When should nasal stitches be removed?

Timing of Nasal Stitch Removal After Surgery

Nasal stitches should be removed 5-7 days after surgery to minimize complications while ensuring proper wound healing. 1, 2

Optimal Timing for Different Types of Nasal Procedures

Septoplasty and Rhinoplasty

• Intranasal splints and associated sutures are typically removed 5-7 days after surgery, though some studies show that removal as early as 3 days may be acceptable 1, 2
• External nasal splints secured with transnasal sutures should be removed at the first postoperative follow-up, typically 10-14 days after surgery 3

Nasal Packing Considerations

• If non-resorbable nasal packing is used, it should be removed within the timeframe recommended by the clinician to prevent complications 4
• Leaving non-resorbable packing beyond the recommended time can increase risk of infection, pressure necrosis, and other complications 4

Factors Affecting Removal Timing

Wound Healing Considerations

• Primary wound healing typically requires 5-7 days for initial strength development 1
• Earlier removal (24 hours) may be considered in select cases where minimal support is needed, but this should be evaluated on a case-by-case basis 5

Complication Prevention

• Longer retention of nasal splints (beyond 7 days) increases risk of mucosal crusting without providing additional benefits for healing 2
• Removal between 3-7 days shows no significant difference in rates of synechia, perforation, or hemorrhage 1, 2

Postoperative Care Instructions

After Stitch/Splint Removal

• Patients should keep the nose humid with saline spray and moisturizing agents to prevent dry crusts and facilitate healing 4
• Small amounts of bleeding may initially occur from raw surfaces inside the nose after removal 4

Activity Restrictions

• Patients should avoid:
  • Blowing their nose for at least 1 week after surgery 4
  • Flying, diving, forceful sneezing, or playing wind instruments for at least 6 weeks 4
  • Straining, lifting over 10 pounds, and bending over until cleared by the surgeon 4

Warning Signs Requiring Medical Attention

• Return of significant bleeding from nose or mouth 4
• Fever over 101°F 4
• Increasing pain or facial swelling 4
• Vision changes or difficulty breathing 4

Conclusion on Timing

The evidence suggests that while there is some flexibility in timing, the 5-7 day window represents the optimal balance between ensuring adequate wound healing and minimizing patient discomfort and complications. Earlier removal (3 days) may be appropriate in select cases, while external splints typically require longer retention (10-14 days).