Metal stitches vs dissolvable stitches

firstinfamily, RN · Feb 11, 2015

I think it depends on the surgical site. I have seen much less of cloth/dissolvable sutures in the last 5 years or so. Could it be that the surgeons are less skilled with cat gut sutures?? As far as the surgical sites: knee replacements, hips etc. are very flexible areas and keeping the suture line approximated to promote healing is a prime, therefore the sutures that seem to do this the best are the staple sutures. Pts who have back surgery seem to have more cloth sutures, and sometimes the gaps between the sutures never really heal or take longer to heal. I personally had 3 C-sections with staple sutures, yes, they do hurt a little coming out, but not unbearable for most pts, it is like a pinch hurts. I have found in my nursing experience that the staple sutures seem to heal better. However, be aware that when assessing your surgical sites, some patients are very sensitive to metals and occasionally you will have an inflammed surgical site, that may not show other signs of infection(purulent drainage, odor, increase in pain, warm to touch). The inflammation may not be due to an infection but due to the sensitivity of the pt to various metals used in the staples. I have also found that when costs are being cut, supplies are one of those areas that are also cut, therefore, cheaper staples made with a cheaper type of metal that can cause more skin reactions!!! Plus, removing cloth sutures takes a little more skill than removing staples, I always found I was a little skeptical and afraid there might have been some "piece" of a cloth suture left in the patient, whereas I always counted the staples before and after removal to make sure I did not miss any. The trick to preventing embedded staples is having them removed before the new skin grows over them. Most staples can usually come out in 7-10 days without any repercussions. I always used steri-strips on my knees and hip patients to give extra support to the healing suture line. Those will fall off naturally when the pt bathes. Good Luck!!

Alnitak7 · Feb 11, 2015

I have seen much less of cloth/dissolvable sutures in the last 5 years...Plus, removing cloth sutures takes a little more skill than removing staples, I always found I was a little skeptical and afraid there might have been some "piece" of a cloth suture left in the patient, Good Luck!!

What I'm assuming is that the only time "cloth/dissovable" sutures need to be removed is if there are complications.

Alnitak7 · Feb 11, 2015

However, be aware that when assessing your surgical sites, some patients are very sensitive to metals and occasionally you will have an inflammed surgical site, that may not show other signs of infection(purulent drainage, odor, increase in pain, warm to touch). The inflammation may not be due to an infection but due to the sensitivity of the pt to various metals used in the staples.
Good Luck!!

So if the patient is allergic to their ear-rings should you also be concerned that they could be allergic to their staples?

And if they do have an allergic reaction to the stitches, do they remove them even if they are not fully healed and give them some other type of stitch?

Editorial Team / Admin · Feb 11, 2015

This is a guide to sutures and suturing techniques that probably goes well beyond what you're looking for: http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/ethicon_wound_closure_manual.pdf

A lot of skin closure depends on the area of the body, the condition of the subcuticular and skin tissues, and surgeon preference. I work in heart surgery. For some of our larger patients, especially females with large pendulous breasts, we will use staples instead of dissolvable suture because it will hold the incision together better. Some patient's tissues don't have the strength to handle sutures along the incision- in those cases, staples have a wider "grasp" on the incision and create less stress on the tissues than the very narrow suture line. It's really a judgement call on the part of the surgeon about what is best for that particular incision or injury, what is best for that patient's tissues, and what they feel will work best for the patient.

Alnitak7 · Feb 12, 2015

This is a guide to sutures and suturing techniques that probably goes well beyond what you're looking for: http://academicdepartments.musc.edu/surgery/education/resident_info/supplement/suture_manuals/ethicon_wound_closure_manual.pdf

Thank you for the link. I just saved it.