Dissolvable Stitches and How long does it take for stitches to dissolve ?

What are Dissolvable stitches?

They are sutures/stitches used to close an incision or wound that is inside the body. They are called dissolvable or absorbable because they no longer need to be removed.

The body treats them as foreign objects and so the immune system creates an inflammatory response so as to dissolve the stitches/sutures. Why is it used to close an incision inside the body? Well, the very reason it is used inside the body is that of its ability to create more scarring. ^{(1, 2, 3)}

Image 1: Dissolvable stitches used on the skin, specifically in the hand to correct carpal tunnel syndrome.
Picture Source: c8.alamy.com

Picture 2: Dissolvable stitches are commonly used by dentist in performing oral surgery.
Photo Source: i.imgur.com

What dissolvable stitches are made of?

• Synthetic polymer materials like polyglycolic acid, polydioxanone, polylactic acid, and polyglyconate.
• Natural materials like collagen, purified catgut, silk, and cow intestines. ^{(2, 3)}

What are the different types of dissolvable stitches?

Photo 3: The different types of absorbable sutures.
Image Source: omnisurge.co.za

• Polyglactin 910 Suture – It is used for soft tissue approximation and ligation. It would take about three to four weeks for the suture to dissolve completely.
• Polyglycolic Acid Sutures – It is the most preferred dissolvable suture by surgeons all across the globe because of its outstanding tensile strength.
• Catgut suture – It is usually made from the intestines of goat or sheep. It is available in two forms: the plain catgut and the chromic catgut.
• Poliglecaprone Suture – It is a fast-absorbing suture made from synthetic absorbable monofilament. It is available in both clear and violet colors.
• Polydioxanone Suture – It is a clear, crystalline biodegradable polymer, highly absorbable suture consists of polyester. It takes about three weeks for the suture to start dissolving but completely degradation may take up to six months. ^{(3, 4, 5, 6)}

How long does it take for stitches to dissolve?

It would take a few days, weeks, or months for dissolvable stitches to dissolve completely. The length of time dissolvable stitches need to dissolve completely varies depending on the following factors/circumstances:

• The type of surgical procedure/the type or kind of wound being closed.
• The kind of suture used to close the wound.
• The size of the suture/stitches. ^{(5, 6, 7)}

When are dissolvable stitches/sutures used?

There are tons of procedures where the use of dissolvable stitches is necessary. However, it will still boil down to the surgeon’s preference and expertise. Dissolvable stitches are primarily used in the following procedures:

• Oral surgery such as in the case of tooth extraction particularly in removing a wisdom tooth. A suture is made to tack the gum tissue flap back into its usual position.
• The doctor uses dissolvable stitches during caesarean delivery. Although there are doctors who prefer using staples. One of the primary reasons why most doctors used dissolvable sutures for caesarean delivery is because it can decrease the wound complication by up to 57%.
• Dissolvable stitches are also used to remove a breast tumor.
• Dissolvable stitches in combination with non-dissolvable type are used in knee-related surgery such as in the case of knee replacement surgery. Polydioxanone is the suture material used for such kind of surgery which usually takes six months to dissolve completely. ^{(3, 5, 6, 7, 8)}

Would there be a possibility of infection?

The chances of wound infection when using dissolvable stitches is little to none. An infection could only be possible if the wound has opened or bleed causing the stitch to poke out from under the skin.

Even so, you need to know when there is an infection. Signs and symptoms include redness and swelling on the suture site, fever, and pain. If the suture poked out, do not cut or pull the stitch out. Just leave it there and let the suture dissolve on its own.

Allow the body’s immune system response to dissolve the stitches. ^{(1, 4, 9, 10)}

Tips

It is important to ask the doctor beforehand the type of dissolvable suture he/she is going to use and the length of time needed for the suture to dissolve completely.

If the stitch remains more than the expected time, then you should contact your doctor. He/she might have the stitch snipped. You can attempt to remove the stitch on your own but it can be dangerous, especially if you don’t have any medical background. ^{(2, 4, 7)}

Taking care of dissolvable stitches

• If the doctor used dissolvable stitches on the skin cleaning it is easy. Start cleaning from the dirtiest part to the cleanest part.
• Do not scrub the incision to avoid irritation.
• If there are scabs, do not scrub them away. Scabs are indicators that your wound is healing.
• You can wash the incision but be very gentle. Make sure you use mild soap and clean water.
• Avoid swimming until the incision is fully closed.
• Monitor your incision and watch for any signs of infection. ^{(2, 6, 9)}

 

Summary

• Absorbable sutures do not need to be removed.

• It would take weeks to months for the suture to dissolve completely.

• Dissolvable tissues are commonly used to close internal incisions.

• Some types of dissolvable tissues can be dissolved completely in 10 days while others may take up to six months.

• Dissolvable stitches do not need a follow-up procedure to remove the stitches as the suture dissolves after some time.

• Dissolvable stitches dissolve because the immune system identifies them as a foreign body. It will attack the stitches just like it attacks other foreign invaders.

• Dissolvable stitches should be allowed to dissolve on their own. Do not attempt to make it dissolve faster than the usual as doing so can lead to complications such as the possibility of the wound to re-open again. Allow the stitch to heal on its own. ^{(2, 5, 7, 10)}

Image 4: A hydrogen peroxide should not be used in cleaning dissolvable stitches.
Picture Source: www.sciencedaily.com

A word of caution

Do not use hydrogen peroxide in cleaning absorbable sutures unless your doctor told you to do so. Studies have shown that hydrogen peroxide can significantly reduce the tensile strength of dissolvable stitches.

Doing so can lead to irritation which will increase the chances of infection. The ideal way of cleansing is using a clean water and a mild soap.

References:

1. https://www.medicinenet.com/stitches/article.htm
2. https://science.howstuffworks.com/innovation/everyday-innovations/question611.htm
3. https://www.healthline.com/health/dissolvable-stitches
4. https://www.verywellhealth.com/what-are-absorbable-sutures-3156838
5. http://www.dolphinsutures.com/resources/dissolvable-sutures
6. https://ic.steadyhealth.com/about-dissolvable-stitches
7. https://www.nhs.uk/common-health-questions/accidents-first-aid-and-treatments/how-long-will-my-stitches-sutures-take-to-dissolve/
8. http://woundcaresociety.org/how-to-make-dissolvable-stitches-dissolve-quicker
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4278146/
10. https://www.wisegeek.com/what-is-a-dissolvable-suture.htm