How long does it take for stitches to be removed from a wound? How to remove surgical stitches at home

Features of suture removal after various operations.

Many of us have experienced surgery. These are most often abdominal operations. Many women are familiar with the operation of caesarean section.

There are two options for sutures after Caesarean:

Horizontal. Most often, a horizontal cosmetic suture is used. It is performed using self-absorbing threads. There is no need to remove the stitches. The threads dissolve completely after 2-3 months. The seams are treated as usual, using an antiseptic.
Vertical. This incision is rarely used, in this case the suture is vertical. It starts at the navel and ends at the pubic area. This seam is sutured using the interrupted method. Each stitch is tied with a knot. Such suture materials are removed 5-10 days after the intervention. The doctor cuts the stitches and uses tweezers to remove the threads.

How are sutures removed after surgery or Caesarean section?

Laparoscopy is a minimally invasive operation during which the doctor makes three small incisions to insert probes and tubes. The size of the incisions does not exceed 1.5 cm.

Features of suture removal after laparoscopy:

Most often, doctors use threads that dissolve as suture material. This results in a neat cosmetic seam.
In some cases, 1-2 sutures are applied using regular threads.
The suture material is removed 5 days after surgery.

How are sutures removed from the perineum after childbirth?

Many women have experienced an operation such as an episiotomy. This is an incision of the perineum during childbirth. This operation allows you to increase the diameter of the hole and quickly remove the newborn. The inside is always sutures made of self-absorbing material.

Features of suture removal after episiotomy:

Such sutures are removed 5-10 days after the intervention.
The doctor cuts one stitch at a time and quickly pulls out the suture material with tweezers.
After removing the seams, this area is treated with brilliant green or an antiseptic.
The internal sutures are not removed; they completely dissolve after three months.

The technique for removing stitches in front of the eyes is completely different from stitches on the body. The fact is that the mucous membrane is very sensitive. After surgery for astigmatism, the sutures are removed no earlier than after 3 months.

Features of suture removal after eye surgery:

The sutures are removed directly from the eyeball no earlier than after 3 months.
It all depends on the patient’s well-being. You can definitely say about the advisability of removing sutures after examination by an ophthalmologist.
Ideally, sutures are removed from 3 to 12 months after the intervention. Further, the threads dissolve on their own, but can cause a lot of inconvenience.
If the threads break, irritation and tearing may occur.

After lacerations or cuts, cosmetic surgical sutures are often applied. How carefully you remove the stitches will determine how the scar will look.

The procedure for removing sutures after surgery:

First, remove the bandage; do not tear off the patch or gauze that has dried. Pour peroxide over the dressing and wait until everything gets wet. Carefully remove the bandages.
Now, using tweezers, gently pull the thread, when the suture material is taut, insert the nail scissors and cut the thread.
Now use tweezers to carefully remove the threads. Hold the skin with a napkin so that it does not stretch. Otherwise, the seam may come apart.

The skin on the lips is quite delicate and thin. In this area, neat cosmetic sutures are applied. It is worth noting that such sutures are not made with self-absorbing threads, as they can tighten the skin.

Features of removing sutures from the lip:

There is a mucous membrane in the lip area. Sutures are removed on the 8th day after their application.
To begin with, the wound is treated with an antiseptic. After this, the seams are cut and the threads are carefully removed.
It is necessary to hold the skin to prevent it from stretching and the seams from coming apart.
After the manipulation, the scar is processed. By the time the stitches are removed, the swelling should disappear.

Stitches are also often placed on the fingers. In these places the seams are very small, since the finger area is small.

Features of removing sutures on fingers:

First, remove the bandage. After this, the wound is disinfected.
After this, it is worth sterilizing all instruments. Using tweezers, pull the end of the thread towards you.
Run the scissors through the loop and cut it. When using tweezers, carefully remove the suture material.
Treat the scar with brilliant green.

The stitches on the leg should be removed a little later. Usually this is 9-12 days after the intervention. In these places, the skin slowly regenerates and grows together. In addition, the timing of removal of suture materials depends on how well everything is with the wound. If it is clean, the suture material is removed faster.

