How to remove medical non absorbable sutures and precautions
When non absorbable sutures are used for surgical incision closure, the sutures need to be removed after the affected area has healed. Removing the wire is not as simple as people imagine, it's not just about removing the wire.
The first step in removing stitches is to understand the condition of the incision. Generally, surgical incisions are classified into sterile incisions, potentially infected incisions, and infected incisions based on whether they are infected with bacteria. When removing the thread, the principle is not to let the previously exposed line segment pass through subcutaneous tissue to avoid bacterial contamination. The time for removing non absorbable sutures should also be determined based on factors such as the incision site, local blood supply, patient's age and nutritional status, incision size and tension. Generally speaking, incisions on the head, face, and neck are removed 4-5 days after surgery; Lower abdomen and perineum for 6-7 days; 7-9 days for chest, upper abdomen, back, and buttocks; Limbs 10-12 days (with some extension near the joints). Sometimes interval rewiring can be used first; Purulent wounds should be immediately sutured; Adolescent patients can shorten the suture removal time appropriately; Older, malnourished and diabetes patients can delay the time of suture removal.
Under normal recovery of surgical incision, the process of removing non absorbable sutures is as follows:
1. Use iodine swabs to disinfect wounds, sutures, needle holes, and surrounding skin from the inside out, with a range of 5-6cm;
2. Hold the tweezers in your left hand and gently lift the suture knot to expose a small amount of the previously buried suture under the skin. Hold the scissors in your right hand and insert the hooked side cutting tip under the suture knot, pressing it tightly against the skin, and cut off the newly exposed suture segment;
3. Hold the tweezers with your left hand to pull out the suture, and the direction of pulling should only be towards the side where the suture is cut, in order to prevent the patient from experiencing pain and tearing the wound with excessive force;
After removing the first seam, if there are no signs of cracking, other seams can be removed at once. If there are more than 10 stitches and the tension is high, the stitches can be removed intermittently in stages;
5. After removing the stitches, disinfect the wound again, cover it with gauze, and fix it with adhesive tape.
Non absorbable suture thread removal method. jpg
When the wound healing is poor, redness, swelling, hardening, hematoma, fluid accumulation or surface skin cracking occur around the incision, after removing the suture line, it is necessary to apply medicine, pull it with butterfly tape, cover it with dressing, and if necessary, add bandages or abdominal straps for protection.
When the surgical incision is completely open or suppurative, sufficient drainage or secondary suturing is required after suture removal.
Precautions for removing non absorbable sutures:
1. Strictly follow aseptic surgical procedures and operate gently.
2. The healing speed of incisions in different tissues, ages, or parts varies, so careful observation of the incision and correct judgment of the healing situation are prerequisites for suture removal. If necessary, 1-2 stitches can be removed to test the healing strength of the incision, and then decide whether to completely or intermittently remove the stitches. Do not rashly remove all stitches at once when the wound is not healing properly.
3. After removing the stitches, pay attention to diet, avoid spicy and stimulating foods, rest, and inevitably engage in vigorous exercise.
If the following situations occur, the disconnection should be delayed:
1. Patients with severe anemia, emaciation, and mild malignant diseases;
2. Severe dehydration or electrolyte imbalance that has not been corrected;
3. Elderly patients and infants;
When coughing is not under control, the removal of incisions in the chest and abdomen should be delayed.
Of course, the later the stitches are removed, the better. The stitches should also be removed at an appropriate time, as removing them too late will leave scars. After removing the thread, the wound immediately faces the problem of increased tension, which may cause the wound to crack or widen scars. At this time, you can apply breathable flesh colored adhesive tape and change it every two to three days. Because it takes about 6 months for scars to mature and stabilize in strength, it is recommended that the adhesive tape be applied for 6 months to achieve the effect of reducing scar width.
In short, when removing non absorbable sutures, the first thing to pay attention to is the healing of the surgical incision. Secondly, attention should be paid to the time and maintenance of the suture after removal, as well as the aesthetic appearance of the incision healing.
