How long does it take for stitches to heal. What are the best methods for wound cleansing. When should tissue adhesives be used instead of sutures. How can pain during local anesthesia be minimized. What are the advantages of absorbable versus nonabsorbable sutures. How effective are topical antibiotics for wound healing.

Understanding Skin Lacerations and Wound Repair

Skin lacerations are common injuries that require proper care and repair to ensure optimal healing and minimize scarring. Effective wound management involves several key steps, from initial assessment to closure techniques and follow-up care. This comprehensive guide explores the essential aspects of skin laceration repair, drawing from evidence-based practices and expert recommendations.

What is a skin laceration?

A skin laceration is a tear or cut in the skin, often caused by trauma or injury. These wounds can vary in depth, length, and complexity, potentially affecting underlying tissues and structures. Proper assessment and treatment of lacerations are crucial to prevent complications such as infection, poor wound healing, and excessive scarring.

Wound Cleansing and Preparation

Before attempting to close a laceration, proper wound cleansing is essential to reduce the risk of infection and promote healing. The choice of cleansing solution and technique can significantly impact the outcome of wound repair.

Is sterile saline the best solution for wound cleansing?

While sterile saline has long been considered the gold standard for wound cleansing, recent evidence suggests that tap water may be equally effective for many types of wounds. A Cochrane review by Fernandez et al. found no significant difference in infection rates between wounds cleansed with tap water versus sterile saline. However, sterile saline remains the preferred option for heavily contaminated wounds or in cases where tap water quality is questionable.

Does the temperature of the cleansing solution matter?

Interestingly, the temperature of the cleansing solution can affect patient comfort and potentially influence wound healing. Ernst et al. conducted a study comparing warmed saline to room temperature saline for laceration irrigation. They found that patients reported less discomfort with warmed saline, and there was no significant difference in infection rates. Using warmed solutions (around body temperature) may improve patient experience without compromising wound care outcomes.

Anesthesia Techniques for Laceration Repair

Ensuring adequate pain control during laceration repair is crucial for patient comfort and to facilitate proper wound closure. Various anesthesia techniques can be employed, depending on the location and extent of the laceration.

How can the pain of local anesthetic injection be minimized?

Local anesthetic injections can be painful, potentially causing distress to patients. Scarfone et al. investigated methods to reduce the pain associated with local anesthesia. Their findings suggest several strategies:

• Using a small-gauge needle (27 or 30 gauge)
• Injecting slowly to reduce tissue distension
• Buffering lidocaine with sodium bicarbonate
• Warming the anesthetic solution to body temperature
• Applying topical anesthetics before injection

Implementing these techniques can significantly improve patient comfort during the anesthesia process.

Are topical anesthetics effective for laceration repair?

Topical anesthetics can be valuable tools in managing pain during laceration repair, especially in pediatric patients or for superficial wounds. Kundu and Achar reviewed the principles of office anesthesia and found that preparations like LET (lidocaine-epinephrine-tetracaine) gel can provide effective anesthesia for many types of lacerations. These agents can be applied directly to the wound, allowing for needle-free pain control in suitable cases.

Suturing Techniques and Materials

Proper suturing technique is fundamental to achieving optimal wound closure and minimizing scarring. The choice of suture material and closure method depends on various factors, including the location and characteristics of the laceration.

What are the advantages of absorbable versus nonabsorbable sutures?

The decision between absorbable and nonabsorbable sutures depends on the wound location, expected healing time, and patient factors. Parell and Becker compared these suture types in facial skin wounds and found that:

• Absorbable sutures eliminate the need for suture removal, reducing patient discomfort and follow-up visits
• Nonabsorbable sutures may provide better tensile strength for certain wound types
• Cosmetic outcomes were similar between the two types when used appropriately

Al-Abdullah et al. further investigated this topic in pediatric wounds, concluding that absorbable sutures are a viable option for many traumatic lacerations, offering comparable outcomes to nonabsorbable sutures while simplifying wound care.

What are the key principles of basic laceration repair?

Thomsen et al. provided a comprehensive overview of basic laceration repair techniques in their video guide. Key principles include:

1. Proper wound cleansing and preparation
2. Appropriate selection of suture material and needle
3. Placement of sutures at the appropriate depth and spacing
4. Eversion of wound edges to promote optimal healing
5. Careful knot tying to secure the closure without excessive tension

Mastering these fundamental techniques is essential for achieving satisfactory wound closure and cosmetic outcomes.

Alternative Closure Methods: Tissue Adhesives and Staples

While suturing remains a primary method for wound closure, alternative techniques such as tissue adhesives and staples have gained popularity in certain situations. These methods can offer advantages in terms of speed, ease of use, and patient comfort.

When are tissue adhesives preferable to sutures?

Tissue adhesives, such as octylcyanoacrylate, have emerged as effective alternatives to sutures for certain types of lacerations. Quinn et al. conducted a randomized trial comparing tissue adhesives to sutures and found that:

• Tissue adhesives were faster to apply
• Patients reported less pain with adhesives
• Cosmetic outcomes were similar to sutures for appropriate wound types

Singer et al. further supported these findings in their prospective study, concluding that tissue adhesives are suitable for many low-tension wounds, particularly in cosmetically sensitive areas.

Are staples an effective option for wound closure?

Staples can be an efficient method for closing certain types of lacerations, particularly in areas with thick skin or where rapid closure is necessary. Lloyd et al. reviewed various closure techniques and noted that staples:

• Are quick to apply, potentially reducing procedure time
• Provide secure wound closure with good tensile strength
• May be associated with increased scarring compared to sutures in some cases

While staples can be effective, their use is generally limited to specific situations, such as scalp lacerations or temporary closure of long wounds prior to definitive repair.

Special Considerations in Laceration Repair

Certain types of lacerations require specific approaches to ensure optimal outcomes. Understanding these special considerations can help healthcare providers tailor their treatment strategies effectively.

How should scalp lacerations be managed?

Scalp lacerations present unique challenges due to the hair-bearing nature of the area. Howell and Morgan investigated scalp laceration repair without prior hair removal and found that:

• Hair removal is often unnecessary for successful wound closure
• Leaving hair in place can aid in wound edge approximation
• The risk of infection was not increased when hair was not removed

Additionally, Hock et al. introduced the hair apposition technique (HAT) for closing scalp lacerations, which involves twisting hair strands across the wound and securing them with tissue adhesive. This method was found to be faster and less painful than standard suturing for appropriate scalp wounds.

What is the best approach for pretibial lacerations?

Pretibial lacerations, common in elderly patients, can be challenging to manage due to the thin, fragile skin in this area. Sutton and Pritty compared the use of sutures versus adhesive tapes for closing pretibial lacerations and found that:

• Adhesive tapes resulted in fewer wound complications
• Healing times were similar between the two methods
• Patient comfort was generally better with adhesive tapes

For many pretibial lacerations, especially in older patients, adhesive tape closure may be preferable to suturing, reducing the risk of further tissue damage and simplifying wound care.

Post-Repair Wound Care and Follow-Up

Proper wound care after laceration repair is crucial for optimal healing and minimizing complications. Patients should be educated on how to care for their wound and when to seek medical attention if problems arise.

Can wounds get wet after repair?

