When should sutures (stitches) on the top of the head be removed in an otherwise healthy adult or child with no significant medical history?

Suture Removal Timing for Scalp Wounds

Sutures on the top of the head (scalp) should be removed at 7-10 days after placement. 1

Standard Timing for Scalp Sutures

• The scalp requires 7-10 days of suture retention before removal, which is longer than facial sutures (3-5 days) but shorter than extremities (10-14 days). 1, 2

• Non-absorbable sutures are typically removed 7-9 days after surgery in most clinical scenarios, and this applies to scalp wounds. 1

• Research comparing staples versus sutures for scalp wounds showed successful removal at 5 days in both groups, though 7-10 days remains the standard recommendation for optimal healing. 3

Why This Timing Matters

• Removing sutures too early (before 7 days) risks wound dehiscence (the wound splitting open), widened scars, and increased complications in areas of tension or movement. 1

• Leaving sutures in too long (beyond 10 days) increases infection risk, causes permanent suture marks, triggers tissue reaction, and allows new skin growth to cover the sutures making removal more difficult. 1, 4

• The scalp has excellent blood supply which promotes healing, but the area experiences tension from movement and hair-bearing skin requires adequate time for proper wound closure. 2

Pre-Removal Assessment

Before removing scalp sutures at the 7-10 day mark, check for:

• Signs of adequate wound healing - edges should be well-approximated without gaps. 4
• Absence of infection - no redness, warmth, purulent drainage, or excessive tenderness. 4
• No signs of dehiscence - the wound should not show any separation or gaping. 4

Special Considerations

• Patient factors such as age and comorbidities (diabetes, immunosuppression, poor nutrition) may warrant extending suture retention slightly beyond 10 days if healing appears delayed. 1

• If absorbable subcuticular sutures were used instead of non-absorbable sutures, removal is not necessary as they dissolve on their own. 5

• Staples are an alternative to sutures for scalp wounds and are removed at the same 7-10 day timeframe; they cause less pain during placement and removal. 3

Post-Removal Care

• Keep the area clean and dry after suture removal. 1

• Consider applying steri-strips for additional support, especially if any tension remains across the wound or in areas of high movement. 1, 2

• Monitor for wound separation in the first 24-48 hours after removal. 2