Suture literally means to join. Surgical suture is a stitch which is used by the dentists to hold the tissues together. If the tooth comes out in one piece without much trauma to the surrounding tissues, then sutures/ stitches are not usually placed. Sutures are given after the surgical tooth extractions and in extractions where there is much of trauma to the surrounding tissues.
Sutures are made of variety of materials and come in several sizes. The two basic types of suture materials are resorbable that the body is capable of easily breaking down the material and nonresorbable sutures. In general, the resorbable sutures don’t require removal whereas the non-resorbable sutures do.
The resorbable sutures which are commonly used are: Gut, polyglycolic acid and copolymer of glycolic and lactic acid. Gut is fabricated from submucosa of sheep intestines or serosa of beef intestine. If prolonged suture strength is required, then gut is treated with basic chromium salts. These sutures are known as chromic cat gut suture. Plain gut sutures retain their strength for 5-7days whereas the chromic sutures maintain strength for 9-14days.
Resorbable sutures are highly reactive as compared to nonresorbable sutures and evoke an intense inflammatory reaction which may affect the healing.
The most commonly used non-resorbable sutures are: Silk, nylon, polyester and polypropylene. Nonresorbable sutures are either monofilamentous, multifilamentous or both. Multifilamentous form increases the strength. Silk and polyester sutures are available in multifilamentous form. Polypropylene is the mono filamentous form. Nylon comes in both mono filamentous and multifilamentous form.
Non resorbable sutures
All nonresorbable sutures have some reactivity. Silk evokes the most intense inflammatory response. Polyester is much less reactive than silk and nylon is less reactive than polyester and polypropylene has least tendency to induce inflammation.
When non-resorbable sutures are given by the dentist, then they are to be removed. They are mostly removed a week after the extraction. Gut sutures are most commonly used resorbable sutures which may be there for couple of days to couple of weeks and then will resorb.
The most common problem with the dissolvable sutures is that they sometimes don’t dissolve even after few weeks. In such a case, the dentist can remove the stitches themselves if they don’t come out themselves.
Post-operative care of sutured wounds:
Postoperative care of sutured wounds is important. Sutured wounds within the oral cavity should be kept clean by having the patient rinse frequently with normal saline, hydrogen peroxide diluted with saline or fresh tap water. There should be no food deposits around the stitches. The teeth near the stitches can be brushed but don’t brush over the gum area.
If the stitches become loose or are dislodged before a week, then there is no cause for alarm. The most important thing is that the clot should remain in its position and there should be no excessive bleeding.
No pain during sutures removal
Many of people are worried that the removal of the stitches or the sutures will cause pain. Removal of stitches is an entirely painless procedure and there is no need of giving the local anesthesia and numbing the area before removing the sutures. The sutures are snipped using a pair of tiny tweezers. The tweezers will pull out the sutures with almost no pain and takes only few seconds. The patient just feels a small pinch while stitches removal but there is no pain.