Encyclopedia of Family Health - Vol. 15

By David B. Jacoby; Robert M. Youngson | Go to book overview

Sutures

Questions and Answers

Does it hurt to have skin stitches
removed after surgery?

No, not really. Modern materials
used for stitches are much
smoother than the old materials
and slide easily through the
tissues. It’s really only the thought
of having stitches taken out that
makes it hurt. Remember it is the
stitch that’s being cut, not you.

After major surgery do internal
stitches last for a long time?

Yes. Some of the stitch material
used will last for a lifetime.
Monofilament nylon, for instance,
is almost inert and does not cause
any tissue reaction. It will still be
there in 30 years’ time, although
it may be weaker than it was
when it was originally inserted.

I recently had surgery on my
stomach. How long will the
stitches have to stay in?

Usually between 7 and 10 days. If
they are taken out before this
time the wound may come apart;
if they are left in longer an
inflammation may develop around
the area of the stitches.

After abdominal surgery, is it
possible to burst the stitches by
coughing or straining?

It would be very unusual. The
strength of an abdominal wound
closure depends on the internal
stitches, not the stitches in the
skin. Most surgeons therefore use
a nonabsorbable material, such as
nylon, to repair the muscle layers.
Previously, catgut was used, but it
lost strength so quickly that the
wound could burst. Now,
however, if the abdominal
muscles have been stitched up
satisfactorily with the kind of
thread that lasts indefinitely, the
stitches should be able to bear
the strain of repeated coughing.

Sutures are simply surgical stitches. They are an efficient method of keeping a wound closed while the tissues heal. Sutures are made in a variety of materials and can be absorbable or nonabsorbable.

The interrupted vertical mattress and subcuticular stitches are those most
commonly used. The latter eliminates any scarring from holes made by the needles.
Deep sutures are used with other stitches when there would be a gap, or dead space,
beneath the surface. With all three kinds, however, each stitch is individually tied, so
that if one gives way, the others remain secure, unlike in continuous stitching. The
actual choice is dictated by the surgeon’s preference, and by practicalities such as
tissue type, location, and final cosmetic appearance
.

When a surgeon stitches tissues back together he or she may use stitches that are very similar to those used by a tailor or dressmaker. The materials used can be divided into two basic types: those that dissolve over a period of time, and those that last for a lifetime. The former Include catgut and Dexon, a synthetic substance; the latter include nylon, silk, linen, and wire.


Methods and materials

The two edges of a wound may be stitched together in different ways. A continuous stitch may be used with a knot at each end, or the same effect can be obtained by inserting a row of separate stitches, each with its own knot. Using separate stitches (Interrupted sutures) ensures that if one knot comes undone, or the material used breaks, the whole seam will not come apart. The decision whether or not to use absorbable stitches depends on many factors, the most important being the speed at which the tissues are likely to heal. Dissolvable sutures lose their strength early and so are used when healing occurs quickly, as in stomach repair surgery, when the wound will heal in a few days (see Healing). By contrast, for a hernia repair, most surgeons use nylon stitches, which remain strong for many years, and especially until scar tissue has formed. If absorbable sutures were used, the hernia would be more likely to recur.


Skin stitches

There are many ways of joining skin. Continuous or Interrupted stitches may be used, with absorbable or nonabsorbable materials. Metal clips or staples may be used, or butterflies made of adhesive tape. When nonabsorbable sutures are chosen, they are usually nylon or silk, and are left in the skin for about a week, until the wound is healed enough so that it will not reopen.

Sutures on the face are usually removed after a few days because the skin heals quickly, and because, if they are left in position too long, they will leave puncture marks. Absorbable sutures, usually Inserted as one continuous thread just under the skin, cannot be seen from the outside.

See also: Hernia; Plastic and reconstructive
surgery; Scars; Surgery

-2144-

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Encyclopedia of Family Health - Vol. 15
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Spastic Colon 2022
  • Specimens 2024
  • Speculum 2027
  • Speech 2028
  • Speech Therapy 2032
  • Sperm 2034
  • Sphygmomanometer 2036
  • Spina Bifida 2037
  • Spinal Cord 2040
  • Spleen 2044
  • Splinters 2047
  • Splints 2048
  • Sports Injury 2050
  • Sports Medicine 2052
  • Sprains 2056
  • Stammering and Stuttering 2058
  • Staphylococcus 2062
  • Starch 2063
  • Stem Cell 2065
  • Stenosis 2067
  • Sterilization 2068
  • Steroids 2072
  • Stethoscope 2074
  • Stiffness 2076
  • Stillbirth 2080
  • Stimultants 2083
  • Stitch 2086
  • Stomach 2088
  • Stomach Pump 2091
  • Strangulation 2094
  • Streptococcus 2097
  • Stress 2098
  • Stress Management 2103
  • Stretch Marks 2105
  • Sty 2112
  • Subconscious 2114
  • Sudden Infant Death Syndrome 2116
  • Suffocation 2118
  • Sugars 2120
  • Suicide 2122
  • Sunburn 2126
  • Sunstroke 2130
  • Suppositories 2132
  • Surgery 2134
  • Surrogacy 2141
  • Sutures 2144
  • Swellings 2145
  • Symptoms 2149
  • Syphilis 2153
  • Syringing 2156
  • Index 2158
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