The traditional advice to keep wounds dry after repair has been challenged by recent research. Heal et al. investigated whether sutures can get wet and found that:

• Allowing wounds to get wet after 12 hours did not increase infection rates
• Patient comfort and hygiene were improved by allowing regular bathing
• Wound healing was not adversely affected by exposure to water

Based on this evidence, it is generally safe to allow patients to shower and bathe normally after the first 12-24 hours, provided they gently pat the wound dry afterward.

Are topical antibiotics beneficial for wound healing?

The routine use of topical antibiotics for wound care has been a subject of debate. Smack et al. compared white petrolatum to bacitracin ointment for postoperative wound care and found that:

• There was no significant difference in infection rates between the two groups
• Allergic contact dermatitis was more common with bacitracin

Diehr et al. conducted a systematic review on the topic and concluded that topical antibiotics offer only marginal benefits in wound healing while increasing the risk of antibiotic resistance and contact dermatitis. For most uncomplicated wounds, keeping the area clean and moist with petroleum jelly is sufficient.

Essentials of Skin Laceration Repair

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Suturing versus conservative management of lacerations of the hand. BMJ.
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Water for wound cleansing. Cochrane Database Syst Rev.
2002;(4):CD003861.

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Warmed versus room temperature saline for laceration irrigation. South Med J.
2003;96(5):436–439.

5. Hollander JE,
Singer AJ.
Laceration management. Ann Emerg Med.
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6. Edlich RF,
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Principles of emergency wound management. Ann Emerg Med.
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7. Howell JM,
Morgan JA.
Scalp laceration repair without prior hair removal. Am J Emerg Med.
1988;6(1):7–10.

8. Scarfone RJ,
Jasani M,
Gracely EJ.
Pain of local anesthetics. Ann Emerg Med.
1998;31(1):36–40.

9. Kundu S,
Achar S.
Principles of office anesthesia: part II. Topical anesthesia. Am Fam Physician.
2002;66(1):99–102.

10. Singer AJ,
Quinn JV,
Clark RE,

et al.
Closure of lacerations and incisions with octylcyanoacrylate. Surgery.
2002;131(3):270–276.

11. Parell GJ,
Becker GD.
Comparison of absorbable with nonabsorbable sutures in closure of facial skin wounds. Arch Facial Plast Surg.
2003;5(6):488–490.

12. Al-Abdullah T,
Plint AC,
Fergusson D.
Absorbable versus nonabsorbable sutures in the management of traumatic lacerations and surgical wounds. Pediatr Emerg Care.
2007;23(5):339–344.

13. Thomsen TW,
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Videos in clinical medicine. Basic laceration repair. N Engl J Med.
2006;355(17):e18.

14. Zuber TJ.
The mattress sutures: vertical, horizontal, and corner stitch. Am Fam Physician.
2002;66(12):2231–2236.

15. Bruns TB,
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Using tissue adhesive for wound repair. Am Fam Physician.
2000;61(5):1383–1388.

16. Quinn J,
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A randomized trial comparing octylcyanoacrylate tissue adhesive and sutures in the management of lacerations. JAMA.
1997;277(19):1527–1530.

17. Singer AJ,
Hollander JE,
Valentine SM,

et al.
Prospective, randomized, controlled trial of tissue adhesive (2-octylcyanoacrylate) vs standard wound closure techniques for laceration repair. Stony Brook Octylcyanoacrylate Study Group. Acad Emerg Med.
1998;5(2):94–99.

18. Lloyd JD,
Marque MJ III,
Kacprowicz RF.
Closure techniques. Emerg Med Clin North Am.
2007;25(1):73–81.

19. Osmond MH,
Klassen TP,
Quinn JV.
Economic comparison of tissue adhesive and suturing in the repair of pediatric facial lacerations. J Pediatr.
1995;126(6):892–895.

20. Lin M,
Coates WC,
Lewis RJ.
Tissue adhesive skills study. Pediatr Emerg Care.
2004;20(4):219–223.

21. Hock MO,
Ooi SB,
Saw SM,

et al.
A randomized controlled trial comparing the hair apposition technique with tissue glue to standard suturing in scalp lacertions (HAT study). Ann Emerg Med.
2002;40(1):19–26.

22. Ong ME,
Coyle D,
Lim SH,

et al.
Cost-effectiveness of hair apposition technique compared with standard suturing in scalp lacerations. Ann Emerg Med.
2005;46(3):237–242.

23. Sutton R,
Pritty P.
The use of sutures or adhesive tapes for primary closure of pretibial lacerations. Br Med J (Clin Res Ed).
1985;290(6482):1627.

24. Heal C,
Buettner P,
Raasch B,

et al.
Can sutures get wet? BMJ.
2006;332(7549):1053–1056.

25. Smack DP,
Harrington AC,
Dunn C,

et al.
Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. JAMA.
1996;276(12):972–977.

26. Diehr S,
Hamp A,
Jamieson B,

et al.
Do topical antibiotics improve wound healing? J Fam Pract.
2007;56(2):140–144.

27. Kretsinger K,
Broder KR,
Cortese MM,

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2006;55(RR-17):1–37.

28. Beebe M, Dalton JA, Espronceda M, et al. Current Procedural Terminology (CPT) 2007. Chicago, Ill.: American Medical Association; 2006.

When Should Stitches or Sutures Be Removed?

While there are numerous methods used to close wounds of the skin, the most common form of repairing the skin is by using stitches or sutures. Other methods for closing wounds can include surgical staples, skin closure tapes, and special adhesives. The removal of stitches or other types of skin closing devices is a procedure which many people want to avoid. It can be helpful and assuring to understand the various methods used to close the skin in addition to the methods used for removal.

Stitches are commonly used to close and secure cuts or wounds on the skin. They can be used on virtually every part of the body, including both internally and externally. A doctors will sew the skin together using individual sutures and securely tie a knot. Once they are placed, stitches allow the skin to naturally heal when it may not come together on its own. It is common to close accidental cuts or lacerations with stitches. Surgeons also use stitches during an operation to secure the ends of a bleeding blood vessel and close the incision.

Sutures are classified as absorbable and nonabsorbable. Sutures which are absorbable quickly break down in the tissues within about 60 days. Absorbable sutures do not need to be removed as they absorb on their own. They are used to close the skin and for other internal uses when a permanent stitch is not required. In comparison, nonabsorbable sutures maintain their strength for more than 60 days. This type of suture is often used to close skin, external wounds, or to repair blood vessels. In most cases, nonabsorbable stitches require removal.

The technique for placing stitches is quite simple. The thread or suture is attached to a needle. The wound is cleaned, and an antiseptic solution, betadine is then used. The area is then numbed with a local anesthetic. The needle and thread are then used to sew the skin back together. Depending on the severity of the wound, sever stitches may be required. Once the wound is closed, a topical antibiotic gel is often used and a bandage is placed to protect the wound. While all wounds which require stitches will have some form of scaring, it is usually minimal and sometimes quite difficult to see.

Based on the location of the wound, the sutures should be removed within a few days to two weeks. The prompt removal of the stitches aids in reducing the risk for marks, infection, and visible scarring. It is important to minimize the risk of complications by following the doctor’s recommendation for removal.

