A retention suture is used to take some of the pressure off of a patient's other sutures so that a wound does not pull open as it is healing. These stitches are usually used after abdominal surgeries in patients who are overweight or who may suffer from a distention of the abdomen due to swelling or disease. These conditions can place a great deal of strain on standard sutures, which can rip apart, causing further injury or illness to a patient. In many patients, the use of this type of suture will increase discomfort and scarring.
A medical professional will choose to use retention sutures if there is reasonable cause to believe that standard sutures will be unable to keep a wound closed until it is fully healed. They will be used on the outside of the other sutures, usually about 1 inch (2.54 cm) away from the wound. Each is tied separately, and the stitches are usually spaced an inch or two apart along the length of the wound. Alternatively, they may be designed to stitch together the patient's subcutaneous layer and then feed up through the wound itself, where they are held in place until it is time to remove them.
In normal suturing, the stitching only encompasses a small portion of a patient's skin, though in deep wounds, there may be multiple layers of sutures. Internal sutures that are made out of a material designed to be absorbed into a person's body after a time may be placed below the surface of the patient's skin. Outer sutures, which are partially exposed above the patient's skin, are often used and are designed to be removed when they are no longer needed. A retention suture is designed to encompass this entire area, holding the tissues in the subcutaneous layer closed and coming up through the skin before being tied off at the top.
This type of suture needs to be removed when it is no longer needed, as it is made from a material that cannot be absorbed into the patient's body. These sutures are stronger than standard ones and are often made from a flexible metal wire. The top of each may be encased in a rubber tube so that it does not rub uncomfortably on the patient's skin. Even with this barrier in place, many patients claim that there is a great deal of pain associated with the use of retention sutures.