How long after stitches removed can I take a bath

Down-to-earth clinical topics and discussions that demystify the aspects of medicine that make us anxious, normalize the seeming insanity of the job, and dissect the practices and thought processes of masters of the field. This free segment is just a sample of the full ERcast show's easily-digestible weekly episodes exploring the most important challenges that clinicians face, from clinical topics to self-care. Get over 2 hours of fresh podcast episodes per month and 27 AMA PRA Category 1 credit(s)™ of click-to-claim CME per year when you sign up for the full podcast at ercast.org Don’t forget to download the ERcast app for even more streamlined listening: https://itunes.apple.com/us/app/ercast/id1361125652?mt=8 Like what you hear? Get more great medical education like board review, adaptive Qbanks and self-assessments at hippoed.com/em

When the cut has healed, the sutures have done their job and are removed. Some types of sutures will automatically dissolve.

Sutures could be made of natural materials such as silk, or synthetic materials such as nylon.

What are the different sutures my doctor might use?

There are different types of sutures and techniques your doctor may use, depending on your wound.

Sutures can be:

• regular stitches — these will be removed by a doctor or nurse once the wound has healed
• dissolvable stitches — these are absorbed by the body naturally and do not need to be removed

Wounds or cuts can also be held together in other ways, such as:

• a special glue for skin, which falls off by itself in a few weeks
• adhesive tape (such as wound closure strips), which also falls off after some time
• metal staples, which must be removed by a doctor or nurse

Stitches in your mouth are usually dissolvable. They will fall out on their own, usually after around a week but can take up to 4 weeks to dissolve.

How can I care for my sutures?

Taking good care of the sutures will help your wound heal cleanly and minimise scarring. It’s important to keep sutures clean and dry, especially for the first 24 hours.

After 24 hours, you can wet the sutured area gently and quickly, for example in a sink or in the shower. Carefully pat the stitches dry immediately, as moisture can slow down the healing process.

The following tips can help you care for your sutures:

• Do not soak in a bath or swim until the sutures are removed or have dissolved.
• Do not pick at the stitches or scabs as it may increase scarring. These will fall off once the wound heals, or when the sutures are removed.
• Only use creams and lotions if they are recommended by your doctor.
• If your sutures have bandages or dressings, follow the care instructions given by your doctor or nurse, including keeping them clean and dry.
• Avoid physical activities that might re-open the wound. Children should avoid activities such as playing in sandpits or mud, riding bikes or swimming.

You can usually manage pain from the sutures with simple pain relief medicine such as ibuprofen or paracetamol. Check the dose of pain medicine recommended on the pack.

How do I prevent or minimise scarring?

The wound will leave a scar, whether it has been stitched or glued. The scar may look red or purple in colour or be raised; however, will fade to light pink, white or be nearly invisible over time. This may take up to two years.

Sun damage can make the scar darker and more visible. You can help protect against a darker scar by using sunscreen on the healed wound for at least 12 months.

How long will my wound take to heal?

Keeping the wound dry will allow your skin to come together and start the healing process. The healing of the wound, as well as the final appearance of the scar, depends on many factors including the original wound, inherited skin qualities and how well the scar is looked after.

When should my sutures be removed?

Stitches are often removed after 5 to 10 days, but this depends on where they are situated. Your doctor or nurse will advise you on the right time to remove your stitches. If the stitches are taken out too soon, the wound might not have healed properly. If you leave them in too long, they can be more difficult to remove and increase the risk of scarring. Dissolvable sutures do not need removal by a doctor or nurse. They will disappear naturally in a week or 2, but some take several months.

A suture is a stitch or a row of stitches holding together the edges of a wound or surgical incision. Sutures can sometimes be called stitches.

It is important to care for your sutures to help the healing process.

Keep the wound dry

• It is important to keep your wound dry, especially for the first 24 hours. The wound needs time to heal and moisture will slow this down.
• After the first 24 hours you can wet the wound for a short time, for example in the shower. Pat the wound dry immediately after it gets wet.
• Do not soak the wound or swim until the sutures have been removed.
• Only use creams or ointments (emollients) recommended by your doctor.
• If you sutures are also dressed with bandages, follow the care instructions given by your doctor.

Keep the wound clean

• Keep your wound clean and dirt free.
• Avoid any activities that may put strain on the area that has been sutured. This could lead to sutures coming apart.

The healing process

• Do not pick covering dressings.
• Do not pick scabs. They will fall off once the wound is healed or when the sutures are removed.
• A slight ooze may occur when the suturing is removed. This is normal.
• It is normal for the scar to be red in colour initially, but this will fade over the next few months.

Signs of infection

A wound may become infected. Signs of infection are:

• fever within 48 hours of suturing
• redness
• swelling
• increased pain
• excessive or persistent ooze
• pus or smelly discharge.

If you are concerned about possible signs of infection or have any other concerns visit your GP or Emergency Department.

Pain relief

• If you have mild pain, consider taking paracetamol or ibuprofen and follow the manufacturer’s instructions.

Removal of sutures

• If sutures fall out before their removal date see your doctor.
• Your GP may be able to remove the sutures.
• In some cases, disposable sutures are used. These stiches will dissolve and break down themselves. These will not need to be removed by a doctor.

Wound healing and scarring

Scars form as a normal part of healing whenever the skin is damaged. All cuts will heal with a scar, however, the scar will be less noticeable if good care is given to the wound when it is healing.

During the first 6 to 8 weeks after the injury, the scar will change from a thick, red raised scar to a thinner, paler, more flexible one. 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 colour 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.

Moisturising

Moisturising lotions such as Vitamin E cream, aloe vera, sorbolene or other un-fragranced products can be used to soften the scar and make massage easier.

Sun protection

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

Daily activity

It is important to avoid activities and areas that will get the wound dirty. This includes bike riding, skateboarding and swimming and play areas like sandpits.

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 (especially dark, Mediterranean or Asian skin), previous problem scars, or post-operative wound complications such as poor healing (greater than three weeks) or infection.

Contact your GP if you are concerned that your scar is not healing as expected.

Where to get help

Acknowledgements

Child and Adolescent Health Service – Community Health (CAHS CH)

This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.

What should you not do after stitches are removed?

What to expect after stitches are removed?

How long after getting stitches out can you get it wet?

How long after stitches removed Can I go in hot tub?