Suture care

Definition
Sutures are stitches used to close certain types of wounds.

General information
Your skin is your body's first line of defense against infection. Any break in the skin provides a possible avenue for germs to enter your body. Suturing certain types of wounds can help prevent bacteria from entering wounds and causing an infection. Sutures also improve and speed healing, as well as help decrease scarring.
Your doctor will give you instructions on how to care for your sutured wound. Use the following suggestions as a guideline:

If your wound has been covered with a dressing, keep it dry for at least 24 hours.

Remove the original dressing after 24 to 48 hours, unless your doctor tells you otherwise. At this point, most wounds can be safely washed with mild soap and water and gently patted dry.

Avoid swimming, using hot tubs, and taking tub baths until the sutures have been removed or you can keep the sutured area out of the water, unless it's approved by your doctor.

Your doctor may recommend applying antibiotic ointment to the wound and then covering it with another dressing -- a clean, dry, sterile bandage, such as a gauze pad. The dressing helps the wounds stay moist, which promotes healing. It also helps prevent bacteria from entering the wound. Change the dressing every day, unless your doctor tells you otherwise. Also change the dressing if it gets wet or dirty. If your doctor told you not to remove it, call for further instructions.

If your wound is not covered, be careful to protect it from dirt and trauma. Facial wounds, for example, are often left uncovered. As with other wounds, your doctor may recommend cleaning the area often and applying an antibiotic ointment every day. Ask your doctor for details.

Call your doctor if the sutures loosen and the wound opens or you notice any signs of infection, such as increased redness, swelling, pain or tenderness, pus drainage, fever, warmth to the touch or red streaks coming from the area.

Suture removal
Depending on their location and individual circumstances, sutures typically remain in place for a certain number of days. Of course, individual circumstances may require changes to the general guidelines below.
eyelid: three days
face: three to five days
ear or scalp: five to seven days
back: seven to 10 days or longer
arm or leg: seven to 10 days
finger, palm of the hand or sole of the foot: 10 to 14 days
over joints: 14 days
It's important to keep your follow-up appointment for suture removal. Sutures left in place too long may cause increased scarring and are harder to remove. Your doctor may suggest a "wound check" visit several days before the actual suture removal if your wound and its sutures require ongoing medical surveillance.


After suture removal
After the sutures are removed, the doctor may cover your wound with small bandages called Steri-Strips. These bandages offer protection until the wound is strong enough to withstand vigorous wear and tear. Keep the Steri-Strips in place -- they typically fall off on their own after about a week. Watch for signs of infection or wound opening until healing is complete.

Tissue adhesives
If you have a small wound, your doctor may choose to use tissue adhesives instead of sutures. The adhesive will typically fall off the healed wound in five to 10 days. To avoid weakening the adhesive, don't apply any ointment or cream to the wound, and avoid prolonged exposure to water.

Considerations
Dirty wounds, wounds more than 12 hours old and puncture wounds (those made with a sharp, pointed object) are typically allowed to heal without sutures. These types of wounds may become infected if they're stitched closed.
Scar tissue from the laceration and skin that has been abraded may become discolored after sun exposure. After your wound has healed, be sure to avoid direct sun exposure or wear sunscreen on the area for up to a year after the injury to decrease the risk of discoloration.