As a general rule, the greater the tension is across a wound, the longer the stitches need to remain. The following is a guideline for the recommended removal times based on the location of the sutures:

• Face: 5-7 days
• Neck: 7 days
• Scalp: 10 days
• Trunk or upper extremities: 10-14 days
• Lower extremities: 14-21 days

Sutures placed in wounds which are under a greater amount of tension may need to remain in place for a bit longer.
In order to promote optimal healing and reduce the risk of complications or scarring, it is important to use the proper technique to remove stitches. Sutures are gently elevated using forceps or tweezers to allow the suture to be cut. The suture is then gently pulled through the skin and removed. Following the removal of the sutures, Steri-Strips can be applied for additional support during the healing process.

What if Stitches or Sutures are Not Removed?

Suture Removal – an overview

Scar management and mobilization begins 24 to 48 hours following suture removal. The patient may benefit from an elastomer pad or silicone gel sheeting, which is typically worn throughout the night but may be worn during the day as well if not inconvenient. Thermal agents (such as, fluidotherapy, paraffin wax, and ultrasound) may also be used as to increase the tissue extensibility and assist in improving tendon excursion.¹

Clinical Pearl

There are two major causes for PIP joint extensor lag after proximal phalanx fracture: 1) soft tissue adhesions between the extensor mechanism and the fracture site, and 2) proximal phalanx shortening secondary to fracture that results in redundancy of the extensor mechanism. ¹⁷ When the extensor lag results from option 2, it is not amenable to soft tissue mobilization.

Tips from the Field

When the extensor lag is a result of soft tissue adhesions, the therapist should provide the patient with a home exercise program (HEP) that includes blocked PIP joint extension exercises with the MP flexed. Heating the digit with the modality of his/her choice (for example, hot water, heating pad, microwaved hot packs, and so on), allows for improved soft tissue extensibility. Providing a piece of Dycem to mobilize the skin and scar opposite of the tendon pull is also an effective scar mobilization technique. This method of scar mobilization is much more aggressive and should be used only after sufficient healing has occurred. Monitor the hand and/or affected digit for increased inflammation, and terminate the exercise if this occurs.

Freeland’s orthosis is forearm-based and places the wrist in slight flexion to increase tension in the extensor mechanism and simultaneously release the flexor tendon tightness. The forearm-based orthosis may be reduced to a hand-based orthosis after about 3 weeks. The MP joint is placed in flexion, and the dorsal block keeps the extension force focused on the PIP joint to prevent an extensor lag. A volar component may also be added for night use in order to maintain PIP extension and prevent PIP joint flexion contracture.

Dynamic or static-progressive orthoses and serial casting may be used when AROM and PROM exercises prove to be insufficient for joint motion recovery.

A dynamic orthosis utilizes traction devices (such as, rubber bands) to alter the PROM of a joint.¹⁸ Commercially-available dynamic PIP extension splints are readily available (Fig. 27-14). An easy option to regain PIP joint flexion may be fabricated by creating a flexion loop splint out of waistband elastic.¹ The wearing schedule varies by patient and condition. However, the rule of thumb is to make sure that the patient feels only a slight discomfort, thereby allowing a very low-load, long stretch preferably longer than 10 to 15 minutes. This should be performed three to five times per day with increasing duration. PIP extension splints seem to be tolerated better, and they often may be worn through the night. If the contracture begins to worsen during the day, the patient should increase the wearing schedule accordingly. This program should be closely monitored by a skilled hand therapist.¹⁹

A static progressive orthosis provides a low-load static stretch over a longer duration. The change in soft tissue length is the result of a process called stress relaxation. “Stress relaxation occurs when a material is held at a constant deformation. The amount of force required to maintain the deformation decreases with time, as the tissue stretches by plastic deformation until equilibrium is reached.”¹⁸ Duration of use will typically be three to four times per day for 30 to 40 minutes at a time. The patient should feel some discomfort but not so much that they need to terminate the orthotic use before end of the wearing time. The patient may adjust the tension as the tissues adapt and lengthen.²⁰ Shultz-Johnson states that joints with a hard end-feel contracture should wear the orthosis for longer durations, sometimes removing only for hygiene. Gains of 5° to 10° per week indicate success.²¹ Static progressive finger flexion slings are also available (Fig. 27-15). Static progressive treatment is usually used after an injury has matured and the end feel of a joint has less give. The same is true for serial static orthoses.

A serial static orthosis immobilizes a joint with the tissue at the end range and is usually used to regain PIP joint extension, but it can be used to regain wrist motion. The joint is stretched to its end range. The cast or orthosis is applied to the extremity in that position. After a period of 1 to 2 days, the tissue has adapted to that length. The therapist will then prepare the tissue again, re-stretch the tissue to its new maximum, and then reapply a new cast or orthosis at that length. ²¹

Suture Removal – Advanced Cardiology and Primary Care LLC

Suture Removal (Removal of Stitches and Staples)

“Suture removal is a simple procedure that can be performed quickly in our office. Although it is an easy procedure, trying to remove sutures yourself is never a good idea, as pieces of stitches can be left behind and infection may occur. If the idea of having your sutures removed makes you nervous, don’t worry- the procedure is not painful and will be over before you know it!”

Repair of the skin is generally achieved by either stitching (suturing) the skin closed or by using staples. If you have sutures or staples, you might be dreading having them taken out. I’m here to assure you that the procedure is quick and virtually painless in experienced hands.

Types of skin closure materials

There are two types of sutures, absorbable and non-absorbable. Absorbable sutures break down eventually (usually within a month or two) and do not have to be removed. Non-absorbable sutures, on the other hand, are used to close external wounds in the skin and must be removed after a period of time.

Staples look just like office staples. They are easy to put in and pose less risk of infection. They may be used to close scalp wounds or operative wounds, but can sometimes leave scarring.

Skin closure tapes are also sometimes used, but it can be difficult to perfectly align the wound edges using skin closure tape, and tape might not adhere very well to areas with lots of body hair or areas that are prone to sweating.

Adhesive agents (skin glue), similar to crazy glue, can also be used to close a wound, especially in children because there is no need to anesthetize the skin prior to gluing. However, skin glue cannot be used on any area of the body where the skin is required to move, such as knees and elbows.

Prior to suture or staple removal

If you have sutures or staples in place, you will have received instructions on how to care for the affected area, such as keeping the area clean and dry for the first couple of days, covering the area with a band-aid if there is bleeding or discharge,  watching for signs/symptoms of infection and when to return for removal of your sutures or staples. You will need to make an appointment to come in and have your sutures or staples removed. In general, removal time for specific areas of the body are as follows (you may be given a different timeline):

• arms/legs- 10 to 14 days
• trunk- 7 to 10 days
• joints- 14 days
• scalp- 7 to 10 days
• face- varies from 3 to 7 days, depending on the area of the face

Using sterile forceps and suture scissors for suture removal.

What can I expect during the suture removal procedure?

You will be positioned comfortably so that the area with sutures or staples is easily accessible. The affected area will be cleansed to remove debris and loosen any scar tissue forming. Using sterile forceps, we will carefully pick up the knot of each suture and, using a blade or sterile scissors, we will cut the suture. We will then use the forceps to pull the suture gently to remove it fully intact. You may feel a slight tugging sensation, but it will not hurt. We will continue with each individual suture until all of them have been removed. If you have staples, we will use a special tool that resembles a wire cutter to grasp each individual staple in the center. By squeezing the handles of the tool together, the staple’s edges are bent upwards and the staple can be gently pulled straight up and out. Again, you won’t feel any pain.

