Day 10 Post OP - Stitches or Staples?

I was never told what they had put my wound back together with after my op. I have read and seen pictures on here of both. I have stitches in wounds before and always had the itching/tugging feeling a few days before they are due to come out and I am  getting that now. I go back on Monday for my first post op consultation and I guess I find out then.

One thing I have not read about though is dissolving stitches being used in the main wound, I know they use them on the internal stitching but have not read anywhere if they are use on the external. Has anyone had this?


21 Responses to “Day 10 Post OP - Stitches or Staples?”

  1. Daz,

    All my stitches were dissolving, apart from one internal stitch which refused to dissolve, at one stage they thought I would have to have the wound opened up, but my physio suggested leaving it a few more weeks, which we did and one day I realised I no longer had the stabbing and stinging pain and swelling, so we presumed it had ginally gone.

    I did a brief synopsis for you of my injury timescale not sure whether you got it or not.

    Having a day off work today to do some much needed decorating which I started way back in March and haven’t been able to finnish. It has been driving me mad looking at a half done room so although I know I will be exhausted at the end of the day I will have achieved one of my goals.


  2. dazf: My first surgery, I had dissolvable stiches on the outside and (unkown to me) NON-DISSOLVABLE stitches put in my Achilles. My second surgery, 2 years later, I had dissolvable ones put on the inside and non-dissolvable ones put on the outside. One of the things my second surgeon had to do was take the old stitches out of my Achilles. He said my body was rejecting the material (ethabon?) they were made out of and told me that if I ever needed stitches again to not let anybody use that material. I was upset that the first surgeon had used non-dissolvable stitches inside my Achilles anyways but I was told that some doctors use them if they are worried about the repair holding and they are not confident in performing any kind of a graft. If I were you, I would specifically ask what was used inside your Achilles. It could affect you later. Oh the things you learn with this injury.

  3. Question about Smish’s comment:
    I had dissolving stitches on the external wound with my first surgery…my body didn’t like them and I had two further surgeries for wound complications. The wound is finally closing now at about 12 weeks with the use of regular stitches in the external wound that needed to be removed after three weeks.
    My understanding was that all stitching of the actual AT was done with a permanent kevlar-type material.
    My question is what other type of surgical repair is made to the AT? A graft using another tendon? My father is a retired orthopedic surgeon, and he seemed pleased with the procedures used to repair my AT.

  4. hilary13: I am not sure if you are asking about the type of sutures used or grafts. There are two types of grafts(that I know about). One is using a tendon that runs through your big toe. If a lot of that tendon is needed, there will be a separate incision on the side of your foot. If just a little of that tendon is needed the surgeon can actually take it through your Achilles incision. The other type of graft can be done with something called a graft jacket. My understanding is that it is either from a cadaver or a pig (I think but not sure). After your Achilles is sewn together the doctor sews this “jacket” around your tendon to give you more of a tendon. I am not a doctor. This is just information I think I understood from talking with many doctors about my situation. Your dad would probably know a lot more except that I heard the graft jacket technique is fairly new. What I was saying in my post was that I had different kind of sutures in the two surgeries I have had. My doctor led me to believe that the non-dissolvable stitches are not the best choice for going inside the Achilles. Either way, it was a bad choice for me. I had NO wound problems with either of my surgeries. In fact, both times the doctors and nurses were amazed. My last surgery was 10 weeks ago and about 1/2 of my 8 inches of scars are already faded and look about 5 years old.

  5. Thanks, Smish.

    Your post made me curious, so I did more googling, and found some references to the procedures you are talking about, but nothing that specific. Thanks for the details.

    I had a moment of panic wondering if something different could/should have been done, but really don’t want to go there! I have a medical condition that makes some grafts difficult (I self-donated my own patellar tendon for an ACL repair a couple of years ago rather than risk using a cadaver donation) so while the big toe tendon might have been a possibility, I think my surgeon did what he thought was best. He’s been in there three times now, so I think if he wanted to do something differently he had the chance!

    I am glad to hear about these new procedures, however, as I think we are all our own best advocates for better health care in general.

