Sutures, Stitches, and Staples

Sutures, stitches and staples are used for the same purpose - to close wounds or surgical incisions - but they are not the same. For sutures, doctors use a thread or strand of material to perform wound closure. The term "stitches" refers to the surgical procedure or process of closing a wound with sutures. Staples are another material that doctors sometimes use to make sutures or stitches.


Sutures can be either absorbable or nonabsorbable. Absorbable sutures are intended to be broken down by the body over time and eventually dissolve completely. Some materials used to make absorbable sutures are derived from animal products that have been specially processed. Other absorbable sutures are made from synthetic polymer materials such as polylactic acid (Vicryl), polyglycolic acid (Dexon), polyglyconate (Maxon) and polydioxanone (PDS).

Permanent, nonabsorbable sutures are sometimes preferred because they are resistant to body chemicals that might otherwise dissolve them too early in the healing process. Non-absorbable sutures are useful for maintaining long-term tissue wound closure (apposition) and healing. Non-absorbable sutures can be made from nylon, polypropylene (prolene), or silk.

Stitches can be divided into the following sub-types:

  • Continuous stitch: This is quick to perform using the same suture line without cutting, which helps distribute the tension along the length of the stitched wound.
  • Simple interrupted stitching: The same suture line can be used more than once to make separate stitches that allow for more precise closure of the tissue, especially that of skin and fascia.
  • Mattress stitches: These can be placed either vertically or horizontally. Mattress stitches go deeper into the skin layers and allow for excellent closure of incision edges while minimizing tension.
  • Sub-cuticular stitch: Using an absorbable suture, the stitch is made at the dermal-epidermal junction to allow for better closure so that postoperative suture removal is unnecessary. This stitch is a convenient technique to close skin incisions.

Staple types are classified according to their material or shape. Medical staples are most commonly made from titanium or stainless steel. However they can also be made from other materials like iron, chromium, nickel or plastic. Medical staples may be straight, curved or circular.


Absorbable sutures:

  • Gut sutures: Used to close tissue that requires minimal support and heals rapidly, such as that of the oral cavity mucosal layer, or procedures of superficial blood vessels
  • Vicryl sutures: Best for the lower layers of skin, and approximating muscle or fatty tissue
  • Maxon and monocryl sutures: Used for sub-cuticular stitches and soft tissue approximation
  • PDS: Used for stitches of muscle and fascia tissue

Non-absorbable sutures:

  • Prolene sutures: Used in tissue of fascia, muscle or blood vessels
  • Nylon sutures: Used for closure of skin, surgical incisions or drainage tubes
  • Silk sutures: Typically used to tie off blood vessels or bowel segments

Staples are usually used as an alternative to suturing to close skin incisions, in areas that are hard to stitch, or during procedures that must be performed in a short time. Circular staples are used to make end-to-end surgical closures or connections, as in a bowel resection to help reattach the separated bowel parts.

Advantages of Each

Stitching with sutures or staples are cosmetically equivalent, and the choice of material and technique used depends on the physician who performs the procedure. Generally, staples tend to allow for rapid skin closure with minimal wound inflammation, and are easier to remove than stitches. Medical staples are removed with a staple remover tool, while stitches are removed by cutting the suture next to the knot, then pulling the knot out gently until the suture is completely removed. Typically, using staples to close skin incisions work best with two health care professionals, where one aligns the skin edges with a forceps while the other makes the staples. Stitches can usually be done by one health care professional.


Regardless of the closure technique being used, the following precautions must be considered to avoid wound breakdown, and to achieve a well-healed incision with minimal scarring:

  • Ensure skin incision is located along the intrinsic tension lines for minimal scarring
  • Maintain good blood supply to the wound
  • Avoid over-tightening the stitches to reduce the tension and prevent any wound breakdown or unwanted scars
  • Eversion (alignment) of skin edges for best healing with minimal scarring
  • Usage of Steri-Strips, Band-Aids, and skin adhesive materials to strengthen incision during and after suture removal


As soon as the wound has healed enough to withstand the expected stress or pressure on that area, the stitches or staples should be removed. If stitches are left in place beyond that period, they will most likely leave an unwanted scar.  Approximate guidelines are as follows:

  • Facial stitches typically remain in place for three to five days
  • Extremities stitches are typically left in place for about ten days
  • Joint stitches are left in place for ten to fourteen days
  • Back stitches should remain in place for fourteen days
  • Abdominal stitches should usually be left in place for seven days

Related Articles

Skin Substitutes

Skin substitutes as a form of wound closure have been found useful since the earliest centuries of medical science. Skin is made up of epidermis (uppe...

