Dr. Ertan Beyatlı

When are surgical stitches removed?

(Update: ) - Skin and soft tissue diseases

You or someone you love has had surgery in a short time. That's why you are reading this article right now - Get well soon ..

Suturing is a painless, simple, short and risk-free procedure. Two types of stitches are used in surgery: Absorbable and Non-Absorbable Sutures.

Absorbed Stitches It melts spontaneously and does not need to be removed. Absorbable suture It is called. For example: vicryl, pagesorbe, catgut, PDS..etc.

Non Absorbable Sutures it does not melt and should be taken after a while. Non-absorbable suture It is called. For example: silk, prolene, nylon ... etc.

Some non-absorbable stitches are not removed and remain in the body for life, such as silk sutures used to tie bleeding vessels and prolene sutures used in hernias.

Recently, metal leather staples (wire clips) have been applied with an automatic gun for skin incisions. The advantages of this method are that it can be applied quickly, easily, with a low rate of infection and in a standard manner in every center. Metal clips can be removed with a special tool. Clips are classified as non-absorbable stitches and must be removed after a certain period of time. Metal or nylon clips that are thrown in closed (laparoscopic) surgeries are not removed.

Sutures that are absorbed under the skin are generally used in aesthetic stitches. These stitches do not need to be removed and will melt and disappear over time.

In how many days do surgical stitches fall off?

When are surgical stitches removed?

The time the stitches are removed depends on the healing time of the wound. Sutures are preferably removed under the supervision of a doctor. Complications related to stitches, wound infection, incomplete healing of wound lips, etc. In cases, the stitches can be removed in a longer time or gradually (skipping).

What happens if stitches are not removed?

In some cases (especially in non-absorbable stitches) long-standing stitches may cause problems. These problems include skin discoloration, inflammation and fistula formation. Sutures that wait too long can be embedded in the wound or remain under the skin. Sometimes even minor surgical intervention may be required to remove these stitches.

The materials used for suturing (scissors, scalpel, forceps, forceps, etc. dressing materials) must be sterile. Otherwise, inflammation of the wound may cause the surgical area to open.

In general, the time of removal of the stitches is as follows.

  • Facial area: 3-5 days
  • Head, Neck area: 5-7 days
  • Arm-leg (extremity): 6-10 days
  • Joint areas: 10-14 days
  • Body (Chest, Abdomen, Back and Waist): 6-14 days

Stitch removal times in some surgeries:

How to Remove Surgical Sutures
How to Remove Surgical Sutures

Dressing time

wound_infection

Wound; It is the disruption of tissue integrity in the skin or another organ. Wound dressing is often done as follows:

  • Very clean surgeries: no dressing (eg brain surgery, transplantation, etc.)
  • Clean surgeries: once (eg goiter surgery)
  • Normal surgeries: 2-3 times in total or every other day (eg appendicitis, ingrown hair)
  • Dirty surgeries: more than one dressing per day may be required (eg open and infected wounds).

Waterproof Dressing - These dressings have adhesive nylon on the sterile wound cloth. Thus, it prevents water from passing to the wound area after it is applied. Patients using this dressing can easily take a bath and shower. These dressing types are sold in some pharmacies and medical stores. In addition, some sprays can be used over half. It creates a thin waterproof film on the wound with spray. For example, opsite spray, hangina spray, 3m cavilon, etc.

Waterproof Dressing Band-Aid
Waterproof Dressing Band-Aid

In cases where stitches are opened after surgery, it is decided according to the condition of the wound. New stitches can be placed instead of stitches opened in the early period (1-2 days). In the late period (5-6 days), it may not be necessary to stitch again. The doctor who intervenes in this situation decides.

Wound healing

The wounds in the body are closed with either normal tissue (regeneration) or scar tissue.

Types of Wounds

  • Acute wounds: They are wounds formed within <1 month. These; burns-dulls, abrasions, incision areas.
  • Chronic wounds: If the wound persists for> 1 month, it has become chronic. These; leg ulcers (arterial insufficiency, venous insufficiency, lymphatic insufficiency, vasculitic wounds), pressure ulcers, diabetic wounds, cancer-related wounds.

Stages of wound healing

  1. Bleeding period (Hemorrhage)
  2. Period of inflammation (Inflammatory)
  3. Breeding period (Proliferative)
  4. Formation period (Remodeling)
Stages of wound healing
Stages of wound healing

After the first bleeding period, thrombus occurs from thrombocytes that accumulate in the area. Growth factors released from these are chemotactic for macrophages and neutrophils. Macrophages and neutrophils work to remove necrotic tissue and bacteria from the wound.

Chief of the Wound Healing team, orchestra Macrophagesd.

On the 3rd day, TGF-B released from macrophages attracts fibroblasts to the wound. The proliferative phase starts with this event. Growth factors released from macrophages also stimulate angiogenesis and new capillary formation. Fibroblasts produce collagen and release it to the extracellular matrix, which provides wound tension. Remodeling starts 2-3 weeks after injury and lasts up to 1 year.

During remodeling, the Tensile strength increases with the increase in the collagen tension force without an increase in the collagen number. However, this non-traumatized collagen can never reach the tensile strength. Tensile strength can only reach 70-80% of pre-trauma.

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