Dissolvable stitches can change into an off-white color when they dissolve because they're originally undyed and colorless. Dissolvable stitches are colored because they were dyed to be a certain color but this color can shed during dissolution.
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Dissolution causes color change
When stitches dissolve, the outer layer which contains the colored dye is the first layer to break down. You may notice it change to an off-white color, which is what the sutures look like beneath the outer dyed layer.
The visual change won't happen immediately because enough dissolution has to have occurred for it to be visible. Each type of resorbable suture will also dissolve at different rates so when you see them change can be different.
In summary, they change colors because the body absorbs the outer dyed layer of the stitches which ultimately reveals the undyed inner layer. This process is especially noticeable for dissolving stitches in the mouth.
Stitches in the mouth
Dissolvable sutures changing colors is even more pronounced if you get them in the mouth such as after an extraction. The most common situation for most people to get them would be for wisdom teeth stitches.
There is a good chance you may get them put in the tooth socket after the wisdom teeth removal. The self-dissolving stitches can change colors at an even quicker pace while in the mouth than in other parts of the body.
The presence of oral enzymes and plaque can make them change colors or at least look more off-white.
Enzymes in mouth. The rate of color changing may happen faster for mouth stitches because enzymes help to break them down faster.
Plaque and biofilm. The sutures can also appear to be a different color if you don't keep them clean. They could potentially get covered in plaque and biofilm which gives it a white color as well.
Sutures are originally undyed
After the outer layer of stitches dissolve, the undyed inner layer will reveal itself. That is the entire reason for the purported color change.
In case you don't believe us, we will prove to you that stitches are originally undyed, meaning that they come white or non-colored.
Vicryl is a commonly used resorbable suture which has a very distinctive violet color that can be identified over a mile away. However, you should know that while most medical offices will stock the violet dyed one, you can purchase the UNDYED version. As you can see in the image above, the undyed vicryl suture is a white color.
Dissolvable stitches will come in different colors depending on the type of material that they are made of. However, you are able to get all of them non-colored or undyed.
For further evidence, look no further than any medical or dental supply company that sells sutures. The option is there to purchase undyed versions of any type of stitch that you can possible think of.
The image above shows one of the dental supply companies which our office uses and their selection of colored stitches.
On a personal note, we've never purchased any of the undyed varieties. We only use the dyed ones that come in various colors. They're just easier to identify visually when they're colored.
Why are stitches colored?
Stitches come in various colors for ease of identification and also for color contrasting. That includes the non-dissolvable stitches as well.
Your doctor can usually tell pretty quickly if your stitches are dissolvable or not with a quick glance. This lets them know if you need to have them removed or if they can simply let them fall out on their own.
It also decreases confusion and complications by having distinct colors. Imagine if you were the doctor and you need a particular suture but your assistant hands you one but it's a different color. You'll know right away that, that one is the wrong one or rather not what you asked for!
If all of them were made in the same color then there'd be no way for you to tell what it is without looking at the label. Their distinctive colors make them readily identifiable.
Unbeknownst to most, having them come in different colors will provide color contrast. That helps your doctor visualize it better but is even more important for the non-resorbable sutures.
Typically for facial lacerations, the outer layer is stitched together with one that does not dissolve. As you can imagine, if you get a cut near your hairline and you have black hair, a silk suture which is black in color may make it incredibly hard to see. It will blend in well but when it comes time to remove it, your doctor is going to have a hell of a time.
On the contrary, for the same situation if you use stitches that are a different color from the hair, you'd be able to see where the sutures are immediately. This makes it much easier for your doctor to remove them when it comes time for them to get taken out.
The blue suture above is made of polypropylene, which is synthetic and non-resborable. It's actually Dr Chen's favorite extraoral one to use for facial lacerations. It looks pretty and stands out so you can't miss it during the suture removal follow up appointment.
Stitches can change colors as they dissolve because they're dyed to be the color that they are but once the dyed latey dissolves, it'll reveal the undyed inner layer. Thus, there's a chance you may see it change to an off-white color if you give it enough time.
This article is brought to you by our dentists in Long Island City.