Addressing the Issue of Retained Sutures After Surgery: A Patient's Guide

Residual suture thread issue

I sustained a deep open wound on my knee during a soccer match in the fourth grade.
I was taken to an emergency room in southern Taiwan, where the wound was urgently sutured.
There are three visible suture ends that were not removed.
The doctor mentioned that the tissue would eventually absorb them.
However, I frequently feel three distinct lumps on my knee, which are painful when pressed.
Later, in sixth grade, after moving to New Taipei City and during track practice, I fell and did not properly care for the abrasion, leading to severe inflammation in my knee.
A doctor at the outpatient clinic drained pus from the area and found intact white suture ends, similar to thick cotton thread.
Now, at 37 years old, those suture ends are still present and remain noticeable lumps that are painful when pressed or when I kneel.
This has been quite bothersome.
I would like to know which specialty I should consult for this issue, and how I should explain my situation to the physician to seek assistance in addressing it.

sung, 30~39 year old female. Ask Date: 2017/09/18

Dr. Li Zhonghuai reply Surgery

Hello! General surgery can handle this.
Please inform the physician that your body cannot absorb the sutures; nylon sutures can be used instead.
Take care! Changhua Hospital cares about you!

Reply Date: 2017/09/18

More Info

Addressing the issue of retained sutures after surgery is an important concern for many patients, especially those who have experienced complications or ongoing discomfort. In your case, it appears that you have retained suture material from a previous knee injury that has resulted in persistent pain and discomfort. Here’s a comprehensive guide on how to address this issue.

Understanding Retained Sutures
Retained sutures can occur when the sutures used to close a wound are not fully removed or dissolve as expected. This can lead to various complications, including inflammation, infection, or the formation of painful nodules under the skin. In your situation, the presence of palpable nodules that are painful upon pressure suggests that the retained sutures may be causing localized irritation or an inflammatory response.

Steps to Address the Issue
1. Consult a Specialist: The first step is to consult an orthopedic surgeon or a general surgeon who specializes in wound care and soft tissue injuries. These specialists have the expertise to evaluate your condition and determine the best course of action. You may also consider seeing a plastic surgeon if the retained sutures are affecting the cosmetic appearance of your knee.

2. Prepare for Your Appointment: When you visit the doctor, be prepared to provide a detailed history of your injury and the subsequent treatments you received. Explain the timeline of events, including when the sutures were placed, any complications you experienced, and the ongoing symptoms you have, such as pain and the presence of nodules.

3. Physical Examination: The doctor will likely perform a physical examination of your knee to assess the nodules and any signs of inflammation or infection. They may also ask about your range of motion and any activities that exacerbate your pain.

4. Imaging Studies: Depending on the examination findings, the doctor may recommend imaging studies, such as an ultrasound or MRI, to visualize the retained sutures and assess the surrounding tissues. This can help in planning any necessary surgical intervention.

5. Surgical Intervention: If the retained sutures are confirmed and are causing significant pain or other complications, the surgeon may recommend a minor surgical procedure to remove the suture material. This is often done on an outpatient basis and can provide significant relief from symptoms.

6. Post-Operative Care: After the removal of retained sutures, follow the post-operative care instructions provided by your surgeon. This may include keeping the area clean, monitoring for signs of infection, and gradually resuming normal activities as tolerated.

7. Rehabilitation: If your knee has been affected by the retained sutures, physical therapy may be beneficial to restore strength and range of motion. A physical therapist can design a rehabilitation program tailored to your needs.

Conclusion
Retained sutures can lead to ongoing discomfort and complications, but with the right approach, they can be effectively managed. By consulting with a specialist, preparing for your appointment, and following through with any recommended treatments, you can address the issue and improve your quality of life. Don’t hesitate to communicate your concerns clearly to your healthcare provider, as this will help them understand your situation better and provide the appropriate care. Remember, it’s important to advocate for your health and seek the help you need to resolve this issue.

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