It is impossible for dissolvable stitches to not dissolve because they were made to be broken down by water via hydrolysis.
Patients are often concerned when they don't see the sutures dissolving but they often underestimate the time it takes absorbable stitches to dissolve. We will describe the different types of materials and when they're expected to get absorbed.
Last but not least, sometimes the stitches don't get a chance to even dissolve because a complication called a spitting suture may occur.
Table of contents:
Dissolvable stitches will dissolve via hydrolysis
Most dissolvable stitches are made of materials that are meant to dissolve in the presence of water aka hydrolysis. That is a chemical reaction where a molecule of water breaks one or more bonds thus forming smaller molecules.
Since the degradation process uses water, that makes it near impossible for the stitches to not dissolve because up to 60% of the adult human body is composed of water.
Below is a chart of all of the absorbable sutures and their dissolution mechanism.
Suture material | What it's made of | How it dissolves |
|---|---|---|
Fast gut | Animal intestines | Proteolytic enzymes |
Plain gut | Animal intestines | Proteolytic enzymes |
Chromic gut | Animal intestines | Proteolytic enzymes |
Polyglycolic acid | Polymers | Hydrolysis |
Polydioxanone | Polymers | Hydrolysis |
Polytrimethylene carbonate | Copolymers | Hydrolysis |
Polyglactin 910 | Copolymers | Hydrolysis |
Glycomer 631 | Copolymers | Hydrolysis |
Polyglytone 6211 | Copolymers | Hydrolysis |
Poliglecaprone | Copolymers | Hydrolysis |
As you can see most of the suture materials degrade via hydrolysis except the gut-type of sutures which dissolve via proteolytic enzymes. Nonetheless, the gut stitches are made of animal intestines so it's literally food and we all know that food can be degraded in the body. The chromic gut are the most favored by dentists to use after extractions.
Expected time for sutures to dissolve
Dissolvable stitches can take as little as 3 weeks to dissolve but also as long as 7 months for them to be completely absorbed by the body. Yes, you read that correctly, it takes a minimum of at least 3 weeks and sometimes it can take more than half a year.
Below is a table showing the estimated time it takes each absorbable sutures to dissolve.
Absorbable Sutures | Dissolution Time |
|---|---|
Fast Gut | |
Plain gut | |
Chromic gut | |
Polyglycolic acid (PGA) | |
Polydioxanone (PDS) | |
Polytrimethylene carbonate (Maxon) | |
Polyglactin 910 (Vicryl rapide) | |
Glycomer 631 | |
Polyglytone 6211 | |
Poliglecaprone (Monocryl) |
The length of time it takes them to dissolve is often much longer than what most people expect. On average, most patients think something is wrong when they don't see their stitches dissolving after a week but little do they know, it often takes longer than that.
It is mostly due to the underestimation of how long it takes absorbable sutures to dissolve that has patients worried. Therefore, it is mostly a misunderstanding and if you know which type of suture material you have, you'll get a better estimate.
To find out which one you have, You can ask your doctor or you can try to identify them by color. Most of them are color coded for ease of identification.
After all, don't forget that it is near impossible for them to not get absorbed since they degrade in the presence of water and our bodies are made of mostly water.
Spitting suture complication
There is a post-operative complication called a spitting suture, which is the only time where your stitches won't get the chance to dissolve. It's not that they won't dissolve, they simply won't have the opportunity to do it.
This condition is when your body rejects the dissolvable stitch and attempts to push it out of your body. That means instead of the normal dissolution process, your body is physically trying to migrate it out of your skin.
Common signs & symptoms:
Redness in the area
Can be slightly swollen
Small raised bump
Stitches poking through the skin
Mild pain or discomfort
Foreign body sensation
This is the only situation where they won't dissolve but the end result is still removable of them. The sutures are getting expelled by your own body. If you have a spitting suture, you should return to your dentist/physician or whoever it is that put them in to have them removed. The condition is often painful and it can get infected.
Takeaway
If you've dissolvable stitches, you can rest assured that they will dissolve because they're made of materials that degrade in the presence of water. Since our bodies are mostly composed of water, that makes it highly unlikely for them to not breakdown.
Although there is one situation where the absorbable sutures may not get the chance to dissolve and that is if you have a spitting suture complication. In lieu of dissolving them, your body actually rejects them but physically pushing them out of your skin via the healing process.
