How do you take care of stitches?

In previous posts we have discussed various ways that plastic surgeons disguise scars. We hide scars in natural boundaries between facial features. We repair skin cancer defects by moving adjacent skin that it is a good color and texture match. Regardless of the surgical techniques used to disguise a wound, proper wound care after a procedure is critical to ensure the best result possible.

The key to good wound care is avoiding scabs. Why? Wound healing, when it comes down to it, is all about your body’s cells. Your body has a team of cells that works together to clean up and repair wounds. Cells need moisture, oxygen, and nutrients to properly do their jobs. Scabs are like the surface of the moon- dry, oxygen-poor and nutrient deficient. The following instructions will help you to take care of a surgical wound with stitches on the face, but the general principles are applicable to pretty much any wound.

To take care of stitches, you’ll need the following things:

1) a bottle of hydrogen peroxide

2) cotton-tipped applicators (commonly called Q-tips®)

3) a tube of antibiotic ointment- I favor bacitracin zinc, but many people have triple antibiotic ointment (like Neosporin®) at their houses already. This is fine, but I’ve seen people have contact allergic reactions to triple antibiotic ointments. This can happen with bacitracin zinc too, but less frequently in my experience.

4) petroleum ointment (commonly called Vaseline®)

In a small cup, dilute some hydrogen peroxide with an equal amount of tap water- roughly a tablespoon of each is fine.

Dip one end of a Q-tip® into the mixture. Use this to gently clean the wound and stitches. You ideally want to remove any scabbing and debris that is in or around a wound. The solution will fizz a little; this is ok. You may make the wound bleed a little; this is ok.

After you’ve removed any crusting and debris, use the other end of the q-tip® to apply a thin layer of ointment to the wound and any stitches. For facial wounds, use antibiotic ointment for the first 48 hours then switch to petroleum ointment. The ointment creates an excellent environment for wound healing and the antibiotic is not necessary after the wound seals itself which takes about 48 hours.

In general, I advise that patients do this twice a day until the stitches are removed. After the stitches are removed, I usually advise leaving the wound alone for a week if everything is going well.

If you want to know more about dissolvable stitches, check out this blog post!

After an incision has healed for a couple of weeks, you can consider ways to care for the resulting scar. For more on that, check out my post on scar management.

Wound care is an essential part of every surgical procedure that I do. While I know plenty of tricks to disguise scars, the ultimate success of these techniques really depends on how well a patient takes care of their stitches. If you follow these directions, you’ll be in good shape!

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