Features of removing stitches from the leg:

Most often, the wound is stitched using silk or synthetics. Such threads are strong and ensure rapid healing of the wound edges. They are very easy to remove.
You need to pull the edge of the thread, and when you see a loop and a knot, cut the thread.
Gently pull the thread with tweezers, holding the skin. If the wound is large, the stitches are removed in two steps with an interval of several days. Stitches are removed one at a time.
Often staples or wires are used instead of threads. It is better to remove them at the clinic. This is due to the rigidity of the material and the possibility of repeated damage to the epidermis.

Time frame for suture removal:

12 days - for amputation
after 6 days - during surgery in the area of the skull and head
after 7 days - after shallow intervention in the peritoneum and 9-12 - after deep surgery
10-14 days – for breast surgery
14 days - for surgical intervention of elderly people, patients with weak immunity and cancer patients
7-10 days - after cesarean section

For more information on how to remove suture material yourself, watch the video.

VIDEO: Removing stitches yourself

In any case, it is best to go to the clinic to remove the stitches. They have all the necessary tools and experienced staff.

VIDEO: Suture removal technique

If you have some knowledge, you can remove the seam yourself. But it is better to seek help from a doctor to avoid the development of infection or tissue damage. To remove stitches at home, you need to have a certain knowledge base.

1) Preparation process

To begin with, know When is it permissible to remove stitches? So, from skin wounds that have an excellent blood supply (this is the area of the face and neck), the sutures are removed on days 4–6, from the knees and feet on days 9–12. You can remove it only after the prescribed period has passed, so you need to call your doctor to clarify it. You cannot begin the procedure if the wound is red and inflamed. In this case, there is a possibility of developing an infection. In this case, it is necessary to take into account the nature of the wound, the patient’s age, immunity, and ability to regenerate.

In elderly and seriously ill people, the wound takes at least two weeks to heal, because their immune system is weakened. If you see that the edges of the wound have already grown together, then only then can you begin to remove the stitches.

2) Tools

You need to prepare tools for removing sutures. These should be sharp surgical or nail scissors.
Working with a blunt object can damage the wound. You cannot remove stitches with a knife, because there is a danger of cutting the skin.
All the tools you need sterilize in boiling water for ten minutes. Then blot them with a cloth and treat them with alcohol to destroy germs.
In addition to the main tool, you need to prepare bandages and antibacterial ointment in case of bleeding.

3) Treatment of the suture removal site

Before work, you need to wash your hands with soap and dry them clean. with a towel. Can also be treated with an antiseptic. Carefully treat the seam area with cotton wool moistened with iodine, peroxide, or chlorhexidine, and then with alcohol. After this, begin the procedure.

4) The process of removing sutures

Using tweezers, lift the thread until a clean piece of thread, which is what you need cut . Important keep track of so that the dirty thread is cut off completely so that an infection does not develop.
Then pull the suture through the skin, holding the knot with tweezers. This action may cause minor discomfort.
Lift the knots with tweezers and pull out the threads until the wound is completely free of stitches. Do not allow dirty thread to pass through the fabric. Appearance of blood testifies that the wound has not yet completely healed.
You cannot pull the knot through the skin, because it will not fit through and will cause bleeding.
Check that there are no pieces of thread left, then treat the wound antibacterial ointment and cover with a bandage for further healing of the wound.

5) Further care

All kinds of injuries. Since the skin heals very slowly and gains durability after some time.
Ultraviolet rays. UV radiation is harmful to human skin, especially if it is young and thin. Therefore, you should avoid solariums and prolonged exposure to the sun.

To quickly restore a closed wound, you need to use products that contain vitamin E.

An experienced specialist will be required to remove sutures, in particular in cases of serious surgery, caesarean section, or deep wounds. The surgeon must monitor the fusion process. If you delay the removal of the suture, this can cause suppuration, ingrowth of the thread and a noticeable mark from the wound.

Surgical operations of any complexity are a great stress for any living organism. Even when performing an operation is a matter of life and death, the specialist’s main goal is not only to perform it correctly, but also to prepare his patient for further recovery.