Following, we will clean the wound again. We may apply adhesive strips to help hold the wound edges together for a few more days until the wound has strengthened again, or we may apply a bandage to cover and protect the wound. It depends on the size and location of the wound.

After suture/staple removal

Just because your sutures or staples are out does not mean you are off the hook as far as wound care goes! You still need to:

• leave the adhesive strips in place for approximately 5 days, or until they fall off naturally
• keep your wound dry and clean
• protect your wound from trauma for about a month, as your wound will be fragile and prone to splitting open should you suffer an injury in the same area
• protect the area from too much sun

If you need to come in for suture removal, don’t worry- the procedure is quick and painless. Be sure to call and make an appointment to come in for your suture removal well before the due date to ensure that your sutures are not left in too long, as this can make it more difficult to remove them. 

Chin Laceration, Stitches or Tape

A laceration is a cut through the skin. If it’s deep, it may need stitches. Minor cuts may be treated with surgical tape, skin glue, or other basic dressings. You may need a tetanus shot if you are not up to date on your tetanus vaccine.

Home care

These guidelines will help as your laceration heals:

• If a bandage was applied and it becomes wet or dirty, replace it. Otherwise, leave it in place for the first 24 hours, then change it once a day or as directed.

• If stitches were used, clean the wound daily:

  • Wash the area with soap and water. Use water on a cotton swab to loosen and remove any blood or crust that forms.

  • After cleaning, keep the wound clean and dry. Talk with your doctor before applying any antibiotic ointment to the wound.

  • You may shower as usual after the first 24 hours. But don’t soak the area in water until the sutures are removed. This means no tub baths or swimming.

• If surgical tape was used, keep the area clean and dry. If it becomes wet, blot it dry with a towel.

• Your doctor may prescribe or recommend an antibiotic cream or ointment to prevent infection. Don’t stop taking this medicine until you have finished the prescribed course or your doctor tells you to stop. Your doctor may also prescribe medicines for pain. Follow the doctor’s instructions for taking these medicines. You may use over-the-counter pain medicine if no other pain medicine was prescribed. Talk with your doctor before using these medicines if you have chronic liver or kidney disease. Also talk with your doctor if you have ever had a stomach ulcer or gastrointestinal bleeding.

• Certain types of skin glues can’t be used if you have an allergy to latex or formaldehyde. Tell your doctor right away about any allergies.

Follow-up care

Follow up with your healthcare provider, or as advised. Most chin lacerations heal within 5 to 7 days. But your wound may become infected even with proper treatment. You should check the wound daily for signs of infection listed below. Stitches should be removed from the chin within 5 days. If tape closures were used, remove them yourself if they have not fallen off after 5 days.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

• Pain in the wound that gets worse

• Redness, swelling, or pus coming from the wound

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Bleeding not controlled by direct pressure

• Wound edges reopen

• Sutures come apart or surgical tape falls off before 5 days

How Soon Can I Swim After Getting Stitches?

It’s not uncommon for people to get stitches in their body at some point in their lifetime. Whether for flesh wounds during an accident or a planned incision through surgery, sutures are a temporary fix to a problem.

The question for swimmers is, can I swim with stitches or sutures? If so, then what do I need to know?

Catherine Hannan, a board-certified plastic surgeon who practices in Washington, D.C., and places and removes sutures every day, helps clarify when swimmers should be able to get back in the water.

She says a little preventive maintenance on a wound trying to heal could be greatly beneficial to long-term health.

“I do realize that it’s difficult to place life on hold for what can seem like a minor injury, but I’ve seen lack of good wound care turn a small problem into a larger one,” Hannan says. 

Hannan says a cut or laceration that has been closed with sutures starts to have epithelial cells regrow at 24 to 48 hours. In other words, the skin starts growing back new on the outside of the wound in two to three days to help seal off the wound from bacteria and other potentially harmful things.

Hannan says she tells her patients they may start showering at the 24-hour mark, but to not submerge the wound underwater for a prolonged period of time. This includes bathing and swimming, which could cause the skin to become “wrinkly” or “pruny,” she says. This could delay the wound healing on the outside.

“Additionally, swimming in poorly treated pool water or lakes/streams that have a greater degree of bacteria and other organisms can predispose to infection of the wound,” Hannan says.

Oceans, lakes, and rivers for open water swimmers could possibly contain bacteria, microorganisms, and viruses that could cause more problems if they got inside a wound trying to heal.

There are two types of stitches. Permanent stitches are stronger from the time they are first placed, and the doctor typically removes them. Absorbable stitches are absorbed into the body over time, and Hannan recommends refraining from swimming or bathing altogether before they’re absorbed. The depth of the laceration also factors in on her advice: a deeper wound needs more time to heal.

“Overall, I recommend avoiding submerging the incision for at least a week if possible,” Hannan says. “If absolutely necessary, a waterproof adhesive bandage should be used, and the minimum amount of time in the water as is possible for that person.”

Once out of the pool, or tub, she recommends drying the area as much as possible by patting it with a towel or letting it air dry. 

All wounds and all patients are different, and she recommends asking your doctor about specific instructions for your wound before getting back into the water.

Taking Care of Your Stitches or Staples

Topic Overview

Your wound will need care and observation. After the stitches or staples are put in, the area may be covered with a thin layer of ointment and covered with a nonstick bandage. Your doctor will give you instructions on how to care for your stitches or staples. Be sure to follow those instructions.

Check with your doctor about how long you need to keep your wound dry. In some cases the bandage can be removed after 24 to 48 hours, and the wound can then be gently washed to remove the crust. Do not scrub or soak the wound during the first 48 hours.

If you did not get instructions, follow this general advice:

• Keep the wound bandaged and dry for the first day.
• After the first day, wash around the wound with clean water 2 times a day. Don’t use hydrogen peroxide or alcohol, which can slow healing.
• You may cover the wound with a thin layer of petroleum jelly, such as Vaseline, and a nonstick bandage.
• Apply more petroleum jelly and replace the bandage as needed.

It is normal for stitches or staples to cause a small amount of skin redness and swelling where the stitch or staple enters the skin. Your wound may itch or feel irritated. Check your wound every day for signs of infection.

Your cut may not need a bandage if it is not likely to get dirty, it is not draining, and it is in an area where clothing will not rub it. If you use a bandage, change it every 24 hours and anytime it gets wet or very dirty.

Your doctor will tell you when to have your stitches or staples removed. When deciding how long to leave your stitches or staples in place, your doctor will consider several factors, such as the location, depth, and size of your wound and your general health. Be sure to follow his or her instructions.

Most of the time, stitches are removed:

• From the face in 4 to 5 days.
• From the hands and arms in 5 to 10 days.
• From the feet, legs, chest, abdomen, and back in 7 to 14 days.
• Over a joint in 7 to 14 days.

90,000 Where to remove stitches after surgery in Moscow?

Removal of stitches

Removing stitches is a manipulation that is performed after the wound has healed and a scar has formed. If absorbable sutures were used for sutures, suture removal is not required. However, if metal staples or synthetic threads are used, you will need to see a surgeon to get rid of them.

