Suture Care

How to care for your sutures and know when to get help.

What Are Sutures?

Sutures are stitches used to hold the edges of a wound together while the skin heals. Good aftercare helps lower the chance of the wound reopening, getting infected, or forming a more noticeable scar.

Keep the Wound Dry

  • Keep the wound and bandage dry for the first 24 hours unless your practitioner gave you different instructions.
  • After the first 24 hours, gentle showering or brief washing is usually fine. Clean the area gently with mild soap and water, then pat it dry with a clean towel. Do not scrub the wound.
  • Do not soak the wound in a bath, hot tub, pool, or natural body of water until the sutures have been removed and the skin surface is closed.
  • Your sutures will be covered with a bandage when you leave. Replace the bandage if it becomes wet or dirty.

Keep the Wound Clean

  • Wash your hands before touching the wound or changing the bandage.
  • Keep the wound clean after you leave and protect it from rubbing and unnecessary strain.
  • Do not scrub the wound while washing it.
  • Avoid activities that pull on the sutured area. Too much tension can cause the wound to reopen.
  • Sutures on the lower extremities have a higher risk of infection than wounds in many other locations, so take extra care with sutures on the legs and watch them closely for increasing redness, drainage, or pain.

Your Aftercare Kit

If you received a suture aftercare kit, it may include:

  • A suture removal kit
  • PurSan cleanser containing PCMX
  • A packet of triple antibiotic ointment
  • Two extra bandages

For routine care at home:

  • After the first 24 hours, gentle cleansing with PurSan or another mild soap is usually enough for routine wound care.
  • A thin layer of triple antibiotic ointment can be helpful for reducing infection risk in sutured wounds, unless you have an allergy to bacitracin, neomycin, or polymyxin, or you were told not to use ointment.
  • Use the extra bandages to keep the wound clean and covered during the first few days, and replace them if they become wet or dirty.
  • The suture removal kit is included in case self-removal has been discussed with you. A clinician can also remove your sutures if you are not able to.

The Healing Process

  • Do not pick at bandages, dried drainage, or scabs.
  • A small amount of clear or blood-tinged drainage can happen in the first day or two.
  • A small amount of spotting may occur when sutures are removed. This can be normal.
  • It is normal for the scar to look pink or red at first. It usually fades and softens over the next few months.

Signs of Infection

A wound may become infected. Warning signs include:

  • Redness that spreads away from the wound
  • Swelling or warmth around the wound
  • Pain that is getting worse instead of better
  • Thick yellow, green, or foul-smelling drainage
  • Fever
  • The wound edges pulling apart

If you are concerned about infection or any other problem with healing, contact your doctor, urgent care, or an emergency department.

Pain Relief

If you have mild pain, consider acetaminophen or ibuprofen and follow the label directions unless you were told otherwise.

Removal of Sutures

  • A clinician can also remove your sutures if you are not able to.
  • If sutures fall out before the planned removal date, or if the wound reopens, get medical advice.
  • These are general timelines. Follow the instructions you were given if they differ.
Wound Location Timing of Removal
Face 3-5 days
Arms 7-10 days
Torso 10-14 days
Legs 10-14 days
Hands / Feet 10-14 days

Removing Your Own Sutures

Only remove your own sutures if that plan was discussed with you and the wound edges are closed.

  1. Gather your suture removal kit and set up a clean work surface.
  2. Wash your hands well with soap and water or use hand sanitizer. Put on gloves if they are available.
  3. Open the packages you will need before you begin.
  4. If there is dried drainage on the area, gently clean around the sutures with saline or mild soap and water, then pat dry. Do not use alcohol or hydrogen peroxide on healing skin.
  5. Use the tweezers to lift one knot gently.
  6. Slip the scissors under the suture and cut one side close to the skin.
  7. Pull the suture out gently by the knot. If it does not slide out easily, stop rather than forcing it.
  8. Repeat one stitch at a time until all sutures that were scheduled for removal are out.
  9. When you are done, clean the area gently, pat it dry, and apply a thin layer of ointment only if you were instructed to use one and you are not allergic to it.
  10. Re-bandage the area if it is likely to get rubbed or dirty.
  11. If the wound opens, bleeds significantly, drains pus, or looks more inflamed after removal, seek medical care.

Wound Healing and Scarring

Scars form as a normal part of healing whenever the skin is damaged. All cuts heal with some degree of scarring, but the scar may be less noticeable if the wound heals cleanly and is cared for well. During the first 6 to 8 weeks after the injury, the scar will often change from a thick, red, raised scar to one that is thinner, paler, and more flexible. Scars can take up to 2 years to fully mature. The final appearance of the scar depends on several factors including the extent of the original wound, inherited skin qualities and how well the scar was looked after.

Looking After Your Scar

Scar Massage

After the sutures have been removed from a wound, or around 2 to 4 weeks after the injury, scar massage can be performed. This should be done for 5 to 10 minutes, twice a day. Do not massage any scar that is open or looks infected. For the first 2 to 4 weeks, massage should be done along the same direction as the incision. The pressure applied should be enough to change the color of the scar from pink to pale, but should not be so firm that it is painful. After about 4 weeks, the scar can be massaged in all directions. Continue to massage daily until the scar is pale and thin.

Moisturizing

A plain, fragrance-free moisturizer can be used to soften the scar and make massage easier. Stop using any product that stings, causes a rash, or seems to irritate the skin.

Sun Protection

It is very important to protect the scar from sun damage, which can permanently discolor the scar. You should always cover the scar with at least SPF 30 sunscreen, wear clothing that covers the scar and stay in the shade.

Daily Activity

It is important to avoid activities and environments that put repeated friction on the wound. This is especially important for sutures on the legs, ankles, or feet. If the sutures are on the lower leg or foot, reduce unnecessary walking and elevate the area when possible during the first couple of days.

Problem Scars

A scar is a problem if it is painful or itchy, hard or raised, restricts movement or remains purple or red. Risk factors for problem scars include certain skin types, previous problem scars, or postoperative wound complications such as poor healing (greater than three weeks) or infection. Contact your doctor or clinician if you are concerned that your scar is not healing as expected.

Sources: