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Are Silk Stitches Dissolvable?

Silk stitches are widely considered to be non-dissolvable sutures but research has actually proven that to be false. Nonetheless, due to the practicality of the dissolvability of this natural material, it's still commonly regarded as non-absorbable.


black silk stitches over extraction socket
black silk stitches over extraction socket

Sounds a little mind boggling at first but we'll make it crystal clear for you.


Table of contents:


Are silk sutures absorbable?

Research has shown that silk stitches are dissolvable but the caveat is that they take a very long time to be absorbed by the body. We'll provide two studies as reference.


According to the first study, silk sutures can become partially absorbed by proteolysis and eventually become completely undetectable within 2 years.

  • Main disadvantage to using silk is that it can trigger acute inflammatory reactions.

  • Despite eventual absorption, removal in a timely manner is recommended to minimize the inflammatory response.


According to a 2012 study, silk sutures will undergo phagocytosis and enzymatic degradation, thus completely disappearing after 2 years.

  • Surgical silk is made from domesticated silkworm thread and is dyed black.

  • Since it is derived from an organic material (it is all natural), it elicits an inflammatory response from the body.

  • It is often used by dentists in the mouth since the threads feel very soft.


Conclusion: Stitches made of silk are absorbable albeit at a much slower rate than other dissolvable sutures. They will dissolve in the same manner as absorbable natural sutures which are different from the synthetic ones. They break down the same way because it is made of a natural material and not synthetically.


 

Dissolvability per manufacturer

Despite scientific studies proving that sutures made of silk can dissolve, manufacturers still label all of them as non-absorbable. They typically come in a black color and are of the braided variety.


silk stitches

Below is an image taken from the Ethicon website which labels their silk stitches as "non-absorbable" and with no absorption time listed.


Ethicon silk sutures - non-absorbable with no absorption rate listed

We presume that they labeled it this way while knowing its dissolvability because they want clinicians to remove silk stitches in lieu of letting it absorb. The most likely reason is because the cons outweigh the benefits if left to dissolve on its own over such a long period of time.


 

What common sense says

You may be surprised but sutures made of silk are actually the same type of silk that you find in clothing. They all come from the threads of silkworms. The only difference is that this medical product comes sterilized so it can be used in wounds.


silk scarfs
Credit: GoodSoftGoods

From your own personal experience as well as ours, we all know that these silk items will NOT dissolve while you're wearing them. Have you ever had a silk item get absorbed while you're wearing them? Probably not.


Therefore, common sense dictates that silk items do not dissolve on their own. That is contrary to what research studies have said. Perhaps the reason may be that our body does not excrete enzymes on the surface of our skin to absorb these items of clothing!


 

Do silk sutures need to be removed?

Removal of silk stitches is not necessary since they do dissolve but removing them can provide multiple benefits. In fact, the pros of having them removed outweigh the cons from letting them self-dissolve.


Pros to removing them:

  • Minimize inflammation

  • Can be removed in shorter time

  • Decreased risk of infection and rejection


Cons to letting them dissolve:

  • Chronic inflammation

  • Takes close to 2 years to dissolve

  • Risk of suture rejection and infection


A point we wish to emphasize is that sometimes the sutures can get infected or rejected by the body, which are complications.

  • Infection. These threads are a foreign body and are recognized as so by your immune system. That is why it elicits an inflammatory response. Yes, it can get infected if you don't keep the surgical site clean and develop into an abscess.

  • Rejection. Sometimes your body can reject sutures by trying to push them out of your body. This condition is called a spitting suture and it can also result in an infection.


In summary, you can minimize the chances of these two surgical complications with suture removal. Don't be afraid of the appointment because it should be quick and painless!


The Verdict

Silk sutures are technically dissolvable but manufacturers label them as non-absorbable due to their slow dissolution time. There is no benefit to leaving them in the body because it can take up to 2 years for them to get absorbed by the body.


In order to encourage removal of this surgical product in a timely manner, they are classified as "non-dissolvable". However, since you've read through all of our research, you now know that that statement is a white lie. Nonetheless, our dentists in Long Island City recommend having them removed.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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