The most common method of connecting different biological tissues, for example, the edges of surgical incisions, lacerations or the walls of internal organs in the body, as well as eliminating severe bleeding, is skilled suturing.

It is best for the sutures to be removed by the attending physician who placed them, but there are situations when this is not possible.

A certain period of time must pass for the wound to fully heal and recover. If this time has passed, and the wound looks completely closed, then the patient can try to remove the stitches himself at home. At this time, it is very important to adhere to safety rules and regulations. It is for this reason that it is worth finding out when you can remove stitches at home and how to do it correctly. First, you should carefully consider what seams there may be.

In order to apply a certain suture, different medical suture materials are used: absorbable and non-absorbable type, threads of both biological and synthetic origin, and also, in some cases, metal wire.

The process of separating the sutures will be carried out depending on the time of their application: primary, delayed, provisional, early secondary, and late. There are also removable and submerged seams.

A removable suture is a type of surgical suture, during which the suture material is removed from the tissues after the wound has completely healed, and when applying a submerged suture, the suture material, remaining in the tissues themselves, after some time begins to dissolve on its own.

A primary suture can effectively close wounds left after surgery. They can also stitch wounds after surgery, lacerations after surgery, and various traumatic cuts.

A delayed primary suture should be applied for a minimum of a day and a maximum of seven whole days, while granulation develops in a random area, after which another secondary suture is applied to the wound.

The provisional connection is presented as one of the types of delayed seam. During this method, the threads are applied during the operation itself, and tied 2-3 days after the surgeon’s work.

Late secondary suture is used for 15-30 days, but if there is tissue scarring in the wound, then the healing time is much longer.

Why take them off?

It is worth remembering that stitches are very important both to apply correctly and to remove on time.

What happens if the stitches are removed too early or too late? If the suture is not removed in time, a process of tissue inflammation may begin, during which the entire body will try to independently remove the foreign material.

There is another question that interests many: is it possible to remove seams yourself? There is no point in trying to remove any type of seams at home. If you act on your own, there is a high probability that you will simply introduce some kind of infection into your body, which is fraught with dangerous consequences and even illness.

Withdrawal terms

The timing of elimination will be influenced by factors such as:

How long after surgery can all sutures be removed? To put it simply, this is a rather individual question. it is for this reason that the time to determine Only the treating specialist can.

But there are also optimal timing, which is what doctors mainly focus on. They will directly depend on the type of surgical intervention (what kind of operation was performed), as well as the general condition of the patient (weakened, for example, with cancer, the patient’s body will recover much worse, so it may require additional time for quality tissue healing).

Most often, sutures are removed after surgery:

Proper removal at home

How to remove a seam? Before you begin the suture removal process itself, you should make sure that the removal is completely safe. In some cases, it is best not to touch them with your hands at all..

If sutures occurred during a surgical operation or when their term has not yet expired, then carrying out such therapy on your own can rarely give a positive result, since in most cases this is fraught with dire consequences.

Need to remember:

You must choose which tools and technique you will use to remove the connections from the wound. At this time, it is worth taking into account that working with dull scissors can only cause harm. Also no need to remove stitches with a simple knife, as it may accidentally slip and seriously cut you.

What tools should you use at work?

You should thoroughly disinfect all the tools you have to work with. To do this, lower them for a few minutes into a container with boiled water, then you need to take them back, put them on a clean cloth and let them dry completely.

After this, you can wipe all the tools with alcohol or peroxide. Such actions will help prevent infection from entering the wound.

Wash the area where the stitches will be removed. All you need to do is use water, soap and a clean towel.

You will also need cotton wool and alcohol to wipe the area around the seams with a cotton wool soaked in alcohol. And only after you are completely sure that the area around the seams is fully disinfected, you can start working.

Removing stitches from a wound

It is necessary to study in more detail the tactics of removing sutures after surgery.

If during removal the wound begins to bleed profusely, this means that you were in a hurry to remove the sutures. In this case, you should immediately stop the removal and contact your treating specialist for help. The doctor will remove the remaining stitches himself.

Never try to pull the knot through the skin; in any case, it will get stuck and cause bleeding.

