Spitting stitches tummy tuck is a procedure that is used to tighten the abdomen after pregnancy or weight loss. The surgery can be performed by either a general surgeon or plastic surgeon.
The procedure is usually done under general anesthesia and takes between one and three hours. It involves removing excess abdominal skin and fat, tightening weakened muscles, and closing the incisions with dissolving stitches.
In this guide, we review the aspects of Spitting stitches tummy tuck, How do you fix spitting stitches? How long does it take for spitting stitches to heal? Is it normal to spit stitches?
Spitting stitches tummy tuck
During surgery, wounds are closed by sewing the skin together with dissolvable sutures or stitches under the skin for healing, and a top layer of stitches is used to close the incision. The deep sutures are primarily dissolving ones. Your surgeon may only use dissolvable sutures or combine them with permanent sutures depending on the procedure. The dissolvable sutures tend to be clear or white in color.
Although they are placed with precision and care, the body may view the sutures as foreign substances and reject them. This means that the body has a mechanism that naturally works to break down or remove objects that it feels don’t belong. While the sutures are meant to break down and dissolve over time, the body may reject them by pushing them out of the body, which is referred to as “spitting a stitch”. When this happens, it may seem like a reason to panic, however, it is a common occurrence during healing and recovery.
A spitting suture can be removed at home. When you notice the suture is protruding from the skin, try gently removing it with a sterilized tweezer or small scissor. If the suture proves difficult to remove, please contact your surgeon and make an appointment to have it removed at their office. Once the suture is taken out of the skin, clean the area with alcohol and place a warm, damp compress on the area for a few minutes. This may cause other sutures to come to the surface. If this is the case, remove them, clean the area, and reapply the warm compress. Pat the area dry with a clean cloth and apply antibiotic ointment to the area. A spitting suture should not affect the wound’s healing, which will continue on its own. It is important to follow your surgeon’s post-operative care instructions for wound care to avoid other issues with the incision or infection.
How to care for wounds after surgery
There is no way to tell if spitting sutures will occur prior to surgery and they aren’t something you could avoid if your body decided to reject them. However, following your surgeon’s post-operative instructions on wound care can help ensure the area remains clear of infection or other wound issues, such as wound breakdown. Here are five ways to care for your wounds post-surgery:
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How do you fix spitting stitches?
A scar forms from the natural healing process that occurs in response to an incision placed during surgery. Scar tissue goes through phases of healing and can often appear red or mildly elevated during this natural process. Scars can be improved by topical products and scar massage. Caring for your scar can help improve its appearance. Patients with a higher risk of abnormal scarring include those with previous history of hypertrophic or keloid scars or patients with darker skin pigmentation. In addition, incisions in higher tension areas or over parts of the body that engage in repetitive movement may result in widened or unsightly scars.
How to Manage Your Scar
Patient participation is critical in achieving an optimal scar. Scar management occurs once your incision is sufficiently healed. This usually happens 4-6 weeks after surgery.
Optimal scar management includes a silicone-based product (silicone gel or silicone gel sheets), scar massage, and sun avoidance. Scar management is most effective in the first year following surgery.
Silicone-based products
Silicone-based scar gel can be applied over scars twice daily. Alternatively silicone gel sheets can be applied over scars for 12-24 hours per day. Silicone-based products increase hydration and oxygen levels in the skin, thereby promoting favorable scar formation. These products can found on Amazon or at a drugstore in the band-aid section)
Scar Massage
Scar massage desensitizes the area and reduces scar tightening. Scar massage can begin 4 to 6 weeks after surgery and should avoid any open part of the incision (open wounds). When performing massage, rub in a circular motion on and around your scar. Use firm, even pressure for 2-3 minutes. Perform this 2 times a day. Dr. Tanna recommends using a silicone-based scar gel or moisturizing lotion while massaging your scar to decrease friction at the area.
Sun Avoidance & Sunscreen
In the first year following surgery, ultraviolet radiation from sun exposure can cause your immature scar tissue to become darker than the surrounding skin. This hyperpigmented scar may remain darker than the other skin. To help prevent this, Dr. Tanna recommends that all patients use a sunscreen when outdoors and avoid prolonged exposure to the sun. This is especially true for new scars (that are readily exposed to sunlight). The SPF (Sun Protection Factor) should be 30 or higher and preferably waterproof. Physical sunscreens (zinc, titanium etc.) are thought to be better than chemical sunscreens. Follow the application directions on the bottle or tube.
