Suture Extrusion – “Spitting Sutures”

WHAT ARE SPITTING SUTURES?

During surgery, wounds are closed by sewing the skin together with dissolvable sutures or stitches under the skin for healing, and a top layer of stitches is used to close the incision. The deep sutures are primarily dissolving ones. Your surgeon may only use dissolvable sutures or combine them with permanent sutures depending on the procedure. The dissolvable sutures tend to be clear or white in color.

Although they are placed with precision and care, the body may view the sutures as foreign substances and reject them. This means that the body has a mechanism that naturally works to break down or remove objects that it feels don’t belong. While the sutures are meant to break down and dissolve over time, the body may reject them by pushing them out of the body, which is referred to as “spitting a stitch”. When this happens, it may seem like a reason to panic, however, it is a common occurrence during healing and recovery.

A spitting suture can be removed at home. When you notice the suture is protruding from the skin, try gently removing it with a sterilized tweezer or small scissor. If the suture proves difficult to remove, please contact your surgeon and make an appointment to have it removed at their office. Once the suture is taken out of the skin, clean the area with alcohol and place a warm, damp compress on the area for a few minutes. This may cause other sutures to come to the surface. If this is the case, remove them, clean the area, and reapply the warm compress.  Pat the area dry with a clean cloth and apply antibiotic ointment to the area. A spitting suture should not affect the wound’s healing, which will continue on its own. It is important to follow your surgeon’s post-operative care instructions for wound care to avoid other issues with the incision or infection.

HOW TO CARE FOR WOUNDS AFTER SURGERY

There is no way to tell if spitting sutures will occur prior to surgery and they aren’t something you could avoid if your body decided to reject them. However, following your surgeon’s post-operative instructions on wound care can help ensure the area remains clear of infection or other wound issues, such as wound breakdown. Here are five ways to care for your wounds post-surgery:

1. Follow the post-op plan – Post-operative care includes no heavy lifting or strenuous activity for the first six (6) weeks post-op. After six (6) weeks, patients can usually resume normal activity.
2. Check incisions daily – Check all incisions every day for signs of spitting sutures, separation, and infection.
3. Brace your wound – Avoid putting tension on the wound, lifting heavy objects, or straining by bracing the wound. Lightly place your hand over the incision when you are coughing, sitting, or using the bathroom to avoid pressure being placed on the area.

4. Clean the incision and dressings – Clean the incision properly and change any dressings according to your post-op instructions. This can not only reduce the chance of issues and infections.
5. Rest – Give your mind and body time to heal and recover. Surgery places trauma on the mind and body through liposuction, injections, cutting, and the use of sutures. It is important to rest, sleep and avoid stress.