    So, did you have the second surgery because you re-ruptured, or because the original internal stitches were causing problems for you down the road? Sorry if you have already explained that elsewhere on this site. And what kind of repair did you have the second time? Did you have only a graft? Was it applied with dissolving stitches? Did the repair require stitches of any kind? Just curious as I have a bump where I imagine the stitches in my AT are under the skin, and it is a little weird. I hope it won’t feel like this forever. And I do have a problem with the way I visualize the repair and how strong it is…I get a bit queasy when I think about stressing that stitched area, and a possible re-rupture at that site.

    Too much thinking I know, but hard not to.

  6. hilary13: My complete rupture and first surgery was July 2006. I have had tendonosis/tendonitis for about 12 years. The surgery went relatively well with a few issues (long story but I will try to figure out how to shorten it). Because of continued problems, I ended up with a foot and ankle orthopedist/specialist this Spring. New MRI and tests showed multiple new tears in my Achilles. It turned out that I needed to have my Achilles lengthened (not enough dorsi-flexion) and debrided (sp?) I also had to have my heel bone shaved down and bursitis removed. While the doctor was in there, that is when he saw the old sutures and saw the inflamed/infection around them. He said most people can have permanent sutures. My body just didn’t like them. While I was waiting for my surgery date, I did a partial re-rupture. I have to have my other Achilles lengthened as soon as I can take another Achilles surgery. My doctor said the, tendonitis then rupture, cycle would probably continue unless I had my Achilles lengthened. I use to walk and run on the outside of my feet and toes. It just finally caught up with me in my 30’s. My right leg got lengthened first because it was in the most trouble. My left leg is hurting pretty bad too. I have not yet ruptured my left foot. Sorry for the long explanation. When do you start PT? I bet your PT will be able to help you with your scar.

  7. hilary13: I forgot to mention; I was told that I would probably get the tendon graft going in to surgery but to my sheer delight, the doctor decided it was not needed yet. I hope to never have to. I think the lengthening procedure is going to prevent it.


  8. Good post,This was exactly what I needed to read today! I am sure this has relevance to many of us out there.

  9. Whats up ! Love your blog.

  10. Really this is a latest news for me. Today, you have been taught me a different news for me. Good work. Thanks for sharing…

  11. Two years ago I fully ruptured my Achilles tendon. Within 3 days I had surgery to repair and was put in a cast for 8 weeks post-surgery (my leg was in an immobile, hard cast).

    After removal of the cast, several of internal stitches that were meant to dissolve, had not, and were visibly poking through my skin. After a few weeks, one of them was naturally discharged and a small, blue, knotted stitch “popped out.” (It literally came out of my skin and I was holding the small stitch in my hand)

    One of the stitches was never discharged. It caused discomfort for several more weeks, but I presume that it eventually “dissolved” as it was designed to do.

    However, at the site of that stitch, I now have a skin to tendon adhesion. It is sometimes painful and causes my skin to “pucker up” during plantar flexion of the calf muscle system.

    I went through post-operative physical therapy, which included techniques to break up adhesions. These included Graston technique, massage, ASTYM, Active Release therapy, and self massage (in addition to general strengthening and flexibility exercises).

    The skin to tendon adhesion causes some pain and discomfort and also restricts my range of motion and flexibility. I believe that it is also inhibiting a full recovery of muscle strength in the calf.

    My question: What options do I have to break up skin to tendon adhesion in my Achilles? Any non-traditional, unorthodox techniques that have worked for anybody? I would try anything at this point to get back to 100%.

  12. hi all,great reading here.2 half yrs ago i ruptured my tendons but was missed diagnosed for 4 months as pulled muscle.had op in June 3 cm of a gap so when tendons freed up was left with 2 cm gap so plantaris was used.was left in cast for 10 weeks.was seating down one day when i notice yellow puss coming from cut.went back to surgeon who Treated the infection on 25 Oct was brought back into surgery and it was cleaned up and a stitch removed.he said there was partial healing.2 yrs of me complaing i was sent to orthotics clinic where he said my leg muscle was 5cm smaller,he made a brace to help me walk and finally i was referred to another surgeon who now tells me i am lookin at another op .my foot is clawing and arch is high.has anyone else this problem Ty

  13. I had Achilles surgery 4 months ago. Over the last 6 weeks I have had extreme pain in my heel area. I had an MRI and it shows that the sutures did not dissolve and my body is rejecting them. By that I mean they have been en-cased by a sack to wall them off from the rest of my body. I have 5 marble size sacks, cells, bubbles, along the my heel bone. Ouch they hurt and I am scheduled to have them surgically removed; has this ever happened to anybody ?