It is necessary to remove the stitches as soon as the wound has healed, since the foreign materials left behind can cause inflammation.You should not try to remove the stitches yourself, only a specialist should do this.

The stitches are removed, as a rule, 5-7 days after the operation, but the stitches are removed later after the most serious operations. You should also take into account the rate of tissue regeneration, the patient’s age and other factors. Therefore, the decision about when to remove the stitches is usually made by the doctor who monitors the patient in the postoperative period.

You can remove the stitches by contacting a surgeon at any of the Family Doctor’s outpatient clinics.Below you can clarify the cost of the manipulation, as well as make an appointment with a doctor by choosing a clinic located in the most convenient area of ​​Moscow.

Dear patients!
Please note that the prices shown are not the final cost of admission.
If the manipulation is at the doctor’s appointment, then the cost of the appointment is added to the cost of the manipulation (accordingly, the cost of the appointment increases by the cost of the performed manipulations).

AllHospital center – BaumanskayaPolyclinic №1 – TaganskayaPolyclinic №2 – People’s MilitiaPoliclinic №3 – DomodedovskayaPoliclinic №5 – BarrikadnayaPolyclinic №6 – KrymskayaPoliclinic №7 – Babushkinskaya Stanzalinic №9 – Ramenki – Pervivocal clinic BratislavskayaPolyclinic №15 – BaumanskayaPolyclinic №16 – Academician Yangel StreetPolyclinic №17 for children – People’s MilitiaAll
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90,000 How to remove stitches at home in a dog?

After surgery, the pet is sutured, which is necessary for the speedy healing of the postoperative wound.Sometimes it becomes necessary for dog breeders to remove them for their pet on their own. Let’s consider how to do this correctly so as not to harm the animal.

When can sutures be removed after surgery for a dog

It would be most reasonable to entrust this manipulation to a specialist, but the owners do not always have the opportunity to take the animal to the veterinary clinic on time. For example, the dog may be nervous and stressful to visit the hospital, or the owner does not have enough time to visit the veterinarian.

The procedure is quite simple and does not require special medical skills, but before that you need to make sure that the dog is healthy, the wound is completely healed and there is no danger of its divergence. In standard operations, sutures are removed on the 12th day after surgery.

In what cases it is impossible to remove stitches from a dog on your own:

• allocation of exudate;

• unpleasant odor from the wound;

• crusts;

• severe redness;

• inflammation, swelling in the area of ​​operation.

If at least one of the above signs is detected, the owner must give up the thought of doing the procedure on his own. The dog has got an infection in the wound, so it should be taken to the veterinarian immediately.

How to remove seams correctly

Disinfectants are not required in most cases, they can irritate the wound and cause discomfort to the dog.

The owner will need:

1. Surgical scissors.In the absence of such, you can use a similar model with rounded edges.

2. Surgical forceps.

3. Cotton swabs.

4. Iodine, chlorhexidine.

5. Clean towel (clean rags, gauze).

On the day the stitches are removed, the animal should be reassured so that it does not get nervous.It is enough to hold a small dog by the head with one hand or to swaddle, but with a large one you will have to tinker, it is quite possible to ask for help from someone from your family so that the dog cannot move. For nervous and aggressive dogs, muzzle is best.

Next, the animal should be placed in a comfortable position so that it lies on its side in a relaxed natural position.

How to remove postoperative stitches for a dog:

1. Clean the healed wound from clotted blood and other contaminants with a towel dampened with warm soapy water.

2. Find the longest ends of the threads, hold them with your left hand and pull towards you.

3. Cut the threads with scissors between the skin and the knot.

4. Press on the skin next to the seam with the fingers of the right hand, with the left fingers, pull the ends of the threads, quickly and carefully pull them out.

5. If threads remain at the site of the healed wound, remove them with tweezers.

6. Treat the postoperative area with iodine.

This completes the procedure for removing the stitches, and if the owner did everything right, then there should be no complications.

Care after sterilization

Many novice dog breeders are worried about what kind of suture a dog should have after the sterilization procedure. In most cases, the removal of stitches is not required, since modern materials promote rapid healing and dissolve on their own.The main thing is keeping the operated area clean and its timely processing.

To protect the seams from bacteria and mechanical damage, use a special blanket with ties on the back. Since the thin breathable material quickly becomes dirty, the bandage should be changed once a day. The new blanket must be ironed and only then put on the dog. During the processing of the seams with chlorhexidine, the device cannot be removed, it is enough just to move it to the side, having untied several tapes.

The animal may try to rip off the bandage in order to comb or lick the cosmetic seam. This should not be allowed, since infection can enter the area that has been operated on. In these cases, an Elizabethan collar is worn on the dog.

Laser ophthalmology

Laser elimination of suture material protruding above the cornea.

Postoperative sutures of the cornea are the cause leading to endothelial-epithelial dystrophy and further to corneal ulcers, neovascularization of the membranes and plastic iridocyclitis.

Photo – mucus on the seams – entry ways of infection.

The first place in terms of the number of intraocular interventions performed is taken by cataract surgery, and all of them end with the sealing of the corneal wound with the imposition of suture material. A number of authors prefer interrupted sutures, others prefer the continuous type of suturing.

Removal of corneal sutures is carried out using microsurgical instruments: tweezers, blade or scissors.

Under local anesthesia (a drop of proxymetacaine) and visual control of a slit lamp, the doctor incisions the thread and pulls it out of the cornea.In this case, the patient does not experience absolutely any sensations, tk. the instrument does not touch the surface of the eye.

Photo – removal of sutures from the conjunctiva.

(photos courtesy of Dr. Dvoryaninov)

After inadequate or incomplete removal of the suture, as well as mechanical destruction of the so-called “non-removable” immersion sutures, a part of the suture material in the form of a thread or knot remains in the corneal stroma. These fragments are rejected and appear above the cornea, and with mechanical action of the eyelids, they contribute to the development of traumatic keratitis and corneal ulcers.It is practically impossible to remove these “roots” by instrumental methods without extensive destruction of the corneal tissue with thinned suture material and a small protruding part of it above the surface of the cornea.

To eliminate this condition, we propose a method that allows you to destroy the protruding parts of the suture material without instrumental dissection of the cornea using non-traumatic non-invasive laser exposure.

As a result of laser destruction of the residual suture material protruding above the cornea, the mechanical cause of the appearance of keratitis and other complications from the cornea of ​​the eyeball is eliminated.

Article “Continuous horizontal intradermal adaptation suture”

Home> News> Article “Continuous horizontal intradermal adaptation suture”

Congratulations to our colleague, surgeon Dr. Igor Alexandrovich Fufaev. His article “Continuous horizontal intradermal adaptation suture” was published on the ForumZdravExpo website.

The unique method of skin excision and subsequent wound closure, proposed by Dr. Fufaev, has been repeatedly confirmed with excellent results.The method and its results can be found in the article below.

Surgical operations are based on the principle of skin incision or excision and subsequent suturing of a skin wound or defect with a skin suture. A surgical suture is the connection of tissue and wound edges using suture material. External sutures, which include the skin suture, are: continuous and interrupted. A continuous suture is called a suture applied by one thread over the entire length of the wound – this is a continuous horizontal mattress suture, a continuous single-row intradermal Halstead suture, a continuous Multanovsky loop suture, a continuous wraparound suture, etc.[1].

