Why Do Patients' Bodies Reject the Green Non-Dissolvable Sutures?

Question

It's been years since my tummy tuck but my body has been rejecting the green non dissolvable sutures according to my surgeon. The affected areas started bruising then swelling until I started feeling a poking sensation which resulted in tearing of my skin, fluid coming out, soreness etc. I had 2 of them fixed and I'm hoping that the rest of the sutures will not give me the same problem. Please tell me why this is happening despite of the fact that it's been years since I had my surgery?

Kevin Brenner, MD, FACS · Answer

There are several reasons why patients may "reject," or "spit" sutures. Most commonly, if sutures are placed too superficially and are a large caliber suture, then the knot may be palpable (i.e. you can feel it with your finger) below the skin.  Over time, the knots from these sutures can cause friction on the immature overlying scar tissue and gradually work their way through. This can occur with both absorbable sutures (i.e. Monocryl, Vicryl, & PDS) as well as with non-absorbable sutures (i.e Nylon, Silk, & Prolene).

	Absorbable sutures absorb through your own body's inflammatory reaction to the suture material. Occasionally, that process can become colonized with bacteria and the suture knot can become infected. This is called a suture abscess. The treatment for this problem is simply to remove the suture.

	Non-absorbale monofilament sutures (i.e Nylon, Prolene) are just that: they are non-absorbable. Most of them are made out of inert material and do not cause much reaction from the surrounding tissues. Non-absorbable sutures are safe to be buried below the skin, as long as they are buried deep within the tissues. When they are placed too close (superficial) to the skin, they can erode through to the surface. Braided non-absorbable sutures (i.e Ethibond, Silk or Mersilene), although softer than non-braided sutures, can also become problematic. Even though braided sutures work very well, because they are braided they tend to harbor bacteria much more easily in the cracks and crevices of the braids. Therefore, should they become exposed to bacteria in your body, they need to be removed.

Tom J. Pousti, MD · Answer

Thank you for the question.

	Unfortunately, what you have experienced can occur occasionally after tummy tuck surgery. The sutures used for muscle plication are either permanent sutures or long-lasting absorbable sutures. Either way, the sutures can come to the surface and cause issues such as  open wounds/inflammation/drainage...

	If this does occur, the sutures must be removed.  If it is a single suture this can usually be done in the office under local anesthesia.  if the entire row of sutures are involved,  more anesthesia may be helpful/necessary.

	I hope this helps.

Otto Joseph Placik, MD · Answer

Patients may reject or "spit" sutures for a variety of reasons. These include infection, foreign body granulation, proximity to ingrown hairs, seeding from bacteremia, etc.

Steven Wallach, MD · Answer

Although many surgeons use non-absorbable sutures to repair the diastasis recti, sometimes these sutures work their way out of the body.  It can happen at any time but is not common.

Mark Broudo, MD · Answer

I had a patient with a very similar problem recently. I'm not sure why it happens, but the only thing to do is to just take them out one at a time if they give you problems.

Why Do Patients' Bodies Reject the Green Non-Dissolvable Sutures?

Answers (5)

Answer: Suture abscesses

Answer: Suture abscesses

Answer: Ethibond sutures

Answer: Ethibond sutures

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.

Why Do Patients' Bodies Reject the Green Non-Dissolvable Sutures?

Answers (5)

Answer: Suture abscesses

Answer: Suture abscesses

Answer: Ethibond sutures

Answer: Ethibond sutures

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.