Nurses’ Experience Removing Superficial Nonabsorbable Sutures From the Skin

Wound Overgrowth of Sutures Complicates the Procedure

Abstract

In many dermatology settings, nurses remove superficial sutures from wounds of the skin. The current practice is to remove sutures between 5 and 14 days depending on the location of the defect to prevent wound overgrowth and subsequent complications. Yet, by 10 days, wound strength is only 5% of that of intact skin, also setting the stage for potential complications, such as dehiscence. We surveyed Dermatology Nurses’ Association members to understand their experiences with removing sutures from the skin. With a response rate of 16.75%, the sample size was 355 respondents. Over 90% of the respondents encountered wound overgrowth (i.e., ingrown sutures) when removing sutures. Moreover, mattress-type closures presented more difficulty on removal than simple-type closures. When sutures were ingrown, complications included patient pain (31.5%), wound bleeding (30.1%), inability to ensure the complete removal of sutures (19.2%), wound dehiscence (7.0%), and increased procedure time by nearly 2 minutes. Our findings of nurse experiences with suture removal support the need for innovative solutions to prevent wound overgrowth.