Dissolvable stitches, also known as absorbable stitches, are a type of surgical suture that does not require removal after the wound has healed. Unlike regular stitches that need to be taken out, dissolvable stitches are made of materials that the body can break down and absorb over time.
What are dissolvable stitches made of?
Dissolvable stitches can be made from a variety of materials that the body can metabolize, including:
- Catgut – Made from purified collagen taken from sheep or cow intestines
- Vicryl (polyglactin) – Synthetic polymer made from glycolide and lactide
- Monocryl (poliglecaprone) – Synthetic polymer made from glycolide and caprolactone
- Polydioxanone (PDS) – Synthetic polymer created from p-dioxanone
The most common dissolvable stitches are catgut and synthetic polymers like Vicryl. The type used depends on the location of the wound and how much time the body needs to absorb the suture.
Do dissolvable stitches look like cotton?
No, dissolvable stitches do not look like cotton. Unlike cotton thread commonly used for sewing, dissolvable suture material has a smooth, monofilament appearance.
Here are some key ways dissolvable stitches differ visually from cotton thread:
- Uniform thickness – Dissolvable sutures maintain an even diameter instead of the twisted, spun strands of cotton thread.
- Stiffness – Synthetic dissolvable sutures have a stiff, wiry quality while cotton is flexible and soft.
- Sheen – Many dissolvable stitches have a glossy or lustrous quality that cotton lacks.
- Color – While cotton thread comes in a range of colors, dissolvable sutures are generally undyed or purple/pink for visibility.
So while cotton sewing thread consists of thin, twisted fibers that create a soft, fuzzy yarn, dissolvable stitches look smoother, stiffer, and more plastic-like.
What are the advantages of dissolvable over regular stitches?
There are several benefits to using dissolvable stitches instead of non-dissolvable stitches that require removal:
- Fewer doctor visits – Dissolvable stitches eliminate the need for follow-up appointments just to take stitches out.
- Less discomfort – Removing stitches can be painful, so avoiding this step improves patient comfort.
- Lower infection risk – With no stitch removal, there is less chance of infecting the healing wound.
- Less scarring – Research shows dissolvable stitches minimize scarring compared to non-dissolving stitches.
- Cost savings – Not needing removal cuts down on medical costs for provider and patient.
- Convenience – Dissolvable stitches provide an overall easier, faster recovery process.
However, there are some locations and wound types where non-dissolvable stitches are still preferred by doctors. But for many common closure needs, dissolvable sutures provide a simpler and less painful option.
What are the absorption times for different dissolvable stitches?
The time it takes for dissolvable stitches to fully absorb depends on what material the suture is made from:
| Suture Material | Absorption Time |
|---|---|
| Catgut plain | 10 to 14 days |
| Catgut chromic | 90 to 120 days |
| Vicryl (polyglactin) | 56 to 70 days |
| Monocryl (poliglecaprone) | 90 to 120 days |
| Polydioxanone (PDS) | 180 to 210 days |
As this table shows, the absorption time can vary widely from about 10 days for plain catgut stitches up to about 180 to 210 days for polydioxanone synthetic sutures. Factors like the thickness of the thread and whether the material is treated to be longer-lasting also affect the dissolution rate.
What do dissolving stitches look and feel like as they are absorbed?
As dissolvable stitches are broken down in the body over days or weeks, their appearance and texture changes:
- The suture loses structural integrity and tensile strength so the thread becomes weaker.
- The material begins to disintegrate, becoming fragmented rather than a continuous fiber.
- The diameter decreases as the suture starts breaking apart and dissolving.
- Instead of smooth and solid, the stitch takes on a rough, granular texture.
- Color often fades first where the most friction occurs at the knot site.
- Over time, the thread becomes barely visible and only small polymeric fragments of the suture remain.
For the patient, these dissolving stitches often feel hard and stiff for the first 5 to 7 days. After that, as they weaken and deteriorate they begin feeling softer and more pliable. The fragmented stitch remnants also become less noticeable or invisible against the skin surface around 2 to 3 weeks before fully absorbing.
What problems require non-dissolvable stitches instead?
While dissolvable stitches are ideal for many wound closure needs, there are some cases where non-dissolvable stitches are still used instead:
- High tension areas – Joints or flex points experience more force and movement that can cause dissolvable stitches to break down too early before the wound fully closes.
- Large wounds – Deep lacerations or incisions with wider gaps need the prolonged strength of non-dissolvable sutures.
- Pediatric patients – Absorption times can vary in children so non-dissolvable stitches allow more control over removal timing.
- Hemostasis – Non-dissolvable stitches work better than dissolvable for wounds that won’t stop bleeding.
- Oral/mucosal tissues – The moist environment makes dissolvable stitches dissolve too quickly before these delicate tissues heal.
So while dissolvable sutures are suitable for many wound closure needs, there are still some cases where a doctor will opt for traditional non-dissolvable stitches instead.
Conclusion
In conclusion, dissolvable stitches do not resemble cotton thread in appearance or texture. Made from materials like catgut collagen or synthetic polymers, dissolvable sutures look smooth, stiff, and plastic-like compared to the soft fuzziness of cotton. As the stitches absorb over the course of weeks or months, they weaken, fragment, fade, and reduce in diameter. While not appropriate for all wound closure needs, dissolvable stitches provide benefits like reduced pain, lower infection risk, and fewer doctor visits for most patients requiring stitches.
