Definition & Overview
The removal of sutures under anaesthesia is a routine medical procedure used to remove sutures post-operatively without causing the patient pain or discomfort. Sutures are used to repair skin wounds by sewing skin together. It is usually used when the wound is too big and cannot close naturally. In such cases, and when non-absorbable sutures are used, the sutures need to be removed once the wound has healed enough. Sometimes the procedure to remove the sutures may be painful. Thus, patients are first given anaesthesia to keep them from feeling any pain.
Who Should Undergo and Expected Results
Sutures are used to close wounds and surgical incisions. They are made of a thread or strand that holds the edges of the skin together. Once the wound has healed, the sutures are no longer needed and would have to be removed.
Some sutures are absorbable because they are made of materials that the body can absorb easily. Some sutures, however, are made of synthetic material that the body cannot absorb. This is why the patient has to go back to the doctor’s office to have them removed.
Doctors usually use non-absorbable sutures because they can be used for larger wounds that take longer to heal. These sutures are stronger and can thus stay in place for a longer period. There are three kinds of non-absorbable sutures and these are:
Before removing the sutures, the doctor first examines the wound to make sure it is fully healed. Sutures have to stay in place for a certain period before they can be safely removed. Generally, they have to be removed within 7 to 14 days after they were placed. The specific length of time, however, depends on the location of the injury. As a rule, sutures in areas with good blood supply can be removed earlier because these areas heal faster. The following is a guide on how long to wait to remove sutures:
- Facial stitches – 3 to 5 days
- Limbs – 10 days
- Joints – 10 to 14 days
- Back – 14 days
- Abdomen – 7 days
After the sutures are removed, the wound will continue to heal until it regains its original strength. Proper wound management is important until the healing period is complete, as it can help prevent scarring and other potential complications. It is normal for patients to have a raised, reddish ridge at the injury site for 2 to 3 months, but the ridge will flatten out within 6 months. It may take up to 8 months for a full recovery.
How is the Procedure Performed?
The following are the steps used to remove sutures under anaesthesia:
- If the wound is covered with a bandage or dressing, it is removed to expose the affected area.
- The doctor then prepares the affected area by putting antiseptic on the wound to clean it.
- He then locates and picks up the knot at the end of each suture using sterile tongs.
- He cuts the suture with a surgical scissor or small knife.
- He then picks up the loose suture and slowly pulls it away from the skin. The exact suture removal technique used depends on what kind of suture technique was used. Some examples are intermittent and blanket stitch sutures.
- Once the sutures are removed, the doctor cleans and dresses the wound again.
Since the whole procedure is performed under anaesthesia, the patient will not feel pain.
Sometimes, sutures cannot be taken out completely in one visit. Thus, the doctor will ask the patient to come back at a later time. If the wound is not well healed yet, alternate sutures, or second sutures, are usually removed first, and the remaining sutures are removed days or weeks later. However, if the wound is well healed during the scheduled removal, all sutures are removed at the same time.
Possible Risks and Complications
Patients who have sutures should take care of their wound to help minimise scarring. They need to keep the wound clean and dry, and to replace the dressing or bandage regularly. If a wound heals properly, the sutures can be removed easily and without complications.
The anaesthesia used during suture removal is usually mild. But even so, it still poses some risks to any patient every time they are used. These risks include:
- Allergic reaction
- Anaphylaxis or severe allergic reaction
- Sore throat
- Injured nerves
The removal process itself may be affected by some complications. These may include:
- Inability to fully remove the suture from the tissue
- Wound dehiscence
- The re-opening of the wound during suture removal
- Hypertrophic scarring
- Keloid formation
Patients should call their doctor if they notice the following symptoms after having their sutures removed:
- Increasing pain
- Red streaks around the wound
- Pus coming out from the wound
Samartsev V, Kuchumov A, Gavrilov V. “Sutures in abdominal surgery: biomechanical study and clinical application.” Central European Journal of Medicine. 2014 Dec; 9(6): 849-859. http://link.springer.com/article/10.2478/s11536-013-0334-7
Young K. “An Overview of Sutures in Surgical Practice.” World Journal of Medical education and Research. 2013 July. 3(1). http://www.wjmer.co.uk/downloads/journal_volume3_indarticles/PDF/An_Overview_of_Sutures_in_Surgical_Practice.pdf