Dissolving sutures

[stumpy]

How do dissolving sutures work? Are they absorbed into the body or is there still a need to get them out if they have not fallen out by themselves after 7 days? These stitches are in a surface would following minor surgery.

 

 

 

Also when they do fall out is not the case that the portion inside the skin stays there?

 

 

 

Thanks in advance.

[tomc12]

Absorbable sutures vary in rate of dissolution and time to complete absorption. Plain catgut takes 70 days, chromic catgut 90 days, Vicryl 50-70 days, Dexon 40-90 days, etc.-this is the time for complete absorption. The strength of the suture decreases much sooner-eg., plain catgut loses 70 % of its tensile strength in the first week, Vicryl in 4 weeks, etc. Another factor is the relative blood flow to the area-high blood flow areas will break the suture down faster. This also determines if or when you remove suture-eg., vaginal tissue has a high blood flow and heals very quickly. If Vicryl sutures are used, a doctor may remove the sutures in 1-2 weeks (could also just let them dissolve as they cause only a mild tissue reaction). On the other hand, skin on flexor surfaces takes much longer to heal to full strength.

[stumpy]

Thanks Tom. I don't really know what sort the sutures are but I was told they would drop out 7 to 10 days. I am now day 6 and they all look fairly solid. I did think about trying to take them out myself, but a couple are fairly well burried inside the scab.

 

 

 

However, if I've understood you correctly there is nothing really to worry about. Even if they don't fall out and stay inside the scab they will still be absorbed into the body?

 

 

 

I was a little concerned as some of the text's I found on the 'net talk about having tunnels if the suture is not removed but I'm guessing even that should go once the suture is absorbed.

 

 

 

Thanks for your help it is re-assurring and beats having to ring the surgeon up.

[Guest]

18 months ago, I had a benign cyst on my forehead removed by a plastic surgeon in Japan. It was a large sucker and the incision was about 2 cm. My Japanese is passable but not brilliant and the doc couldn't, or wouldn't, speak English (this may be relevant to what follows). Before surgery, he assured me there would be minimal scarring, for he would use absorbable sutures which would cause the incision-line to be noticably raised at first, gradually to settle down and disappear leaving a "fine, hairline scar". He seemed to be saying that after 7 days I'd be walking around without stitches or dressing.

 

 

 

I had the op. Went back a few days later to get the dressing changed and saw the stitching for the first time: oops, didn't look like dissolvable stitching to me, more like bog-standard nylon aboard a ridge as thick as a cigarette. I asked him about it and he said, yes, the outer stitching was just run of the mill nylon he'd remove after week. I thought you said "absorbable", says I. Ah, the absorbable sutures are BENEATH the skin, he says, causing the raised ridge which would flatten when the sutures were absorbed into the body. And this process would take 7 . . . months! (My flawed Japanese had got me thinking he'd originally said 7 days, so the 7 MONTHS verdict kind of floored me.) However, he was right on the button, in fact he was being overly pessimistic (probably covering his ass in case anything went awry); the skin flattened back to normal after about 4 months and the scar is almost invisible (he said if the absorbable sutures hadn't been used, the scar would have been much more conspicuous (I'm ugly as sin anyway, so I wasn't too bothered, but his professional pride was obviously an issue).) So, tomC12, you sound like you know your stuff: any idea what that was all about? Was it Dexon?

 

 

 

He did a good job, anyway. Only cost me about fifty quid ($70) as I had company medical cover. I even get called hansum man nowadays, now and then.

 

 

 

 

 

 

 

 

[tomc12]

stumpdog,

 

I am a little surprised that you were told the sutures would drop out in 7 days. Generally the fastest dissolving suture is catgut, but we don't usually use it on skin because it causes more tissue reaction (thus scarring) than Dexon or Vicryl.

 

There are many factors a surgeon has to consider when making and repairing an incision-location, direction, size, depth, etc. in addition to the type and gauge of suture material. Only the doctor who put them in can determine if and when sutures are to be removed.

[tomc12]

Val Doonican,

 

Hard to say if he used Dexon or Vicryl as I am not sure what he meant by the seven month time period. Both sutures are absorbed by about three months, but the redness in the incision line may take six months to fade to skin color. Maxon and PDS take six months to dissolve and are usually used for fascial closure, but because they cause even less tissue reaction than Dexon/Vicryl, he could have used one of them.