If the suture was applied intradermally, then in most cases it is not removed. In this case, you just need to trim off the excess threads on both sides, pull them up a little and notch them. Afterwards, the wound must be treated according to the already indicated method, and a clean bandage must be applied.

Sometimes intradermal injections are removed cosmetic stitches for the patient. At this time, you should pull the thread by one end, holding the other end of the wound.

If at the same time a person experiences pain, and the wound itself causes discomfort, then it is best to take a painkiller (Ketanov, Meloxicam or Diclofenac).

In addition to all this, pain after stitching a wound can occur due to the fact that during the process of tying knots, a small part of the nerve ending remains in the wound, which at this time is pulled, and therefore causes severe pain in the patient.

If the wound was sutured with silk threads, and this, as is known, is a non-absorbable material for sutures, then they must be removed in time using the method already described.

If the patient has all the knowledge and carefully removes the sutures after surgery at home, then he will not have to worry about the process of possible infection and tissue damage, and the scar itself will never bother you with its pain.

Attention, TODAY only!

Any operation (surgical intervention) is stressful for the patient’s body. Even if an operation is vitally necessary, the doctor’s main task is not only to perform it correctly, but also to prepare the patient for subsequent recovery.

The most common way to connect all kinds of biological tissues (this can be both the edges of a wound and, for example, the walls of organs), reduce bleeding, bile leakage, etc. is by the surgeon applying sutures.

Plaster for healing postoperative sutures

The rate and pattern of healing is divided into three classes, depending on the type of tissue involved and the circumstances of closure. The periods required for healthy and well-perfused soft tissues have been summarized but may vary. Healing from the first intention.

All surgeons who close a wound want to heal the primary union, or first intent, with minimal swelling and no local infection or excessive secretion. He makes an incision that heals according to the first intention in a minimum amount of time without separating the edges of the wound and with minimal scarring. This is done in three different phases.

There are different types of suture materials - there are absorbable sutures, which are made from threads that do not require removal as the body regenerates. Metal braces or synthetic threads are often used, which can be problematic to get rid of without visiting a medical center.

What are they needed for? They not only help the body cope with the intervention, reduce the risk of bleeding and “opening” of the wound (which can easily become infected), but also have an aesthetic function - modern suture materials reduce the length of the wound, and, accordingly, the size of the scar.

Fluids containing plasma proteins, blood cells, fibrin and antibodies enter the wound. A crust forms on the surface to seal the fluid outlet and prevent bacterial invasion. Inflammation caused by the migration of white blood cells into the area occurs over several hours and causes local swelling, pain, fever and redness around the wound site. White blood cells are degraded to remove cellular debris and phagocyte microorganisms and foreign substances. Monocytes, which later come from more distal bone marrow, become macrophages, phagocytose the remaining debris and produce proteolytic enzymes.

Why is it important to remove stitches on time?

It is important to remember that the sutures not only need to be applied correctly, but also removed in time, since otherwise inflammation may begin (after all, the fixing material is foreign to the body, and the human body has a negative attitude towards such “implants”). It is not recommended to remove suture material at home - there is a high risk of infection and putting your life at risk.

Finally, basal cells at the edges of the skin migrate over the incision to close the wound surface. At the same time, fibroblasts located in the deepest connective tissue initiate the reconstruction of nonepithelial tissue. During the acute inflammatory phase, the tissue does not recover appreciable tensile strength and is dependent only on the suture material remaining in application.

In the first or second week after surgery, fibroblasts migrate to the wound. With enzymes in the blood and surrounding tissue cells, fibroblasts form collagen and ground substance. These substances attach fibroblasts to the substrate. Fibroblasts contain myofibroblasts with smooth muscle characteristics that promote wound contraction. Collagen depot begins around the fifth day and rapidly increases the tensile strength of the wound.

What determines the period for their removal?

The timing of suture removal depends on many factors:

the presence of local complications of the surgical wound
regenerative features of the body
the patient's condition
his age
anatomical region and its trophism
the nature of the surgical intervention
features of the disease.

How long after surgery are sutures usually removed?

