Suture Care After Orthopedic Surgery

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Should You Keep Sutures Covered?

Most sutures or stitches will be removed in your surgeon’s office at a post-op visit. However, with the use of early motion protocols, your Occupational Therapist or Physical Therapist may be instructed to remove your sutures (or a portion of them) in therapy.. There are several “styles” of sutures and each one has a special removal technique and requires specialized scissors and pick-ups. All equipment is sterilized.

How Do You Take Care of Stitches After Surgery? Can I Shower with Stitches?

Keep your sutures clean and dry. That means: no showering directly on sutures, no immersing into a bathtub, no swimming, and no sweating while you have sutures in. Why? Because a suture is a pathway to infection. 

• No showering: water gliding on your skin can pick up bacteria, virus, and fungus which would then glide right into your suture line. 

• No bathtub: water could make bacteria, virus or fungus from elsewhere on your body float off and into your suture line. 

• No swimming: soaking in water weakens the healing wound bed and can macerate your suture line; ocean water and lake/river/pond water carry marine bacteria that are toxic and difficult to diagnose (therefore making infection more challenging to treat) 

• No sweating: a little bit of bacteria could be in that sweat and drip into your suture line. If you had arthroscopic surgery, this then could travel deep into your joint.  

• Sponge baths or bathing everywhere but your surgery site is the best way to keep clean and smelling nice.  

Ankle sutures

Special Considerations 

Arthroscopic portal site sutures: Most of the time, your big bulky post-operative dressing may be removed by your therapist at your first therapy visit or Initial Evaluation. Your therapist may then apply simple band-aids over your portal sites sutures and other suture incision lines. The purpose of these band-aids is to occlude the area from dirt, sweat and bacteria; but also, to keep the suture ends from getting caught in the fibers of your clothing. Rest assured that at JOI Rehab, if the therapist removes a bulky post-operative dressing that he or she has been trained to do so and is in communication with your surgeon.  

• Staples: medical surgical staples have a special remover device and should never be “pulled” out 
• Steri-strips: (commonly known as butterfly stitches) are applied after sutures or staples are removed. These will “wear off” in about a week. These provide graded support to incision line edges and help in healing. 

After sutures are removed, give your incision line about two days before returning to bathtub, pool, or beach. Those suture holes need to close up! 

Clinical Challenges Regarding Suture Lines

Sometimes an incision line can open up. For example you might “pop a stitch” or have another medical issue that makes you a slow healer and now have an open area, that is considered a wound. 

Wounds need special care in specialized clinics and at your home. They must be kept clean and dry. You may have to purchase specialized wound dressings such as non-adherent layer or mesh. This is so that the gauze will not stick to your bleeding wound and potentially rip off new tissue when you remove bandages. Square folding’s of gauze called 4x4s and 2x2s are often applied after the non-adherent layer to catch any bleeding or liquid that your wound exudes. Gauze rolls or clinging gauze is used to wrap an appendage over the 4x4s or 2x2s and keep all the dressings in place. 

Taping and Whirlpool Treatment

Often paper tape or other tape is applied longitudinally along your arm or leg to keep the bandages from migrating off your arm or leg. Some of your surgeons may prescribe a whirlpool treatment for your wound or refer you to a wound care center where specialized oxygen and air pressure levels promote tissue healing.

By: Julia Guthart, OTR/L CHT

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