Suture care
What are sutures?
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.