Should the primary care provider remove facial sutures placed by the trauma team that have been in place for two weeks, with follow‑up scheduled next week?

Primary Care Should Remove These Facial Sutures Immediately

Facial sutures that have been in place for 2 weeks are significantly overdue for removal and should be taken out by primary care at the earliest opportunity—waiting another week for trauma follow-up will cause unnecessary complications including permanent suture marks, increased infection risk, and worse cosmetic outcomes. 1

Critical Timing Issue

The face requires the earliest suture removal of any body location at 3-5 days due to excellent blood supply that accelerates healing and the critical importance of minimizing visible scarring. 1 At 14 days (2 weeks), these sutures are already 9-11 days overdue for removal. 1

Consequences of Current Delay

• Delayed removal beyond 5 days on the face increases risk of:
  • Permanent suture marks (track marks) 1
  • Tissue reaction and inflammation 1
  • Increased infection risk 1, 2
  • New skin growth covering the sutures (epithelialization) 2, 3
  • Worse cosmetic outcomes in this highly visible area 1

Immediate Action Required

Primary care should remove these sutures at the current visit without waiting for trauma follow-up. The standard 3-5 day window has long passed, and each additional day increases complication risk. 1

Pre-Removal Assessment

Before removing the sutures, check the wound for: 1, 3

• Adequate healing (wound edges well-approximated)
• Signs of infection (erythema, purulent drainage, warmth)
• Any dehiscence or separation
• Patient comorbidities that might impair healing (diabetes, smoking, immunosuppression) 1

At 14 days post-placement, facial wounds should be well-healed given the face's excellent vascular supply. 1

Post-Removal Care

After removing the sutures: 1

• Keep the area clean and dry 1
• Apply steri-strips for additional support if any tension remains across the wound 1
• Monitor for wound separation in the first 24-48 hours post-removal 1
• Advise the patient to contact you if any separation, redness, or drainage develops 1

Common Pitfall to Avoid

The most critical error is leaving facial sutures in place beyond 5 days, which significantly increases scarring risk in this cosmetically sensitive area. 1 Deferring to the trauma team's scheduled follow-up when sutures are already 9-11 days overdue compounds this error and prioritizes administrative convenience over patient outcomes.

Communication with Trauma Team

Document the suture removal and notify the trauma team that you removed the sutures due to the significant delay beyond recommended timing. They can still evaluate wound healing at their scheduled follow-up visit. 1