How long should non‑absorbable sutures remain in on the face for uncomplicated lacerations, and does the timing differ for children, deep or tension‑bearing wounds, or patients with impaired healing (e.g., diabetes, infection)?

Facial Suture Removal Timing

Non-absorbable sutures on the face should be removed at 3-5 days to optimize cosmetic outcomes and minimize scarring, with this shorter timeframe justified by the face's excellent vascular supply and lower infection risk. 1, 2

Standard Timing for Facial Sutures

• Remove facial sutures at 3-5 days for uncomplicated lacerations in adults 1
• The face tolerates earlier removal than other body locations due to rich blood supply and rapid healing 2
• This contrasts sharply with hand sutures (10-14 days) and other high-tension areas 1

Why Earlier Removal on the Face?

• Excellent vascular supply reduces infection risk and accelerates healing, allowing safe early removal 2
• Earlier removal (within 5 days) prevents suture track marks and minimizes visible scarring 1, 3
• Delayed removal beyond 5-7 days increases risk of permanent suture marks, tissue reaction, and epithelialization over sutures 1

Special Populations and Modifications

Children

• Consider removal at the earlier end of the 3-5 day window (day 3-4) as pediatric facial skin heals rapidly 4
• Children may benefit from absorbable sutures to avoid the trauma of removal 5

Deep or Tension-Bearing Wounds

• Use deep absorbable sutures (4-0 poliglecaprone or polyglyconate) to bear tension, allowing surface sutures to be removed early 6, 5
• Deep sutures should carry the mechanical load, not superficial skin sutures 4, 6
• Surface sutures serve primarily for fine edge approximation, not tension management 7

Impaired Healing (Diabetes, Infection Risk)

• Still remove at 5 days maximum but provide additional support with steri-strips after removal 1, 2
• If active infection is present, sutures may need earlier removal (day 2-3) to allow drainage 2
• Consider absorbable subcuticular sutures from the outset in high-risk patients to avoid removal timing concerns 5

Post-Removal Support

• Apply steri-strips immediately after suture removal to provide continued wound support for 7-10 additional days 1, 2
• Keep the area clean and dry for 48 hours post-removal 6
• Avoid excessive facial movement or tension on the wound during the first week after removal 6

Critical Pitfalls to Avoid

• Never leave facial sutures beyond 7 days unless absolutely necessary—this dramatically increases scarring and suture track marks 1, 3
• Do not rely on surface sutures to hold tension; this leads to wound spreading and requires longer suture retention 7, 8
• Avoid removing sutures if signs of dehiscence are present (wound edges separating, inadequate healing)—consider leaving 2-3 additional days with close monitoring 3
• Do not remove all sutures at once in high-tension areas; consider removing every other suture first, then the remainder 1-2 days later 3

Alternative: Absorbable Sutures

• Consider using rapidly-absorbing sutures (5-0 polyglactin 910 Rapide) for facial wounds to eliminate removal entirely 5
• Studies show no difference in cosmetic outcomes between absorbable and non-absorbable sutures on the face at 6 months 5
• This approach saves time, reduces patient anxiety, and eliminates the risk of delayed removal 5