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Suture Removal

Sutures may be absorbent (dissolvable) or non-absorbent (must be removed). Non-absorbent sutures are usually removed within 7 to 14 days. Suture removal is determined by how well the wound has healed and the extent of the surgery. Sutures must be left in place long enough to establish wound closure with enough strength to support internal tissues and organs.

The health care provider must assess the wound to determine whether or not to remove the sutures. The wound line must also be observed for separations during the process of suture removal. Removal of sutures must be ordered by the primary health care provider (physician or nurse practitioner). An order to remove sutures must be obtained prior to the procedure, and a comprehensive assessment of the wound site must be performed prior to the removal of the sutures by the health care provider.

Alternate sutures (every second suture) are typically removed first, and the remaining sutures are removed once adequate approximation of the skin tissue is determined. If the wound is well healed, all the sutures would be removed at the same time. Alternately, the removal of the remaining sutures may be days or weeks later.

Complications related to suture removal, including wound dehiscence, may occur if wound is not well healed, if the sutures are removed too early, or if excessive force (pressure) is applied to the wound. In addition, if the sutures are left in for an extended period of time, the wound may heal around the sutures, making extraction of the sutures difficult and painful. Table below lists additional complications related to wounds closed with sutures.

Complications of Suture Removal

Complication

 Solution

Unable to remove suture from tissue Contact physician for further instructions.
Wound dehiscence: Incision edges separate during suture removal; wound opens up

Stop removing sutures.

Apply Steri-Strips across open area.

Notify physician.

Patient experiences pain when sutures are removed

Allow small breaks during removal of sutures.

Provide opportunity for the patient to deep breathe and relax during the procedure.

Wound becomes red, painful, with increasing pain, fever, drainage from wound These changes may indicate the wound is infected. Report findings to the primary health care provider for additional treatment and assessments.
Scarring related to sutures All wounds form a scar and will take months to one year to completely heal. Scarring may be more prominent if sutures are left in too long.
Keloid formation A keloid formation is a firm scar-like mass of tissue that occurs at the wound site. The scarring tends to extend past the wound and is darker in appearance.
Hypertrophic scars Hypertrophic scars are scars that are bulky but remain within the boundaries of the wound. These scars can be minimized by applying firm pressure to the wound during the healing process using sterile Steri-Strips or a dry sterile bandage.
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