The disadvantages of a continuous seam are:

• tendency to crinkle leather;

• if the thread is damaged in any area, the fastening property of the suture is completely violated throughout the wound;

• the possibility of disrupting the blood supply to the edges of the wound along the entire suture line;

• bedsores from nodes in the corners of the wound [2].

The search for new methods of applying a skin suture is explained not only by the non-decreasing number of various complications from postoperative wounds, but also by the dissatisfaction of surgeons in achieving a cosmetic effect from the use of traditional skin sutures [3].

The disadvantages of traditionally used sutures include the fact that when stitching the edges of the excised wound using known methods, the length of the suture is more than the length of the defect by an average of 25% (Fig. 1).

Fig. 1.

The disadvantages include the fact that when the edges are stitched with a continuous horizontal intradermal Halstead suture, used in plastic surgery, on the mobile areas of the skin, where the force loads on the scar are greatest, the divergence of the edges occurs quite often, due to the weak strength of the suture, which does not withstand tension of tissues.This suture is also not very effective when applied to a wound after excision of a superficial skin neoplasm. It should be noted that plastic surgeons prioritize the suture imposed in accordance with the course of the lines of force, which does not always coincide with the shape of the neoplasm (uneven edges of nevi, epitheliomas, the presence of daughter satellites in the resection area).

We bring to your attention a suture that can be used for excision of a superficial neoplasm of the skin (no more than 3.0 cm in diameter) when a skin defect is obtained from 0.5 to 3.5 cm in diameter (Fig. 2, 3).

An attempt was made to apply a suture, which will allow, without compromising the principles of radicalism and abblastic surgery, to excise the superficial neoplasm of the skin by performing an extended biopsy and close the defect with the most cosmetic effect, regardless of the location of the lines of force (Fig.4, 5, 6).

Fig. 6. After operation

The suture is applied by passing the ligature horizontally, strictly intradermally along the entire perimeter like a “pouch” with only one injection and one puncture on each of the two semiaxes of the wound, the knot is between the edges of the skin wound and does not protrude above the surface, due to which the likelihood of a pressure ulcer is sharp decreases.

The suture is removed 10-12 days after application (Fig. 7, 8, 9).

Fig. 9. One year after surgery

For fifteen years (1999–2013), we performed more than three thousand extended biopsies with the closure of the skin defect with a continuous horizontal intradermal adaptive-submerged suture, in all cases the skin scar was not larger, and in more than half of the cases, less than the removed neoplasm.A continuous horizontal intradermal adaptive submersible suture effectively closes skin defects after stopping foci of acute purulent destruction of the skin and subcutaneous tissue (furuncle, carbuncle, atheromatous and other abscesses) (Fig. 10, 11, 12).

Fig. 12. One year after surgery

Thus, the advantage of the proposed method is that the suture does not require any additional technical equipment, it can be applied by any surgeon who has basic general surgical training.The time spent on suturing does not exceed the time spent on the application of a conventional interrupted suture. The suture is continuous, the edges of the skin wound are intimately adapted to each other, the knot is immersed under the skin. The seam does not depend on the direction of the lines of force and the scar after such a seam is the lowest possible.

References

1. O.S. Kochnev, S.G. Izmailov Method of applying a skin suture. Guidelines. – Kazan, 1998.
2. Semenov G.M., Petrishin V.L., Kovshova M.I. Surgical suture.- SPb .: Peter, 2001 .– 57 p.
3. Sleptsov I.V., Chernikov R.A. Knots in surgery. – SPb .: Salit-Medkniga, 2000 .– 8 p.

➤ Removal of stitches and staples at home in Moscow | We work 24/7

Entrust your health to professionals

The human body is a unique system capable of self-regulation and recovery. For example, the skin is our most extensive organ in terms of area, which primarily performs a protective function, has properties to regenerate.That is why abrasions, scratches and other damage to the skin over time heal and heal without outside interference.

However, when it comes to torn, deep incisions, as well as surgical operations that require suturing, letting the process take its own course is extremely dangerous to health, especially in the postoperative period.

The suture material fixes the skin in the desired position, preventing it from diverging. After the wound has healed, the fixing agents must be removed.To exclude contamination of a fresh wound, the extraction of threads and the subsequent processing of the fixation site must be carried out in compliance with all sanitary and hygienic standards and requirements. Therefore, it is better to entrust the removal of stitches and staples to the professionals of our clinic in Moscow and not put your health at risk.

Removal of stitches and staples at home around the clock

Without special knowledge and specialized skills, it is extremely difficult and unsafe to carry out the procedure on your own. The doctors of our clinic in the city of Moscow have not only the appropriate qualifications to provide such services, but also a lot of practical experience.We also visit patients within the region.

Removing a seam is a task no less important than applying it. If, through negligence or inattention, a foreign body is left in the hole, it can provoke further inflammation and suppuration. That is why a specialist should remove the seam! He can conduct a professional examination, objectively assess the condition of the tissues and accurately schedule the removal of suture material.

When you decide to remove the stitches yourself, especially when you do it yourself, there is a huge risk of leaving thread fragments in the wound, it is not enough to treat it well with disinfectants.In such cases, the inflammatory process is guaranteed!

Of course, after the surgery, even if the operation was not very difficult, I do not want to tire myself once again with trips in public transport and go to the hospital.

The postoperative period requires maximum rest. The best option in this situation is to call a specialist of our clinic home, who will provide qualified assistance in removing staples without risking your health.The service is available in Moscow at any time.

Our specialists adhere to all sanitary and hygienic requirements, using only sterile antiseptic tools in their work.

Before proceeding with the extraction of the staple, the skin area is carefully treated with antiseptic preparations. Typically, hydrogen peroxide or chlorhexidine is used to rinse the surface. After that, with the help of tweezers, the doctor removes the staples and performs secondary treatment of the skin with antiseptics.It is important that the holes from the needle are especially carefully processed.

At the final stage, a healing ointment is applied to the treatment site, which relieves inflammation and helps the tissues recover as quickly as possible. To protect the patient from possible infection, a bandage must be applied.

Removal of stitches at home – Moscow departure price from 1300r

Suturing is a vital necessity in the presence of lacerations and lacerations, serious abrasions and other skin injuries.With the help of threads, it is possible to correctly fix the wound and speed up the regeneration of the dermis, however, the sutures (with the exception of self-absorbable ones) must be removed – and only a professional can do this correctly.

Nurse home call is an excellent solution for the physical and psychological comfort of the patient, especially the immobilized one. Removal of stitches and staples at home will be carried out by a professional medical professional with extensive experience, who will make the unpleasant procedure as painless as possible.

How to remove stitches

Removal of stitches at home is performed according to the following algorithm:

1. The nurse will disinfect the area with an antiseptic.
2. The threads must be cut carefully.
3. Suture material is carefully removed so that no threads remain in the wound.
4. The site is re-treated with an antiseptic and a healing ointment is applied.
5. To prevent dirt from getting into the wound, a bandage is applied after the suture has been removed.

Our specialists work on weekdays, weekends and holidays, so their services can be used at any time convenient for you.

