Images of Suture, Surgical
Sutures, also known as stitches, are synthetic or animal gut-derived threads used to close a wound after a surgical procedure or injury. A variety of sutures exist that vary in size, strength, and durability. Stitches placed deep inside the wound always require the use of dissolvable (absorbable) sutures, whereas stitches visible on the skin (placed superficially) may use dissolvable or non-dissolving (non-absorbable) sutures.
Who's at risk?
- To repair a cut or scratch (laceration) of the skin
- To close an open area of skin after surgery
- To hold a skin graft in place
Pulling the skin together with sutures decreases healing time. Additionally, sutures allow the skin to heal with less scarring – in some cases – by approximating the wound edges.
Signs and Symptoms
If undergoing surgery, no special preparation is necessary other than what is recommended for the surgery itself.
In the case of a laceration, the patient is placed in a comfortable position and the affected area cleaned with an antiseptic solution. The wound is often irrigated with sterile water to clean out any debris or bacteria. The physician will inject a numbing solution (most likely lidocaine) into the skin so that the suturing will not hurt.
Depending on the depth of the injury, each layer of tissue, starting with the deepest, is stitched together. Placing a suture involves taking a long thread with a curved needle at one end. The end with the needle is held by a special tool called a needle driver, which looks like a pair of scissors with clamps to hold the needle instead of blades. The doctor holds the needle driver and uses the needle to insert the thread into each side of the wound. The doctor then pulls the thread, which brings the skin together, and then quickly ties a knot.
Once the defect is closed, a pressure dressing is applied and wound care instructions are discussed with the patient to follow at home.
Patients are discouraged from allowing the wound to get wet during the first 24–48 hours. After that, they may shower without fear of disrupting the healing process that has already taken place. Vaseline® or antimicrobial ointment may be applied on a daily basis with a gauze dressing or a Band-Aid® applied until the wound heals. The stitches may be removed in 5–14 days.
When to Seek Medical Care
- Allergic reaction
- The stitch may fail, causing the wound to reopen (dehiscence)
- A deep stitch may "split" (extrusion)
Treatments Your Physician May Prescribe
- Specialized glue to seal a wound
- Allowing an open area to gradually close on its own (second intent healing)