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Sutures

Alternate Names

  • stitches

Definition

Sutures, or stitches, are materials used to sew a wound closed. Their intent is to improve and speed the healing of the wound.

What is the information for this topic?

Many different types of materials can be used to close a wound. These materials range from a special glue to wire staples, and from animal protein to synthetic thread-like materials. Sutures are used to close cuts from injuries or surgery and other procedures.
Sutures are commonly used on the skin, but can also be used for internal tissues, organs, and blood vessels. One important distinction among different kinds of skin sutures is whether the sutures are absorbable or nonabsorbable.
  • Absorbable sutures dissolve on their own and may not require a return visit to the healthcare professional.
  • Nonabsorbable sutures must be removed. This often requires a repeat visit to a healthcare professional or emergency department.
The type of suture used is often related to the professional's preference as well as the type and location of a wound. Sutures applied to deeper tissues are usually never noticed.
A person is normally put to sleep with general anesthesia during procedures that require internal sutures. Generally, these sutures never need to be removed, even if they do not dissolve.
When sutures are applied to the skin after a cut, the wound is first cleaned. Local anesthesia may be injected under the skin that will be stitched. A cotton ball soaked in numbing medicine can be used to apply topical anesthesia to the wound on a child. This is generally left on for 15 minutes. Once the area is numb, the skin is stitched closed.
After the sutures are in place, antibiotic cream and a bandage may be applied. After getting sutures in the skin and other visible areas, it is important for a person to follow steps for proper home care. This allows the wound to heal properly and helps avoid infection. These instructions vary and will be provided by the healthcare professional who put in the sutures.
Generally, a person will be told to:
  • keep the wound clean and dry
  • leave any bandage on for at least 24 hours. If any pieces of tape were applied over the wound, they can be left in place until they fall off. This normally occurs within 48 hours.
  • clean the wound gently with soap and water until all crusted blood is removed once the bandage can be taken off. Usually, this should be done within 24 to 48 hours.
  • apply an antibiotic cream and a clean bandage after cleaning the wound. If a bandage gets wet or dirty, it should be replaced.
  • avoid tub baths or soaking. Showering and sponging off is generally fine after 24 hours. Sometimes waterproof bandages are recommended while showering. Afterward, the wound should be gently patted dry, not rubbed.
A person should return to the healthcare professional or emergency department as scheduled if the sutures need to be removed. This needs to be done for most nonabsorbable sutures. Most sutures are removed 4 to 10 days after being applied. Leaving sutures in longer than advised can lead to increased scar formation or infections.
All wounds, whether made during surgery or sustained as an injury, may get infected. It is important to watch for signs of infection in the wound, which include:
  • increased pain
  • swelling
  • increased warmth in the area
  • redness
  • pus coming from the wound
  • fever
If signs of infection occur, a healthcare professional should be notified. If any bleeding from the wound occurs, gentle pressure can be applied with a clean bandage or gauze. If bleeding continues for more than 15 minutes, a healthcare professional should be called.
By pulling the edges of a wound together, stitches usually help in healing. However, they have the potential to cause infection and scarring. This is especially true when sutures are left in for too long.
For most large cuts or gashes, the individual comes out with a better result with sutures than without. After examining a wound, a healthcare professional can advise whether or not sutures are needed.

Sources

Principles of Surgery, 1999, Schwartz et al.

Emergency Medicine, 1998, Rosen et al.

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