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Still Spitting Stitches 7 Mths Post-op TT, is this Normal? (photo)

I have a small spot on my scar that is still spitting stitches/disolvable staples 7 mths out. I've had multiple ones removed and the spot is sore/tender. A stitch that was shaped like a loop and attached to some part inside me came out the top of the hole but isnt sliding out it is wrapped around a muscle or chunk of tissue. it almost looks like a blister with a stitch looped through it. I have an appt with my surgeon tomorrow so he can check. Is this rare to still have spitting this late?

Doctor Answers (10)

Suture "spitting" 7 months after tummy tuck--remove it and all will be fine.

+3

If only dissolving sutures are used, by 7 months they would all be long gone--any spots like this would be due to an ingrown hair or infected cyst, both of which can occur along scars.

However, many plastic surgeons (myself included) use permanent sutures as part of the muscle plication. Braided sutures can become infected somewhat more easily than monofilament sutures, but braided sutures can allow tissue ingrowth for a more durable internal scar. Thus, there is no right or wrong, only surgeon preference based on individual patient needs and tissue characteristics. But this problem is why I prefer monofilament permanent sutures for the muscle repair; when stitch 'spitting" occurs, it is almost always with braided permanent sutures. The same even applies to dissolving skin stitches--braided sutures have a much higher likelihood for "suture reaction" (actually stitch abscess) than monofilament.

Unfortunately, once one "permanent" (non-dissolving) suture becomes contaminated by bacteria, others nearby can also have the same issue, and neither the bacteria nor your body "wins" the battle against each other until the suture is removed. Sometimes the offending suture is removed and all is well until an adjacent suture becomes a "new" problem. The treatment is the same--removal eliminates the source, and your body quickly heals the area, usually with little additional scarring. But until it is removed, the contaminated stitch can indeed take several months to cause a tract to the skin surface

The rest of your suture line looks great, and I see no other areas of redness or irritation similar to the one in the center just above your pubic area. Once the stitch is completely removed (either no or local anesthesia), the problem is usually solved without any additional antibiotic therapy, though this may be something your surgeon will add if needed. It should heal in several weeks either way, and the redness and blister-like swelling will resolve. See your surgeon as planned and be reassured. Best wishes!


Minneapolis Plastic Surgeon
5.0 out of 5 stars 123 reviews

Sutures after abdominoplasty

+2

sutures can be permanent or absorb able       either way..  if they continues to cause a problem   they should be removed

 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 16 reviews

Spitting Sutures 7 Months after Surgery

+2

Although not common, once in a while, a suture may work its way out. Most patients heal fine after the suture is removed.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
5.0 out of 5 stars 17 reviews

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"Spitting" Stitches 7 Mths Post-op TT

+2

We often have to use non-dissolving stitches to keep structures from moving and scars from widening. Unfortunately, while these stitches are great in keeping scars from widening and elevated thighs from sliding lower, once bacteria colonize them, the body pushes the stitch out. Your wound (smooth, round, like a punched out hole) is typical of a chronic wound. Complete removal of the stitch would result in rapid wound healing in a few weeks with a reasonable scars.

Good Luck with your appointment. It wiil NOT hurt.

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Stitch Spitting after Tummy Tuck?

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Thank you for the question.

What you are  experiencing does occur occasionally after tummy tuck surgery. Usually, it is related to the permanent sutures used for muscle plication.  If these sutures continue to be problematic they may need to be removed before the wound healing problems cease to occur. I have seen this in a few patients;  the wound healing problems around the umbilicus is a classic finding.

Continue to follow-up with your plastic surgeon.

Best wishes.

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Still Spitting Stitches 7 Mths Post-op TT, is this Normal? (photo)

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This issue can occur over a few months to years depending upon WHICH type of suture material was used. Check with the operative surgeon and tell us the answers. 

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Very Common Problem

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A tummy tuck procedure places many sutures in at various level and many of them dissolve   As they melt away they may cause a reaction the suture area open up and discharge the suture.  The will heal the area.

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Spitting suture

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7 months is getting the long side of normal for sutures to be causing problems.  If the suture is very superficial, usually warm compresses can work that suture out.  If not, I recommend excision of that problem area.

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Spitting sutures

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Spitting sutures 7 months after surgery is certainly uncommon but not unheard of, cause may include:

  • retained suture material (absorbable suture that has not been completely dissolved
  • permanent suture material
  • suture granuloma - inflammatory tissue that has formed as a reaction to the suture material
  • ingrown hair
  • sebaceous cyst

if removal of the foreign material (suture) has not resolved the problem, you may need a scar revision to address the underlying problem, in other words, excise the granuloma, hair, sebaceous cyst, or remaining suture material.

 

Sean A. Simon, MD
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Spitting suture

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What you are describing is a finding that can happen with non-dissolving sutures.  Because it is located in the midline, I suspect that the suture you are seeing is the one used to plicate (repair) your rectus diastaisis.  Once these sutures are involved with bacteria (colonized) the issue won't typically resolve until the definitive suture is removed. Regardless of how the suture became colonized, your experiencing an easily correctable issue. Best of luck.

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.