Post-Surgery Stitch Concerns: What to Do If a Stitch Falls Out?

Postoperative suture issues?

Dr.
Li: Hello, about a week ago I had a wound on my calf that was sutured with eight stitches after debridement.
Yesterday, during a dressing change, I noticed that only seven stitches remain, and I am unsure when one of them fell out.
I would like to ask:
1.
Since I cannot find the missing stitch and it may have integrated with the tissue, could this non-absorbable suture cause harm to my body? I had a previous experience where a stitch fell into the tissue, and I removed it, but this time I can't see it, and I am wondering if I should open it up to check?
2.
The doctor mentioned that I am somewhat overweight, which may affect wound healing, and that I need to wait three weeks to have the stitches removed.
I am concerned that if a stitch is embedded in the tissue, it may not be visible at that time.
Aren't these sutures considered foreign bodies? What reactions might occur if they are not removed properly?
3.
If there is indeed a stitch embedded in the tissue and it is not addressed now, could there be any consequences? Thank you.

Xiao Xin, 50~59 year old female. Ask Date: 2018/03/12

Dr. Li Zhonghuai reply Surgery

Hello! Unless the suture ends are very short, they should be detectable; if not found, they will gradually be expelled.
Take care! Changhua Hospital cares about you!

Reply Date: 2018/03/12

More Info

After undergoing surgery, particularly one involving stitches, it's common to have concerns about the healing process and the integrity of the stitches. Let's address your questions regarding the situation where one of your stitches has fallen out.

1. Concerns About the Missing Stitch: If a stitch has fallen out and you cannot find it, it is important to assess whether the remaining stitches are holding the wound together adequately. Non-absorbable stitches, if they have fallen out, can sometimes lead to complications if they are left embedded in the tissue. However, if the stitch has already integrated into the tissue and is not causing any irritation or infection, it may not pose a significant risk. It's generally not advisable to attempt to dig into the wound to find the missing stitch, as this can introduce bacteria and lead to infection.

2. Impact of Non-Absorbable Stitches: Non-absorbable stitches are designed to remain in place until they are removed. If they are left in the body, they can sometimes cause a foreign body reaction, leading to inflammation or infection. If the stitch is deeply embedded and not causing any symptoms, it may not need to be removed immediately. However, if you notice increased redness, swelling, or discharge from the wound, it would be prudent to consult your physician. They may recommend imaging studies to assess the situation further.

3. Potential Complications: If a stitch is left in the body and is causing irritation, it could lead to complications such as chronic inflammation or the formation of a granuloma (a small area of inflammation). In some cases, the body may eventually expel the stitch, but this process can take time and may not always occur without intervention. If you experience any unusual symptoms, such as persistent pain, swelling, or fever, it is essential to seek medical attention promptly.

In summary, while it is understandable to be concerned about a missing stitch, it is crucial to avoid self-managing the situation. Instead, monitor the wound for any signs of infection or complications and follow up with your healthcare provider for a professional evaluation. They can determine the best course of action, whether that involves monitoring the wound or possibly removing any problematic stitches. Your health and safety should always come first, so do not hesitate to reach out to your doctor for guidance.

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