Suture Extrusion (“Spitting Sutures”)
As your incision heals, it is normal to have some minor redness, swelling, itching, skin irritation, drainage, and/or small lumps in the skin near the incision. If you notice a small suture poking through the skin, try to gently remove it with scissors or tweezers. You can also come to our office so Dr. Tanna can remove it. A spitting suture is a dissolvable suture under your skin that is rejected by your body before it can completely dissolve. These spitting sutures can cause swelling, redness and/or oozing at the incision. This is normal and will eventually go away on its own.
How long does it take for spitting stitches to heal?
When we repair a wound, we sew your skin together like layers on a cake, aligning each layer. A deep layer of sutures, also known as stitches, is used under the skin to guide the healing process, and a top layer of sutures is used to close the skin. The deep sutures are primarily dissolving ones. Dissolvable sutures are usually clear in color, and permanent sutures are dark blue or black in color.
Since all sutures are technically “foreign substances” the human body has a tendency to reject them. Ideally, this means the body breaks them down and dissolves them. Sometimes instead of dissolving the sutures, your body will push the suture out of your body. When it does this, we call it “spitting” a stitch. This happens quite commonly, and when a stitch does come out, it can come to the surface with an inflamed red spot. Usually you can feel something like fishing line around this area.
If the suture does “spit,” it is not something to worry about. If you are able to grab it with tweezers, give it a gentle pull. Applying a warm moist compress to the area may help bring more of the suture to the surface. At that point, the surface material may be cut or trimmed away. After removal or trimming, clean the area with a little rubbing alcohol and then apply Vaseline. If the area is persistently irritated or is getting increasingly painful then you may require an office visit.
Is it normal to spit stitches?
When Mohs surgery is performed to remove skin cancer, the last step of the procedure is typically closing the wound with a suture. This can be accomplished using different techniques, such as a side-to-side linear closure or a skin flap, but regardless of the reconstructive approach, the surgical site is usually closed in two layers of stitches. “A deep layer of stitches is used under the skin to guide the healing process, and a top layer of sutures is used to close the skin,” says fellowship-trained Mohs micrographic surgeon Dr. Adam Mamelak.
As surgical materials have continued to advance, a variety of sutures are available based on the details of the case. Non-absorbable sutures may be used, which will need to be removed later. Others are absorbable, which means the body will naturally break them down over the course of about 3 to 4 months. These absorbable stitches are ideal for closing the deeper layer of tissue after Mohs surgery. However, keep in mind that although they dissolve, absorbable sutures are still a foreign object that the body may reject.
What Is a Spitting Suture?
In some cases an absorbable suture can be “spit out” if the body doesn’t break it down. This happens when the stitch is gradually pushed out of the skin because the body is rejecting the material. Spitting sutures can feel like a sharp spot on the incision, and a small white thread may start emerging. Other times, a spitting suture can simply look a pimple or red bump near the wound. While this can happen with some patients after Mohs surgery, there are ways to reduce the risk of a spitting suture.
Dr. Mamelak utilizes specific suture types that tend to cause fewer adverse reactions. He also checks the size and depth of the suture to make sure any non-absorbable sutures are taken out when appropriate. In addition, there are some cases that don’t require the use of a suture at all, which completely avoids the chance of the body spitting it out.
What to Do if a Spitting Suture Happens?
Spitting sutures, also known as suture extrusion, is a common occurrence after a surgical procedure. This happens when the body rejects the suture material and pushes it out through the skin. While this can be alarming, it is usually not a cause for concern and can be easily treated.
One of the first steps in treating spitting sutures is to apply a warm, moist compress to the raised area. This helps to soften the skin and expose more of the suture, making it easier for your doctor to trim the material. The warmth of the compress can also help to reduce any discomfort or pain associated with the spitting suture.
Once the suture is exposed, your doctor can carefully trim the material to remove the portion that is causing irritation. This is typically done using sterile instruments to prevent infection. In some cases, your doctor may also prescribe an antibiotic ointment to apply to the area to prevent infection and promote healing.
It is important to follow your doctor’s instructions for caring for the spitting suture to ensure proper healing. This may include keeping the area clean and dry, avoiding activities that could put strain on the suture, and taking any prescribed medications as directed.
In rare cases, spitting sutures may be a sign of an underlying issue such as infection or poor wound healing. If you experience persistent pain, redness, swelling, or discharge from the suture site, it is important to contact your doctor for further evaluation and treatment.
Overall, spitting sutures are a common and usually minor complication of surgery that can be easily treated. By following your doctor’s instructions and keeping the area clean and dry, you can help promote proper healing and prevent any further complications.