  14. Sorry to hear that! I haven’t but if you go to the homepage of the site in the upper right corner there’s a search function try typing in

    sutures rejected

    there seems to be some info there. Hopefully someone with experience will chime in.

  15. Not sure if it has been the exact same issue, but I know there are a number of people here who have had similar issues and had surgery to remove stitches, knots etc. GerryR (use the search) is one at least.

  16. All,
    Thank you for your stories and experiences. I tore my AT August 30th this year and had it operated on Sept 1, basically 2 days after the injury. The Surgeon who performed the operation is a sports focused surgeon who said he was using new Kevlar stitches and should provide more strength to the tendon than prior to the injury. This all sounded good to me as I was afraid of having loss to physical activities due to the injury. Now that I am reading all of your experiences, I’m not sure wether the Kevlar is a good thing or a bad thing. Guess I will just have to wait and see as the operation just happened today and I know I have about 6 months of ups and downs before truly evaluating the repair. Also, I’m a bit nervous about the pain. I was given a nerve block and also am looking at pain management with some pretty strong pain killers. Question I have is this. Is the recovery pain more intense than the original injury pain? I mean that hurt. That hurt a lot. More than the first time my girlfriend broke up with me on my birthday, freshman year in college. Well anyways, thank you. I’m feeling more prepared for what’s ahead thanks to all of you.

  17. Make sure you take you pain meds regularly before your nerve block starts to wear off! It’s not fun when it does, so try to stay ahead of it. Thankfully mine lasted around 36 hrs, but some people’s wear off after 6-12. I didn’t have a rupture, so I can’t help you with that question. Wishing you a speedy recovery! Happy healing!

  18. Hang in there, Adam. The physical pain wears off after 2-3 days, but then the real fun begins. Achilles rupture recovery is a bear of an experience to have to endure, but you will come out the other side stronger. Luckily, you’ve found plenty of reading material to help pass the time here. Try to keep a positive attitude and stay in shape from the couch, too. Happy healing!

  19. Adam - pain is a very personal thing. If the injury hurt then you may find a bit of pain in the first couple of weeks after surgery but it should improve after that. Do not use Ibuprofen of other NSAID’s as they inhibit prostoglandin which is necessary to induce the healing response in the tendon. Opiates are OK initially but have side affects. 2 x 500mg paracetamol (Tylenol) taken every 6 hours religously is effective and can be taken with the opiates. Check with your pharmacy if you need that confirmed. Cannot say if the kevlar stitches will help. Maybe in the short term but usually you find once the tendon has healed it is actually stronger than before. The sutures become redundant after time and are only as good as the soft tissue they are threaded through. Beachy is right though. Get onto the pain meds before the nerve block wears off. Happy healing.

  20. Well the pain hit at about 3am this morning and it is definitely noticeable but am staying ahead of it as best as possible. Seems to be in waves and spikes when I lower my leg in a standing position. Thanks for the advice around pain killer usage and staying away from ibuprofen. My wife is a doctors daughter so she is really in charge of my pain management and doing an awesome job. Trying to stay positive and again very thankful for all of your advise and responses. It really does give me comfort that there is this support group out there. You guys are the best!
    Kind Regards,

  21. My AT repair was 19 days ago. I had the AT lengthened and the tendon transfer. Also, had the heel shaved back. Stitches and staples were removed on day 16. I’ve been experiencing a sharp stinging intermittently at the incision line. Anyone else have that issue? It first felt like a scorpion sting! I’m in a hard cast, so I can’t peek. Also, still uncomfortable enough to need more than Tylenol. Is that normal? I really appreciate this blog! Thanks, in advance,for your feedback!

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