Dissolvable, or absorbable, stitches (sutures) are used to close wounds or surgical incisions, typically inside the body. Some wounds or incisions are closed by a combination of dissolvable stitches below the surface and non-dissolvable stitches, or staples, on top.
Dissolvable stitches are treated by the body as foreign objects that don’t belong. The immune system generates an inflammatory response in order to dissolve, or eradicate, the perceived invasion. For this reason, dissolvable stitches may create more scarring than non-absorbable ones do. That is why they are most often used internally instead of externally.
Dissolvable stitches are designed to disintegrate on their own, over a specific amount of time. They’re made of ingredients that absorb readily into skin. Suture ingredients are always sterile. They include:
- synthetic polymer materials, such as polydioxanone, polyglycolic acid, polyglyconate, polylactic acid, and polydioxanone
- natural materials, such as purified catgut, collagen, sheep intestines, cow intestines, and silk (though stitches made of the latter are usually treated as permanent)
How long does it take?
Several factors determine the amount of time it takes for dissolvable stitches to break down and disappear. These include:
- the surgical procedure used or type of wound being closed
- the type of stitches used to close the incision or wound
- suture material type
- The size of the suture used
This timeframe can range from a few days to one to two weeks or even several months. For example, wisdom tooth removal may require dissolvable stitches, which last anywhere from three days to four weeks.
When are they used?
The type of sutures used for specific procedures may be determined, in part, by your doctor’s preference and expertise. Dissolvable stitches may be used in cases where follow-up wound care is not needed. Procedures that may use dissolvable stitches include:
- Oral surgery, such as wisdom tooth or impacted tooth removal. Dissolvable stitches are used after tooth extraction to tack the gum tissue flap back into its original place. A curved suture needle is used, and the number of stitches required is based upon the size of the tissue flap and each individual’s needs.
- Cesarean delivery. Some doctors prefer staples, and others prefer dissolvable stitches, after cesarean delivery. You may wish to discuss the pros and cons of each with your doctor prior to your delivery to determine which is best for you. A randomized, clinical trial conducted at three U.S. hospitals found that women who had C-sections with dissolvable stitches had a 57 percent decrease in wound complications over women who had their wounds closed with staples.
- Breast cancer tumor removal. If you have breast cancer, your surgeon will remove the cancerous tumor, surrounding tissue, and possibly several lymph nodes. If they use dissolvable stitches, the stitches will be placed in areas where scarring can be reduced as much as possible.
- Knee replacement surgery. Knee surgery, including knee replacement surgery, may use dissolvable or non-dissolvable stitches or a combination of both. In some instances, a line of dissolvable stitches will be used under the skin to reduce surface scarring. These stitches typically last around six weeks.
What to do if you see a stray or loose stitch
It’s not unusual for a dissolvable stitch to poke out from under the skin before it has completely dissolved. Unless the wound has opened, is bleeding, or shows signs of infection, this is not cause for alarm. Unlike with permanent sutures, dissolvable ones are much less likely to create stitch reactions such as infection or granulomas.
Signs of infection include:
You may be tempted to simply try to cut or pull the stitch out, but it’s better to have patience and let the process take its course. Your wound may not have fully healed. Let your doctor know about your concerns. Also, ask your doctor how long the dissolvable stitches are designed to remain intact for your specific procedure. If more time than that has passed, they may recommend you come in to have the stitch snipped or let you know if you can remove it yourself.
Home removal and aftercare
Dissolvable stitches that poke through the skin may ultimately slough themselves off, perhaps in the shower from the force of the water or by rubbing against the fabric of your clothing. This is because they are continuing to dissolve under your skin. If you must remove a dissolvable stitch on your own, don’t do so without your doctor’s approval.
Make sure to use sterilized equipment, such as a surgical scissor, and to wash your hands thoroughly. You’ll also need to sterilize the area with rubbing alcohol. Check out this step-by-step guide for removing stitches at home.
You were probably given wound care instructions by your doctor, which includes information about keeping the area clean, dry, and covered. Your instructions may include information about using antibacterial ointment, as well as how often to change your wound’s dressing. You may also be instructed to limit your physical activity. Make sure to follow those instructions and keep an eye out for signs of infection.
Dissolvable stitches are used for many types of surgical procedures and for wound care. These types of stitches are designed to dissipate on their own, over time. If you’re having a surgical procedure, ask your surgeon about the type of sutures you’ll receive and how long you can expect them to remain in place. Also, be sure to ask about follow-up care and what you should do if a dissolvable stitch doesn’t dissolve on its own.