The time for suture removal is individual and determined only by your attending physician. The average time frame that specialists are advised to focus on directly depends on the type of surgical intervention (what kind of operation was performed) and the patient’s condition (it is quite natural that the patient’s body, weakened, for example, by cancer, as mentioned earlier, will recover worse, this will require additional time for tissue scarring).

Plasma proteins promote the cellular activity necessary for the synthesis of fibrous tissue during this healing phase. In addition to collagen synthesis, other damaged connective tissue components are replaced. Lymphatics are recanalized, blood vessels form buds, granulation tissue forms, and numerous capillaries develop to feed fibroblasts. Many of them disappear during the final stage of healing.

Tension continues to increase until one year after surgery. The skin recovers from 70% to 90% of its original tensile strength after a week. The collagen content remains constant, but the tensile force increases due to the formation and cross-linking of collagen fibers. The deposition of fibrous connective tissue leads to the formation of scars. Normal wound healing occurs over several weeks and months. The increase in collagen density reduces the formation of new blood vessels, and the scar tissue becomes pale.

As a rule, sutures are removed after surgery:

during head surgery - after 6 days
after a small opening of the abdominal wall (this could be an appendectomy or, say, hernia repair) - after 7 days
after operations that require a wide opening of the abdominal wall (for example, laparotomy or transection) - the sutures are removed on days 9-12
surgical interventions on the chest (thoracotomy) allow stitches to be removed only on the 10-14th day
When performing amputations, the sutures are removed on average after 12 days
after surgical interventions in the elderly, weakened by infections and diseases, cancer patients (due to a decrease in the body’s ability to regenerate) - the procedure is carried out at least 2 weeks later.

How does the deletion work?

Sutures that have been placed on the skin and mucous membranes are easy to remove, so their removal is most often entrusted to an experienced nurse. In other cases, the work is carried out by a surgeon, however, almost all medical specialists can remove the sutures.

Healing healing. When a wound is not healed by primary attachment, a more complex and lengthy healing process is performed. Secondary scars are caused by infection, overuse trauma, loss, or imprecise application of tissue. In this case, the wound can be left open to allow it to heal from the deep layers to the outer surface. Granulating tissue is formed, which contains myofibroblasts and closes with contraction. The healing process is slow and granulation and scar tissue usually form.

As a result, the surgeon may need to treat excessive granulation tissue that may protrude over the wound edge and prevent epithelialization. The third intention is scarring. Also called delayed primary closure, third intent healing occurs when the two granulation tissue surfaces are approximated. It is a safe method for repairing infected wounds, as well as dirty and infected and traumatized wounds with extensive tissue loss and a high risk of infection. This technique has been widely used in the military field and has proven successful after excessive trauma associated with automobile accidents, firearms incidents, or deep and penetrating stab wounds.

The sutures are removed using small surgical scissors and tweezers. The nurse uses tweezers to grab one of the ends of the knot that the doctor made when suturing the wound, and “pulls” it in the direction opposite to the direction of suturing. In the area of the white segment (appears during tissue healing), the thread is crossed with scissors. At the end of the procedure, the removed threads are disposed of. In order to prevent the occurrence of infection and accelerate the regeneration of the integument, the site of the postoperative scar is treated with a weak solution of iodonate, after which a fixing bandage is applied.

The surgeon usually treats these lesions by removing nonviable tissue and leaving them open. An open wound that heals gradually regains sufficient resistance to infection to allow uncomplicated closure. This is usually done 4-6 days after the injury. This process is characterized by the development of capillary buds and granulation tissue. When closure is performed, the edges of the skin and underlying tissue must be approximated and accurately secured.

Complications of healing. Whenever the integrity of tissue is compromised due to accident or cut, the patient is vulnerable to infection and its complications. Even when the surgical team carefully monitors the correct procedure, some patients may experience complications that delay recovery. The two main problems a surgeon may encounter are infection and injury.

To fix and hold the edges of the wound in surgery, sutures are used. After 5-7 days, the skin sutures must be removed, that is, the suture material must be removed. This manipulation is carried out as prescribed by a doctor and under his supervision. Suture removal technique is not particularly difficult, but requires the nurse to be attentive, dexterous and comply with all the rules of asepsis and antisepsis.

