Suture Abscess--dig It out or Leave It Alone?

I am 4 weeks post FTT. At my day 5 doctor visit, we noticed a red bump at the top of the incision. I figured it was a stitch coming out, and the nurse tried to coax it out w/ sharp tweezers, but nothing came of it. Yesterday while massaging the incision, I realized that the bump was no longer red and was just skin colored, and underneath it feel like a small pebble. The PS nurse said it would go away by itself eventually or I can try to get it dug out again. No infection. What should I do?

Doctor Answers 9

Leave it-- Let it dissolve.

It’s not unusual for plastic surgeons to utilize buried absorbable sutures when they perform abdominoplasty surgery. These sutures are placed in the dermis to provide strength to the wound closure.
Depending upon the specific type of suture utilized, these sutures typically resorb in two to three months following surgery. At this point the wound has gained most of its tensile strength and scars are less likely to spread.
Unfortunately, these sutures are a foreign material and for this reason your body has a tendency to work them to the surface before they’re totally dissolved. This doesn’t represent a true allergic reaction, but instead a normal response to a foreign material. When sutures break through the skin, they can sometimes become infected and form a stitch abscess.
This is a common occurrence when this type of suture is utilized. When these sutures protrude through the skin they should be removed to avoid secondary problems. If the sutures are buried and not causing problems they should be left alone to dissolve on their own.

Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

Spitting suture in Reno

I'm  almost sure your surgeon would have used a dissolving suture. I have seen some surgeons use a deep permanent suture. If its coming to the surface it will likely spot, in that case it's easy to numb the area and remove the suture. Either way this is not a serious issue. You should not try to dig it out. 

Charles Virden, MD
Reno Plastic Surgeon
5.0 out of 5 stars 70 reviews

Treatment of Suture Abscess?

Thank you for the question.

It is difficult to give you good advice without direct examination. I would suggest that you make sure your operating plastic surgeon sees the area ( not just the “PS  nurse").

If the area is truly related to a stitch,  then either modality of treatment will work. Usually, the stitch will come to the surface and be removed easily. Generally, there is no need to “dig it out”.

Again, your plastic surgeon is in the best position to help you with this and other postoperative questions and concerns.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,485 reviews

Suture abscess

Either option is acceptable and you may see more of this over the first 3-4 months after surgery. Follow up with your plastic surgeon

Michael Hueneke, MD
Nashville Plastic Surgeon
4.9 out of 5 stars 63 reviews

Dealing with sutures deep to the skin

From the information that you provided, it appears that your doctor's office is providing you with the correct information. If a suture is coming through the skin and possibly causing inflammation, it should be removed. If it is situated right below the skin, causing no inflammation or any symptoms and is dissolvable, there is really no reason to remove it - it will disappear on its own over time. This sounds like your situation.

A permanent deep suture poking into the skin (which does not sound like your situation) may present a problem in the future and may ultimately need to be removed. 

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

Does a stitch need to be removed from a tummy tuck

dissolving sutures will dissolve 

sutures that are permanent may work their way to the surface like a splinter but

they can be removed if troublesome

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 107 reviews

Spitting stitch after abdominoplasty

If you have what's called a spitting stitch, which is coming up to the surface of the wound, it will work itself out and can then be removed easily. However, if you had a buried stitch, such as Prolene, that had caused a true wound abscess, it would require opening the wound and removing the suture material. If there is any question, you should be seen by your plastic surgeon and not by the nurse.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 39 reviews

Leave it

This is a deep suture that will absorb. It is not uncommon for them to spit out and cause inflamation in the process.  Listen to your plastic surgeon.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 75 reviews

Most stitch abscesses will fix themselves with topical wound care.

Most abdominoplasties are performed with the placement of many buried sutures.  The body disposes of these sutures over time by an inflammatory reaction.  Occasionally this may be intense and mimic a small localized infection (usually it is sterile, however).  The body will "push" the suture to the skin and expel it over time, call necessitating.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

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.