Stitches (cont.)
When and how are sutures removed?
The optimal time for suture removal depends upon both the location of the
laceration and how much stress is placed on the laceration. For example, a knee
laceration will require the suture to remain in place longer than on the thigh,
since the skin will be stressed each time the knee flexes and extends with
walking, sitting, and standing.
Sutures form a loop that surrounds the laceration and when pulled tight cause
the wound to close. The body can start to form a scar around the suture itself,
and it is important to remember this when deciding the appropriate time to
remove the sutures. This scarring tends to occur within seven to eight days and can have
an appearance resembling crosshatching or railroad tracks.
Sutures on the face are usually removed within five days since there is such
good blood supply in this region and healing occurs more quickly. The goal is to
minimize scarring; therefore, the risk of the sutures causing a scar in their
own right is balanced against the strength and potential weakness of the healing
laceration. Elsewhere on the body, sutures may be left in for seven to 10 days. In some
circumstances, in which scarring is not an issue or if there is concern that
wound is under mechanical stress (like a laceration over a joint), the sutures
may be left in longer.
What happens to the site after suture removal?
While the sutures may be removed, the scar continues to mature over time. For
the first three months, there will be a raised, red healing ridge at the
laceration site. Over the next two to three months, the ridge will flatten and
then will start to weather and lighten. It may take six to eight months or longer before
the final result of the laceration repair can be appreciated.
Are there any special considerations regarding wound repair?
People with diabetes or those with peripheral vascular disease may have
delayed healing and increased risk of infection.
Animal bites are especially prone to infection, and the decision to repair a
bite with sutures must balance the risk of infection with the benefit of a
better-looking scar. Approximately 50% of dog bites, 80% of cat bites, and 100% of
human bites will become infected.
- Wounds or lacerations must be explored and thoroughly cleaned prior to
closure.
- Suture materials vary in their composition and thickness, and the choice
of the appropriate material depends upon the nature and location of the wound.
- Staples, Steri-Strips, Band-Aids, and skin glue can be alternatives to suture
material for skin closure.
- Dissolvable suture material may be used for repair
of deep tissues.
- Most sutures are left in place for seven to 10 days.
Last Editorial Review: 4/16/2009
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