Retained Suture Material Consequences and Management

Immediate Consequences of Retained Suture Material

Retained non-absorbable sutures increase the risk of surgical site infection, particularly when they remain close to the skin surface or are exposed to the external environment 1
The American College of Surgeons notes that infection risk is higher when sutures are left in place too long, as seen in various surgical procedures 2
Suture abscesses can develop around retained material, presenting as localized inflammation, pus formation, and drainage, as reported by the World Journal of Emergency Surgery 3
The World Health Organization guidelines suggest that "spitting sutures" may occur where the body attempts to extrude the foreign material through the skin 3

Examine the wound for signs of infection, such as erythema, warmth, purulent drainage, increased pain, or systemic signs, as recommended by the Infectious Diseases Society of America 1
Remove all accessible retained suture material immediately if the wound shows signs of infection, as advised by the Clinical Infectious Diseases journal 1
Obtain Gram stain and culture of any purulent drainage and initiate antibiotic therapy active against Staphylococcus aureus, including MRSA coverage if risk factors present, as suggested by the Centers for Disease Control and Prevention 1

Non-absorbable sutures should be removed at 7-9 days for most surgical wounds to prevent complications, as recommended by the World Journal of Emergency Surgery and the American College of Surgeons 2, 5
Consider using absorbable subcuticular sutures to eliminate the need for removal and reduce wound dehiscence risk, with a relative risk of 0.08 (95% CI 0.02 to 0.35), as reported by the World Journal of Emergency Surgery 5, 6
Triclosan-coated sutures significantly reduce surgical site infection prevalence compared to non-coated sutures, as demonstrated by the World Journal of Emergency Surgery 3

Do not leave superficial or exposed suture material, as this significantly increases infection risk, as warned by the American College of Surgeons 2
Avoid attempting needle aspiration of any abscess that forms around retained sutures; incision and drainage is required, as recommended by the Clinical Infectious Diseases journal 1
Do not pack wounds after removing infected sutures and draining abscesses, as this causes more pain without improving healing, as advised by the Infectious Diseases Society of America 1