Suture Questions

Symptoms

DEFINITION

• This topic covers common questions about sutures (stitches).

Suture Removal Date: Guidelines for when particular sutures (or staples) should be removed:

• Face: 4-5 days
• Neck: 7 days
• Scalp: 7-10 days
• Chest, abdomen, and back: 7-10 days
• Arms and back of hands: 7 days
• Legs and top of feet: 10 days
• Fingers and toes: 10-14 days
• Palms and soles: 12-14 days
• Overlying a joint: 12-14 days

Numbness of Skin Near a Laceration

• Local Anesthesia - Duration of Action: Duration of numbness from local anesthesia depends on what type of local anesthesia was used. Numbness can last from 1 to 8 hours.
• Numbness from the laceration itself: Some people report a small area of numbness right along the edges of the sutured wound. This can last 1 to 3 weeks.
• Nerve injury:. Sometimes a cut can be deep enough that it cuts an important nerve. This should be suspected if the area of numbness extends beyond just the edges of the wound and lasts more than 8 hours. An example of this would be a digital nerve injury of the finger; a person with this injury might notice some persisting numbness of one side of the finger. If you think that you have a nerve injury, you should call your doctor.

See More Appropriate Topic (instead of this one) If

• You have a cut and you wonder if you need stitches, see SKIN INJURY
• The wound looks infected, see WOUND INFECTION

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

HOME CARE ADVICE

General Care for the Sutured or Stapled Wound

1. Suture Care for a normal sutured wound:
   • Can get wound wet (e.g., bathing or swimming) after 24 hours.
   • Apply antibiotic ointment 3 times a day (Reason: to prevent infection and a thick scab).
   • Cleanse with warm water once daily or if it becomes soiled.
   • Change wound dressing when wet or soiled.
   • A dressing is no longer needed when edge of wound closed (usually 48 hours)
   • EXCEPTION: dressing needed to prevent sutures from catching on clothing.
2. Removal Date: Guidelines for when particular sutures (stitches) or staples should be removed:
   • Face 4-5 days
   • Neck 7 days
   • Scalp 7-10 days
   • Chest or abdomen 7-10 days
   • Arms and back of hands 7-10 days
   • Legs and top of feet 10 days
   • Back 10 days
   • Palms and soles 12-14 days
   • Overlying a joint 12-14 days
3. Removal Delays: Do not miss your appointment for removing stitches. Stitches removed late can leave unnecessary skin marks and occasionally cause scarring. Delays also makes suture removal more difficult.
4. Suture Out Early: If the sutures come out early, reinforce the wound with tape or butterfly Band-Aids until the office visit
5. Wound Protection: After removal of sutures:
   • Protect the wound from injury during the following month.
   • Avoid sports that could re-injure the wound. If a sport is essential, apply tape before playing.
   • Allow the scab to fall off on its own. Do not try to remove it.
6. Pain Medicines:
   • For pain relief, take acetaminophen, ibuprofen or naproxen.
   • Acetaminophen (e.g., Tylenol):
     • Take 650 mg by mouth every 4-6 hours. Each Regular Strength Tylenol pill has 325 mg of acetaminophen.
     • Another choice is to take 1,000 mg every 8 hours. Each Extra Strength Tylenol pill has 500 mg of acetaminophen.
     • The most you should take each day is 3,000 mg.

   • Ibuprofen (e.g., Motrin, Advil):

     • Take 400 mg by mouth every 6 hours

     • Another choice is to take or 600 mg by mouth every 8 hours.

     • Use the lowest amount that makes your pain feel better.

   • Naproxen (e.g., Aleve)

     • Take 250-500 mg by mouth every 12 hours.

     • Use the lowest amount that makes your pain feel better.

   • Extra Notes

     • Acetaminophen is thought to be safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription medicines. It might be in more than one medicine that you are taking. You need to be careful and not take an overdose. An overdose can hurt the liver.

     • Before taking any medicine, read all the instructions on the package.

7. Call Your Doctor If:
   • Looks infected
   • Fever
   • Sutures come out early
   • You become worse

Preventing Scars - Questions About

1. Preventing Scarring:
   • Be certain to get the sutures removed during the time frame that your doctor recommended (Reason: if you leave them in too long they can leave "railroad tracks").
   • Avoid getting a sunburn in this area for 2 months.
   • Avoid re-injuring this area.
   • Some people apply Vitamin E lotion (or cream) to a healing wound to prevent scarring. Research has not shown that this helps.
2. Scarring:
   • Scarring is unfortunately a natural part of the healing process after a cut or wound from surgery or trauma.
   • The more serious the injury and the larger the wound/cut, the greater the likelihood of scarring.
   • Almost all cuts that require closure with sutures, staples, or skin glue will heal with some scarring.

Some people are more prone to scarring than others.

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Photo Example

Wound Infection - Suture Site