Stitches Healing Phases: What to Expect After Surgery

During a surgical procedure, a surgeon makes an incision or cut into the body’s skin and tissues. This is done to expose the underlying tissues and organs, allowing the surgeon to visualize the surgical area and insert surgical instruments. The size, location, and type of incision varies according to the surgery being performed.

After the surgery, the surgeon performs an initial closure of the surgical wound in the operating room with sutures (stitches), staples, or surgical glue. This helps to facilitate proper wound healing in the postoperative period.

Please continue reading to learn more about how a surgical wound heals, what to expect during the wound-healing process and the signs and symptoms of an infected wound.

How long does it take for a surgical incision to heal with stitches?

There is no single answer to how long it takes for a surgical incision to heal with stitches. Several factors can affect surgical incision healing time, such as:

Type of surgical wound

A large incision will take longer to heal than a smaller one. Several small laparoscopic incisions made during a minimally-invasive surgery usually heal faster than one large incision performed during a traditional open surgery.

Location of surgical wound

The area where the surgical incision is located also affects how fast wounds heal. For example, mouth wounds typically heal faster than skin wounds due to the presence of saliva, which provides moisturization. Also, muscles and tendons tend to heal faster because they have ample blood flow.

Type of surgical wound closure

Some surgical wounds are closed with stitches, while others are left open to allow drainage of blood and fluids from the surgical site. Sometimes, the original wound that was closed in the operating room has to be reopened, partially or fully, due to an infected wound. These things can affect overall healing time.

Underlying health status

Your age, nutritional, and overall health status also affect wound healing. If you are in good general health before your surgery, your surgeon can give you a fairly good estimate of wound healing time, barring any complications. However, if you have underlying health conditions, it can delay the healing process.

Incisional care

How well you follow wound care instructions from your healthcare provider after surgery will affect the healing process. Keeping your wound clean and dry and changing the dressings as directed will promote faster tissue growth, wound healing and also prevent surgical site infections. In addition to postoperative surgical site care, you should also follow instructions about exercise and return to work which can slow down or speed up wound healing.

Slow healing wounds

People with diabetes, vascular disease, or those who receive radiation therapy at the surgical site may have poor healing or slow healing wounds. Smoking and heavy alcohol use can impair wound healing and lead to chronic wounds. Other risk factors for slow wound healing or chronic wounds include infections, burns, certain medications like steroids, and obesity. A chronic wound or slow-healing surgical incisions may require special wound care.

What are the stages of stitches healing or wound healing?

Here is a brief overview of the wound healing phases:

Stage 1: Hemostasis

Bleeding from a surgical wound occurs due to broken blood vessels. The first stage of wound healing is hemostasis or stopping the bleeding from the cut or wound. This phase of wound healing (to stop blood flowing) takes place in the operating room itself.

Stage 2: Clotting

In the second phase of wound healing, blood vessels become narrower to control blood loss. Blood clots consisting of platelets, collagen, and fibrin form within minutes at the wound site to close off the wound and form a scab. This is followed by new blood vessels bringing fresh blood to the wound containing oxygen, nutrients, growth factors, and white blood cells to prevent infection. As a result, there can be pain, swelling, and redness in the wound area for up to one week after surgery. It is a normal part of the body’s response to injury and does not necessarily indicate a wound infection.

Stage 3: Growth and Proliferation

Once bleeding has been stopped and the wound tissue is clean, the body starts repairing the surgical wound site by removing dead tissue and rebuilding healthy new tissue. This is called granulation tissue, and the body makes it to protect the wound and fill the wound with healthy new epithelial cells. It can result in the formation of a raised red scar due to deposits of elastic tissues called collagen and fibrin at the incision line. The scar gradually flattens and fades over time. This wound-healing phase lasts for 2-4 weeks after surgery.

Stage 4: Maturation

The last phase of wound healing is called the maturation or remodeling phase during which the body strengthens the area. This phase can last anywhere from 3 weeks to 2 years. The wound may look pink, puckered, or stretched during this time, even though it has been repaired. There can be continuing itchiness or tightness in the areas where the scars form.

How to care for surgical stitches?

Most wounds heal without complications if you follow your surgeon’s instructions on wound care and surgical stitches care. Your surgeon will also tell you how to manage pain with pain medicine. The most important things are to:

Keep your incisions clean and dry.
Protect your stitches by avoiding scratching the incision, swimming, heavy lifting, and contact sports until your surgeon says it is okay.
Watch out for signs of infected wounds such as increased inflammation, pain, warmth, redness, swelling, oozing pus, a wound that smells bad, fever, or swollen glands.
Keep your appointment for stitches removal in 3-14 days as advised by your surgeon (some stitches dissolve on their own and do not need to be removed).
Eat well and get plenty of rest.

Remember that your surgical incisions go much deeper than a cut in the skin. They may appear healed on the surface but can take several weeks to months to fully strengthen. That’s why it’s important to follow all wound care instructions from your surgeon and doctor, even if your stitches appear healed and you have new skin on the wound.

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