Infection – This continues to be one of the most serious complications affecting surgical patients. Infection occurs from the introduction of virulent microorganisms into a susceptible wound. If left untreated, it can lead to long-term illness, gangrene, or even death.

When can stitches be removed?

Postoperative infections can be classified according to the source of infection and the anatomical and pathophysiological changes. The key to effective treatment is rapid identification of the responsible pathogens. A significant number of infections are of mixed bacterial origin. Once infection becomes apparent, purulent secretions should be analyzed or tissue cultured to identify the responsible microorganisms. Antibiotic treatment for cellulitis and fasciitis should be started immediately according to culture results.

The indication for suture removal is wound healing. In case of an extensive wound, the stitches are first removed one after another, and the rest are removed the next day. The main thing for the nurse is to ensure that there is no suture material left in the patient’s skin.

Suture removal equipment

Sterile gloves, mask.
Sterile kidney-shaped tray.
Auxiliary kidney-shaped tray.
Tray for waste material.
Sterile gauze wipes.
Sponges.
Anatomical tweezers.
Sharp sterile surgical scissors.
Alcohol 70%.
Iodonate or iodopyrone.
Cleol or adhesive plaster.
Containers with disinfectant solution.

Preparing to remove sutures

The day before, we inform the patient about the upcoming procedure and its necessity. We clearly explain the essence of the procedure, create a positive mood in the patient and a desire for recovery.
Before the procedure, we check the sterility of materials and instruments.
We wash our hands and put on sterile gloves.
We place sterile material and instruments on a sterile tray.
In the auxiliary tray we place cleol, adhesive plaster, and, if necessary, a bandage.
We place the waste material tray close to the place where we will perform the manipulation.

Suture removal technique

Remove the bandage over the seam and throw it into the prepared tray.
We examine the wound and count the number of stitches that need to be removed.
We treat the wound with a solution of iodonate, iodopirone or 70% alcohol using napkins or swabs using blotting movements. The dressing material is changed to sterile as the wound is treated. We carry out the treatment twice - first wide, then narrow.
Using anatomical tweezers, grab the suture knot and slightly lift it.
After a 2-3 mm white thread appears above the surface of the skin, we bring the sharp jaw of scissors under it and cross it.

However, no treatment will be successful unless appropriate incision and drainage are performed first, with necrotic debridement if necessary. This treatment is not required for superficial wound infections. Viral and fungal infections may also occur. Its incidence has increased with the clinical use of steroids, immunosuppressants, and multiple antibiotics.

Separation of the wound. Wound separation occurs more often in older or frail patients, but can occur at any age. It appears to affect more male patients and is more common between the fifth and twelfth day after surgery.

We remove the thread with the knot: carefully, without applying excessive force, pull the seam with tweezers. The thread lying on the surface should not get under the skin.
Place the extracted thread on a gauze napkin.
We check the integrity of the wound. If there is a gap, ask the doctor about the number of stitches to be removed (most likely, not all will need to be removed).
We remove as many stitches as necessary.
We count the number of stitches removed.
We check whether the suture material remains in the skin.
We treat the wound with an antiseptic solution (alcohol, iodonate).
Place a sterile napkin on the wound.
We fix the napkin with cleol or adhesive tape, and if necessary, with a bandage.

The final stage

We immerse the used dressing material and used instruments and gloves in containers with a disinfectant solution.
We wash and dry our hands.

Correct suture removal technique and compliance with the rules of asepsis avoid complications such as wound infection.

The term "splitting" means "separation". Wound dehiscence is the partial or complete separation of tissue layers after the wound has been closed. Looseness may be caused by excessive tension on the recently sutured tissue, inadequate suture technique, or the use of inappropriate suture materials. In the vast majority of cases, the cause is tissue failure and not suture destruction.

When splitting occurs, the wound may or may not close again, depending on the extent of the separation and the surgeon's assessment. There is no difference in the rate of disappearance of vertical and transverse cuts. The highest incidence occurs after gastric, biliary and intra-abdominal cancer.

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