses, and avoid aggressively pulling at the protruding thread to encourage its release without disrupting healing.

• Dissolvable Stitches: Spitting is most common with dissolvable sutures that are placed near the surface of the skin, as the body works to reject the material before it fully dissolves.

• Know When to Call a Doctor: Contact a healthcare provider if you have signs of infection, increasing pain, significant swelling, or if the wound reopens.

Understanding the "Spitting Stitch" Phenomenon

During the recovery period from a surgical procedure, it's not uncommon to notice a small, hard bump or a piece of thread emerging from your incision. This event, known as a "spitting stitch" or suture extrusion, occurs when the body's immune system identifies an internal stitch as a foreign object and begins to push it to the surface of the skin. While it can be alarming, it's a normal part of the healing process for many patients, especially those with dissolvable sutures. The term 'spitting' accurately describes how the body actively works to expel the material it cannot fully absorb or process. This reaction is a testament to the body's powerful natural defense mechanisms.

Dissolvable vs. Non-Dissolvable Stitches

To understand why a stitch might push itself out, it's helpful to distinguish between the two main types of sutures used in surgery.

Dissolvable (Absorbable) Sutures

Dissolvable stitches are designed to be broken down and absorbed by the body over time. However, the rate of absorption varies from person to person. If the body breaks down the suture material too slowly or reacts negatively to it, it can trigger an inflammatory response. The body then essentially "spits" the stitch out before it has a chance to dissolve completely. These stitches are commonly used for deep internal layers of tissue and sometimes for closing the outermost layer of skin.

Non-Dissolvable (Non-Absorbable) Sutches

These stitches are made of materials that the body cannot break down. They are intended to be removed by a healthcare professional at a later date. If non-dissolvable stitches are left in for too long, or if the skin grows over them, it can cause irritation or an abscess. While it's rarer for non-dissolvable stitches to spontaneously "spit," they can still cause local inflammation and may need to be professionally removed if they become problematic.

Why Does a Body Reject Stitches?

Several factors contribute to the body's decision to reject and push out a stitch:

• Individual Reaction: Every person's immune system is unique. Some people are more sensitive to certain suture materials than others, prompting a stronger rejection response.
• Inflammatory Response: As part of the natural healing process, inflammation occurs at the wound site. In some cases, this inflammation becomes directed at the foreign suture material, causing it to push towards the skin's surface.
• Suture Placement and Technique: The way the stitches were placed can sometimes contribute to extrusion. If a dissolvable suture is too close to the skin's surface, it has a higher chance of being "spit out."

What Does a Spitting Suture Look Like?

A spitting stitch can manifest in a few distinct ways, and understanding these signs can prevent unnecessary panic.

1. A Pimple-Like Bump: A small, red, and sometimes tender bump may form along the incision line. This can be mistaken for a pimple or an ingrown hair, but upon closer inspection, you may see the end of the suture thread protruding.
2. Visible Thread: You might see a small piece of clear, white, or blue thread emerging from the wound. It may look like a piece of fishing line and can be slightly itchy or irritating.
3. Localized Redness: The area immediately surrounding the spitting stitch may be red and inflamed, indicating the body's localized inflammatory response.

Spitting Suture vs. Wound Infection

It's important to differentiate between a harmless spitting suture and a more serious wound infection. While both can cause redness and irritation, their characteristics differ significantly.

Feature	Spitting Suture	Wound Infection
Appearance	Localized red bump, visible thread	Widespread redness, warmth, swelling around the incision
Discharge	Minimal or no discharge, sometimes clear fluid	Pus (yellow, green, or foul-smelling), increasing drainage
Pain	Mild, localized irritation or tenderness	Increasing pain that is often throbbing
Fever	No fever	May be accompanied by a fever or general feeling of being unwell
Resolution	Resolves after suture is expelled or removed	Requires medical treatment, often antibiotics

How to Care for a Spitting Suture

If you believe you have a spitting suture, follow these steps for proper care. However, if you have any doubts, always consult your healthcare provider.

• Monitor the Area: Keep a close eye on the incision for any signs of increasing redness, swelling, or discharge. As detailed by reputable medical sources like the Cleveland Clinic, most spitting sutures are a nuisance and not a serious problem.
• Keep it Clean: Continue to follow your doctor's instructions for wound hygiene. Gently clean the area with mild soap and water. Pat it dry with a clean cloth.
• Apply a Warm Compress: A warm, moist compress can help encourage the suture to work its way out. Apply it to the area for 10-15 minutes, several times a day.
• Avoid Pulling: Do not forcefully pull on the thread, as this can disrupt the healing process and cause more damage. If the suture is hanging out loosely, you can gently try to remove it with sterilized tweezers. If it resists, leave it alone and contact your doctor.
• Protect the Wound: Cover the area with a small, clean bandage to prevent irritation from clothing and protect it from bacteria.

When to Contact Your Doctor

While spitting sutures are often harmless, certain signs warrant a call to your doctor. You should seek medical attention if you experience:

• Signs of a wound infection, such as fever, pus, or throbbing pain.
• Significant pain or swelling at the site.
• Bleeding from the wound.
• The wound reopening or gaping open.
• Concerns that the thread is not a dissolvable suture.

Conclusion

While a spitting stitch can be an unexpected and somewhat unpleasant part of the healing process, it is typically a normal and manageable occurrence. The body's ability to heal itself includes this mechanism for expelling foreign objects like sutures. By understanding the difference between a spitting stitch and a true infection, and by following proper wound care instructions, you can manage the situation effectively. If you ever have concerns or experience any symptoms of infection, don't hesitate to contact your doctor for guidance, ensuring your recovery remains on track.

Frequently Asked Questions

Is it normal for a stitch to push itself out?

Yes, it is a normal and fairly common occurrence, particularly with dissolvable stitches. It happens when the body reacts to the suture material as a foreign object and expels it during the healing process.

What does it mean when a stitch pushes itself out?

It means your body's immune system has recognized the suture as a foreign object and is actively pushing it out. This process, called suture extrusion or "spitting a stitch," is a sign that your body is managing the healing process.

How do I know if the stitch is pushing itself out versus being infected?

A spitting stitch usually involves a small, red bump and a visible thread. An infection, on the other hand, will typically have more widespread redness, warmth, swelling, pus, and may be accompanied by a fever. Monitor your symptoms closely.

Can I pull the stitch out myself if it is poking out?

If a small piece of dissolvable suture is clearly protruding and very loose, you may gently remove it with sterilized tweezers. However, do not force it. If it resists, leave it alone and contact your doctor to prevent damaging the wound.

Will a non-dissolvable stitch push itself out?

It is less common for non-dissolvable stitches to spontaneously push out. However, if they are left in too long, the body can react to them, and they may cause irritation or an abscess that needs medical attention. These are typically removed by a doctor.

How should I care for the area where a stitch has been pushed out?

Keep the area clean with mild soap and water, and apply a warm compress for 10-15 minutes several times a day. Cover it with a clean bandage to protect it and allow the healing process to continue.

Does a spitting stitch mean my wound is not healing properly?

No, a spitting stitch does not typically mean your wound is not healing properly. It is often an isolated, localized event. As long as there are no signs of infection, the rest of the wound should continue to heal normally.