Biatain Foam

Biatain foam was introduced as early as the 1970s. Biatain foam is a soft, pliable dressing which is comprised of an outer layer that helps guard agai...

Biologic Debridement

Biologic debridement is the use of living organisms to remove necrotic or dead tissue from a wound. The most commonly used biologic debridement method...

Topical Wound Treatments

When it comes to wound care, the challenge is to strike a balance between keeping the wound clean and moist, while at the same time fighting off the b...

Advanced Dressings

Biatain Foam Biatain foam is a soft, pliable dressing which is comprised of an outer layer that helps guard against bacteria and infection, and an in...

Growth Factor Therapy

Growth factor therapy is the use of growth factors to promote wound healing. Growth factors are substances secreted by the body whose function is to s...

Vacuum-Assisted Closure

Vacuum-assisted closure (VAC) is a sophisticated development of a standard surgical procedure—the use of vacuum-assisted drainage to remove bloo...

Nutritional Support for Wound Healing

Nutritional support for wound healing can greatly affect the three stages of the process: the inflammatory, proliferative, and remodeling phases. Poor...


Electromyography (EMG) is a diagnostic test that measures the health and function of the muscles and the nerves which controls these muscles.  H...

Nerve Studies

Nerve studies are also known as nerve conduction studies. These studies measure how well nerves send signals through the body. Uses This procedure i...

Compression Stockings

Compression stockings or socks are special stockings used for the treatment of venous diseases such as varicose veins. These stockings can exert press...

Vascular Studies

Vascular studies measure and assess the amount of circulation within the blood vessels. Uses This noninvasive procedure is used as a tool in the tre...

Total Contact Casting

Total contact casting is a method used to treat diabetic foot ulcers by fitting a non-removable cast around the affected leg. The whole cast is in con...

Hyperbaric Oxygen Treatment

Hyperbaric oxygen treatment, or hyperbaric oxygen therapy (HBOT), involves breathing 100 percent oxygen at increased atmospheric pressures to increase...

Low Level Laser Therapy

Low level laser therapy (LLLT) is a medical procedure used to treat pain and speed up wound healing. This treatment uses low-level lasers to alte...

Ultraviolet Light Therapy

Ultraviolet (UV) light therapy has been used for centuries to help in the treatment of many skin conditions, disorders and diseases. While exposure to...

At Home Wound Treatment

Applying first aid as initial medical care to a wound or an injury temporarily until a professional medical care is available can, in many cases, be l...

Ultrasound Therapy

Ultrasound therapy uses high-frequency sound waves far beyond those that are distinguishable to human hearing. These high-frequency sound waves can be...

Negative Pressure Wound Therapy

Negative pressure wound therapy is a medical procedure in which a vacuum dressing is used to enhance and promote wound healing in acute, chronic and b...

Wound Closure

Whether they are caused by surgery or injury, wounds generally must be closed for proper healing. Wound closure is typically done with sutures (stitch...

Nerve Conduction Study (NCS)

A nerve conduction study (NCS) is used to determine electrical conduction within motor and sensory nerves, essentially determining the functionality o...

Sharp Debridement

Sharp debridement is a surgical procedure that uses scissors, scalpels and other sharp instruments to cut away or remove infected tissue. It improves ...


Topical Antibiotics Antibiotics are often prescribed to treat an infection topically. This means that you will apply antibiotic creams, ointments or ...
Find a Doctor
List Your Facility
Be found by clients looking for your exact skills. Learn more.