What Can I Do About "Stitch Spitting" and Absess when the Sutures Are Nondissolvable?

Question

My ruptured breast implants were removed on July 2nd, 2011. Since then, sections of my scars remained red and oozed blood and a puss. After about a month of triple antibiotic treatment, the areas have not improved. When a nondisolvable suture came to the surface, I consulted with my P.S. who said the sutures were about a half inch below the surface and that I must have sensitive skin and to be patient. Is it proper to use nondisolvable sutures below the skin? Will I have scars from these?

Tom J. Pousti, MD · Answer

Yes it is &ldquo;proper&rdquo; to use non-dissolvable sutures. Sometimes this is done to avoid spreading of tissues such as areola  after surgery. Unfortunately, these non-dissolvable sutures can be more problematic than dissolvable sutures. If you continue to experience problems that you described and demonstrate,  the sutures may need to be removed.  Sometimes when the sutures are removed (if it had been used in a purse string fashion) you will find that the areola does spread.

	It is likely that once your problem resolves (one way or another) no significant additional scarring will be present.

	I would suggest continued follow-up and communication of your concerns with your surgeon.

	Best wishes.

Peter A. Aldea, MD · Answer

It is obvious that your surgeon has not properly educated you on the REASON he used non-dissolving sutures.

	First some Chinese fortune cookie philosophy - Good and bad are intertwined. There would be no light without dark or good without evil. Similarly, there is no such thing as a delicious non-fattening chocolate cake or a wonderful stock which always wins without losing.

	We use non-dissolving stitches when we want things to stay put and not move - No sane surgeon would stitch a heart valve, blood vessels and other items under tension with a titch which would be gone in 3-6 months at the most. Similarly, when you undergo certain procedures where tissues are under tension and stay so (High Lateral Tension Tummy Tuck, certain Breast Lift procedures, certain Facelift procedures) we use such sutures to permanently anchor things in place. HOWEVER, the "fattening" dark side of such stitches is that once they are colonized by bacteria and pock out of the skin, they will NOT heal over and must be removed.

	It appears this is the case here and your stitches are best removed. Once this is done the wounds will heal rapidly.

	Good Luck.

Steven Turkeltaub, MD · Answer

Nondissolvable sutures can be used deep to the skin. If they are poking through the skin or into the skin causing redness or pain, they should be removed.

	If you were applying a triple antibiotic ointment to the skin for a month - stop! This can cause skin irritation, rashes and skin breakdown.

	Request to be seen by your plastic surgeon again. If you are not satisfied with the situation, you also can obtain a second opinion from a reputable board certified plastic surgeon.

What Can I Do About "Stitch Spitting" and Absess when the Sutures Are Nondissolvable?

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What Can I Do About "Stitch Spitting" and Absess when the Sutures Are Nondissolvable?

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