Price

1300 rub

Manipulation removal of stitches at home is paid separately, the price can be checked with the operator.

It is additionally paid: Departure for the Moscow Ring Road, in the evening after 18.00, on weekends.

Manipulation at home:

Dropper
Intravenous
Intramuscular

Home visit of a nurse – at Moscow Region

• Khimki, Mytishchi, Balashikha, Korolev, Elektrostal.
• Leningradskoe shosse house call – Khimki, Skhodnya, Zelenograd
• Dmitrovskoe highway house call – Dolgoprudny, Lobnya
• Yaroslavskoe highway call a doctor at home – Mytishchi, Korolev, Yubileiny
• Shchelkovskoe highway call a doctor at home – Shchelkovo, Fryazino
• Novoryazanskoe highway house call – Lyubertsy, Tomilino, Malakhovka, Dzerzhinsky, Lytkarino
• Kashirskoe highway house call doctor – Vidnoe, Domodedovo
• Varshavskoe shosse house call – Butovo, Shcherbinka, Podolsk
• Kaluzhskoe highway house call – Gorodishche, Troitsk
• Kievskoe highway house call doctor – Vnukovo, Aprelevka
• Mozhaiskoye highway call a doctor at home – Odintsovo, Gorodok, Golitsino
• Volokolamskoe highway house call – Krasnogorsk, Nakhabino, Dedovsk, Anikeevka

Address: Moscow, Mirsky lane, house 8, bldg.1
License LO 77-01-005759

Make a home visit for a nurse:

By phone: 8 (495) 229-80-67 (We work on holidays and weekends)

90,000 How to remove stitches from a dog: preparation and step-by-step guide

Almost all pet owners face surgery. The most common are castration and sterilization. Regardless of the task, surgical intervention is carried out with the obligatory suture.If the used threads are not absorbable, then after the healing of the postoperative wound, they must be removed. As a rule, this procedure is performed by a veterinarian, but sometimes circumstances force you to solve the problem yourself. When you follow the step-by-step instructions, even a beginner can handle the removal of stitches.

Features of suture material

According to the method of location, the seams are divided into internal and external. The former are used to connect cut tissues: muscles, blood vessels, subcutaneous tissue.They cannot be seen during external examination, therefore, they try to reduce possible complications with high-quality material. In 90% of cases, internal sutures are applied with absorbable sutures. The external version is often made from synthetic threads. It is him that you have to shoot yourself. With a prolonged stay in the body, the threads begin to be rejected, suppuration occurs.

Any of these materials are foreign. As a response of the body, the four-legged patient experiences itching or other inconvenience.In an attempt to eliminate it, the animal licks and damages the wound. If it is not enough to follow the pet, then you will have to sign up for a second operation.

Benefits of removing stitches at home

Removing stitches for a dog after surgery is not as difficult as it initially seems. Ideally, it is recommended that you consult with your veterinarian prior to the procedure. After examining the four-legged patient, he will confirm that the wound is healed and will not disperse when the strings are removed.Additionally, the doctor will explain how to remove stitches for a dog at home. After receiving the conclusion and detailed instructions, you can proceed to the intended actions without fear of possible consequences.

As a rule, you will have to resort to the help of a veterinarian in two situations: after cropping the ears and after eye surgery. Pain is indispensable here, so sometimes animals need anesthesia.

Undoubtedly, the services of veterinarian doctors are safer and faster.But in some situations, it turns out to be impossible to see a doctor. A lot of people live in the region, so it’s hard for them to get out to the big city. In addition to hopelessness, other 90,055 benefits of removing stitches at home are also an important factor. These include:

1. Protection against infection. Not only healthy, but also sick animals are brought to the clinic. In the postoperative period, immunity decreases. The dog is more vulnerable to infections than usual.The problem can be solved by recording at a specific time, but even so, the appointment hours are often shifted due to too long examination of the previous patient.

2. Reducing stress factor. The veterinary clinic is associated with pain. Most animals experience strong nervous tension when they find themselves within the walls of this institution. Because of this, even simple manipulations are equated with the ninth circle of hell. The performance of the same actions on familiar territory by any owner is perceived more adequately.If going to the veterinary clinic is one of the stress factors for your pet, then it is better to get rid of unnecessary worries and learn how to remove the stitches from the dog yourself. Otherwise, there is a high likelihood of a secondary infection due to stress.

3. Saving. Independent work, although it takes time, is absolutely free. If you are confident in your abilities, save money for more important things.

After the stress of neutering and neutering, the dog will be grateful for the absence of strangers smelling of medications.Before carrying out the procedure, it is necessary to prepare the instruments, find an assistant and make sure that the upcoming operation is safe.

How to understand that the wound has healed?

Not only early, but also late suture removal is considered dangerous. In the first case, there is a high probability of wound divergence, in the second – ingrowth and suppuration of the threads. As a rule, at the end of the operation, the veterinarian announces a conditional healing date. On average, healing is about 10-14 days and depends on the site of the surgery:

• neck and head – 5-7 days;

• chest, paws and peritoneum – 10-14 days.

In addition to the operated area, age also affects the rate of healing. Tissue regeneration in puppies is higher than in adult and elderly animals.

Focus on the date announced by the doctor, but do not forget to observe external changes. After 4-5 days, the formation of granulation is permissible – a painless ball under the skin. It will resolve on its own a little later. If the edges of the incision become almost invisible, and the adjacent skin is not reddened or inflamed, proceed with the removal.

You will have to postpone the procedure and seek help from a doctor only if the following symptoms appear:

• unpleasant odor;

• increased redness;

• discharge of pus;

• the presence of bleeding or blood crusts;

• an increase in local temperature;

• the formation of swelling and inflammation.

All of these symptoms occur when an infection gets in and are fraught with an abscess with subsequent blood poisoning. If you find at least one of them – give up independent actions in favor of visiting a veterinary clinic. Pulling the threads out during the inflammatory process is more difficult because of the pain. Watch your pet closely to avoid infection.

Preparation for the procedure

Make an appointment in advance with a friend who is willing to take on the role of a nurse, or get the help of a family member.The dog must know him so as not to feel anxiety about the appearance of a stranger. The tasks of the assistant will include holding the four-legged patient until the end of the manipulations. You cannot cope with an animal alone. You will either hurt him or cause stress from the bondage. As an exception, representatives of small breeds can be called, but even here it is better to have two free hands, since removing the seams from a dog is a little more difficult than the usual hygienic procedure.

To remove the threads, you will need the following materials and tools :

1. Thin surgical scissors with rounded edges.In extreme cases, ordinary manicure is also suitable. The main thing is to make sure that they cut well and do not cause problems at a crucial moment.

2. Surgical tweezers. Here, a manicure set will not save you. The branches (rod levers) of this tool have special notches. With their help, it is easier to grasp the thread. More experienced owners assure that nail clippers also cope with the task. But it’s safer for beginners to work with reliable tools.You can buy them at your regular or veterinary pharmacy.

3. Water and a metal bowl. Boil water and pour it into a container. Boiling water is an excellent disinfectant for instruments.

4. Bandages or gauze. They are useful for bandaging the wound after removing the threads.

5. Disinfectants, antibacterial ointment and cotton pads for their application.Don’t use cotton wool. Its villi may remain inside during processing. Also, do not use alcohol-based products or high-strength hydrogen peroxide. They cause irritation accompanied by a feeling of pain. Lubrication of the postoperative surface with these agents is provided only in one case – with inflammation. Do not try to treat the inflammatory process on your own and see your doctor right away.

