Surgical Stitch Healing: When to Worry and Care Tips

It seems that the surgical stitches are almost merging with the skin?

Hello Doctor, I had surgery on the 10th (for a sebaceous cyst) near my anus, with one incision on the left side and one on the right.
I just used the restroom and while cleaning and applying medication, I noticed that the stitches on the left side are almost gone (I was startled).
I also looked online and found information about absorbable and non-absorbable stitches.
My stitches appear to be a bluish-green color under light, but I'm not sure; they do reflect light.
I don't know if my stitches are absorbable, but I have an appointment on the 26th to have them removed.
I'm unsure how quickly they might be integrating into the skin (I haven't checked them under light these past few days).
The stitches on the right side look intact, but the left side seems to be merging with the skin.
I'm concerned about whether this is normal.

Additionally, I wanted to ask about my hygiene practices.
From the 10th to the 16th, I started showering and used water to clean the area near the anus (since I didn't want to touch water while having a bowel movement, I only used wet wipes).
Eventually, I felt some itching around the anus.
It seems like there was an increase in discharge (a bit more than when I wasn't using water).
Should I not have used water? (I did ask the doctor, and I was told it was okay to use water.) However, today I noticed there isn't much discharge anymore.
I've already scheduled a follow-up appointment for Monday (the 22nd).
Thank you, Doctor.

An, 40~49 year old female. Ask Date: 2024/01/20

Dr. Ke Fangxu reply Surgery

I just saw the letter today (the 23rd), and the sutures should have already been removed.
Generally, surgical sutures are mostly non-absorbable, meaning they need to be removed.
The timing for suture removal depends on the location and length of the incision, typically ranging from 5 to 14 days.
However, if it exceeds 10 days, the sutures are likely to become embedded in the skin, so they should not be removed too late, as this increases the difficulty and risk of infection.

Reply Date: 2024/01/20

More Info

After undergoing surgery for a pilonidal cyst near the anal area, it is essential to monitor the healing process of the surgical stitches closely. Here are some insights and care tips regarding surgical stitch healing, when to worry, and how to manage your recovery effectively.

Understanding Surgical Stitches
Surgical stitches, or sutures, are used to hold the edges of a wound together to promote healing. There are two main types of sutures: absorbable and non-absorbable. Absorbable sutures dissolve over time and do not require removal, while non-absorbable sutures need to be taken out by a healthcare professional after a certain period.

In your case, it seems you are concerned about the appearance of the stitches on the left side, which appear to be fading or integrating into the skin. This can happen with absorbable sutures as they begin to dissolve. However, if you are unsure whether your stitches are absorbable or non-absorbable, it is crucial to consult your surgeon for clarification.

When to Worry
1. Infection Signs: If you notice increased redness, swelling, warmth around the wound, or discharge that is yellow or green, these could be signs of infection. Additionally, if you develop a fever, it is essential to seek medical attention promptly.

2. Stitch Integrity: If the stitches appear to be coming apart or if there is a significant gap in the wound, this could indicate a problem with healing. If the left side's stitches seem to be disappearing while the right side remains intact, it is advisable to contact your doctor.

3. Increased Discharge: While some discharge is normal, especially in the early stages of healing, a sudden increase in discharge, particularly if it is foul-smelling, warrants a medical evaluation.

4. Pain Management: If you experience increased pain that is not alleviated by over-the-counter pain medications, or if the pain worsens over time, you should reach out to your healthcare provider.

Care Tips
1. Wound Cleaning: It is generally recommended to keep the area clean and dry. If your doctor has advised that you can shower, ensure that you gently clean the area with mild soap and water. Avoid scrubbing the wound directly; instead, let the water run over it and pat it dry with a clean towel.

2. Moisture Management: If you notice that the area becomes itchy or irritated after exposure to water, it may be beneficial to limit direct water contact. You can use a damp cloth to clean the area without soaking it.

3. Medication Application: If your doctor has prescribed ointments or creams, apply them as directed. Avoid using products that are not recommended by your healthcare provider, as they may irritate the wound.

4. Monitoring Healing: Keep an eye on the wound's appearance daily. Take note of any changes, such as color, size, or discharge, and report these to your doctor during your follow-up appointment.

5. Follow-Up Appointments: Attend all scheduled follow-up appointments. Your doctor will assess the healing process and determine if the stitches need to be removed or if further intervention is necessary.

Conclusion
In summary, while it is normal to have concerns about surgical stitches and healing, being proactive in monitoring your recovery and following your doctor's instructions is crucial. If you have any doubts or notice concerning symptoms, do not hesitate to reach out to your healthcare provider for guidance. Remember, your health and peace of mind are paramount, and your doctor is there to help you navigate this healing process.

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