Suture Reaction

  • Suture granuloma
    • Presents 1–3 months after surgery as an erythematous papule or sterile pustule along epidermal suture lines; ↑ risk of granuloma formation with larger caliber suture (more reactivity), braided sutures (vs. monofilament), and/or placement of too many knots
    • May resolve spontaneously; may treat with IL kenalog or lancing papule with subsequent suture removal
  • Suture spitting
    • Results from subcutaneous sutures being too high in the dermis, can occur from several weeks to several months after surgery
  • Suture track marks
    • Sutures too tight or left in place too long; puncture scars on either side of wound connected by linear suture lines give “railroad track” appearance