Dr. Reed, Should my adult circumcision sutures be removed, in that my doctor says they’re absorbable. How soon can I have sex? Daren
Dear Daren, It takes about 7 to 8 weeks for a properly approximated incision to regain full tensile strength. I advise patients not to have penetrating sex until then. And if there is a delay in wound healing at one place in the circumference, you need to wait until that is completely healed (epithelialized). The vagina is a friendly place but not a microorganism free place. Of course many of these organisms belong there. but still.
The reason we want to remove sutures on or about the 12th to 14th day, is if not done about 10% of patients will have permanent cross hatch marks. Some of this is attributable to the suture material itself, other factors relate to how tightly the suture is tied. Certainly not tighter than needed to approximate the skin.
The fastest absorbing sutures we have today are Vicryl Rapide. (think rapid). The cost about $10 to $12 (3 times a regular suture). An adult cosmetic circumcision requires about 4 to 5 sutures, as many knots can be tied with one suture, especially if the doctor does an instrument tie. The thickness of the suture also affects dissolution.
The higher the suture number like 4-0 vs 2-0,, the faster they absorb. We prefer 4-0 mostly and 5-0 for the frenular area.
Below is a photo of circumcision cross hatch marks probably caused by failure to remove sutures 12 to 14 days after surgery. This of course is a permanent effect. Who needs that?
Harold M. Reed, M.D.
The Reed Centre for Cosmetic Circumcision
Circumcision cross hatch marks, most can be avoided by gently tying and timely removal of suture, even if it is absorbable.
Cosmetic adult circumcision after photo. Wouldn’t you rather have this?
Same patient after photo of circumcision result, (Dr. Reed’s patient)