After making sure that the wound has healed, treat the resulting crusts with saline.The day before the procedure, lubricate the surface with a greasy cream to soften the threads and improve their slippage.

Before starting the manipulation, calm and pet the dog. Dealing with a pacified pet is much easier than dealing with a shy and aggressive pet. If you are not sure of a calm reaction on the part of the animal, protect yourself and your friend with a muzzle. Put it on your dog, and wrap it tightly with a towel on top. For brachycephalic breeds with a short muzzle, one towel is sufficient.Make sure the ends are tied in a strong knot behind the head.

Prepare a flat and solid surface. A regular table is suitable for this. Cover it with a soft cloth or diaper. After all the manipulations, place the pet on its side in a relaxed and comfortable position. Do not try to roll the dog onto its back. In this position, she feels more vulnerable, which increases her fear. Remember to be comfortable and reduce stress with approving pats and conversations.

Suture Removal Instructions

It is enough to hold small-bred dogs by the head, while larger ones will have to fix the limbs.Pay special attention to the hind ones, as from the fright the animal can injure itself and those around it during manipulations. They can be wrapped tightly with a cloth or covered with a blanket.

Try to stay in contact with your pet at all times. Talk, scratch, do your best to shift your attention away from unpleasant actions. Position your pet’s head so that he cannot see the tools and activities. Panic isn’t always about real pain. If a pet is afraid of clipping, then he will easily come to a state of horror, just by looking at a manicure set.Don’t tempt fate.

After following all the preparatory steps, including treatment with saline, proceed to basic steps :

1. Keep the tools in boiling water and treat with alcohol. Any dirt trapped inside will cause inflammation. The safer the devices used, the higher the chance of a successful operation. It is equally important to take care of the cleanliness of your hands. Wash them thoroughly under running water and soap.

2 Take a clean towel and dampen it in warm water. Remove any caked blood and other debris from the wound.

3. Soak a cotton pad with 3% hydrogen peroxide and treat the cleaned wound. Examine the seam carefully. It is divided into an outer and an inner part. The first includes two tails and a knot, the second – everything that is hidden from you and is under the skin.

4. Gently wiggle each of the threads from the outside using the tweezers to grasp them.After the wound has healed, they stick to each other, preventing quick removal. Fear not, the threads are foreign to the body, so they easily move under the skin. During the manipulation, slight discomfort for the animal is possible.

5. Pick up one of the knots with scissors and pull vertically. Cut the stitch outside the knot while holding one of the tails with tweezers. Remember that the tips of the tool should be rounded. Otherwise, you are more likely to scratch or puncture with a sharp tip.

6. Monitor the condition of the dog. If the four-legged patient starts to worry, take a break. Set aside your tools and talk to your pet. Don’t show pity and don’t encourage fear. In this case, the dog will decide that the fears are justified and it will not be possible to finish what he started without consequences. Be confident and speak in a calm voice. Cheer up your dog by shaking his paw or patting his rump. Reassure him that the situation is under control, and all experiences are not justified.Veterinarians note that the pain threshold of animals is lower than that of humans. Remember that the pet squeals not from pain, but from ordinary fear. The success of the operation depends on your confidence.

7. Gently pull the tweezers upward while holding the cut seam. Due to the tension created under the skin, the dog will feel mild anxiety. This is fine. Continue pulling until the threads are completely removed from the body. The alarm will have to be raised only when the thread sits firmly under the skin, and its removal will be accompanied by real pain for the patient.In this case, stop the procedure and hurry to the veterinary clinic.

8. Remove the rest of the threads in the same way. If the animal is very worried, postpone suture removal for a couple of days. If the condition of the dog does not change, humble yourself and leave the four-legged patient to a qualified veterinarian. The same solution is recommended when withdrawing after a complex operation.

9. If you have removed all the stitches – once again treat the wound with a cotton swab dipped in peroxide.Check that there are no loose threads left inside and outside.

10. After making sure that bleeding, pus and other alarming symptoms are absent, lubricate the wound with Levomekol. This antibiotic is approved not only for humans, but also for animals. Make sure that it is always in your home medicine cabinet. Apply a sterile dressing or bandage over the top. After completing the final action, be sure to treat the four-legged hero to your favorite treat, regardless of behavior. This will allow you to switch from a stressful factor to positive emotions.

Remember to pull off the end of the thread, not the knot itself. It is also important to cut the thread under the knot while maintaining its integrity. Otherwise, some of the threads will remain under the skin, and you still have to go to the veterinary clinic. When removing suture material, it is important to prevent the outer suture from passing through the inner tissue. To do this, cut off the outer thread just next to where it enters the skin. Otherwise, when pulling, not the clean side will go inward, but the dirty side.Such a mistake is another way to get infected.

If you strictly followed the instructions, then you can not be afraid of failures or complications. The whole process takes no more than 10-20 minutes. Monitor the wound carefully for 1-1.5 weeks. If there is blood or pus, contact your veterinarian.

Postoperative Care Rules

Safe and painless suture removal is directly dependent on the care of the postoperative wound.Treatment is carried out until the wound is completely overgrown. The veterinarian is obliged to set approximate dates. If the edges are pulled together before this time, do not stop processing. When caring for your operated pet, it is important to observe the following rules:

1. Examine the wound at least 2 times a day. Dirt and dust should not accumulate there. The edges of the wound should be not only clean, but also even. It is normal for some redness and bruising to develop, and a pinkish fluid leak in the first few days after surgery.If these symptoms persist, sound the alarm.

2. Make sure the dog doesn’t damage the stitch. Due to possible itching and other unpleasant sensations, the pet will lick or try to gnaw through the threads. The Elizabethan collar will solve the problem. This protective cone will restrict the dog’s mobility and prevent the wound from spreading.

3. Avoid daily treatment with ointments and antiseptics.This action is only permissible as directed by your veterinarian. As a rule, it is excluded, since excess moisture reduces the rate of regeneration. The drier the wound, the faster it will heal.

4. Keep the litter clean. During rehabilitation, the animal does not move much, so all activity is concentrated in the area of ​​the bed or house. Clean them regularly from dirt, protect from moisture and drafts.

5. Eliminate bathing.If your pet looks dirty, be patient. Wetting the suture material can even cause wiping with a damp cloth. Remember that the combination of heat and moisture is the most comfortable environment for attracting pathogens.

6. Avoid contact with other animals. Games with neighbors’ dogs are temporarily prohibited. Keep your pet on a short leash and take lonely routes. Also remember to avoid sudden movements and walk at a relaxed pace.All exercises and runs are postponed until complete recovery.

Following these tips will help you recover faster after surgery. The faster and more painlessly the wound heals, the easier it will be to deal with the threads tightening it.

Everyone can get rid of postoperative stitches at home. To successfully complete the procedure, it is sufficient not to deviate from the step-by-step guide.If you are not confident in your abilities, watch the training videos. If your hands continue to shake even after reading a good example, stop being brave and rely on doctors. Remember, your pet’s safety should always come first.

This article is for informational purposes only. See your veterinarian!

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