Can I swim before removing the wound stitches?

In outpatient or emergency department, patients often ask how long they can swim after the wound is sutured. Most clinicians may tell patients not to swim after suturing the wound, waiting for the wound to heal and the suture to be removed before swimming.

Orthopaedic doctors usually tell patients using external fixators that they can swim in chlorine-containing disinfectant water or a clearer swimming pool after the wound surface of the fixator needle path heals.

The main concern about whether the wound can swim in the pool after suturing lies in two aspects: the potential infection of the wound surface after contacting the water surface and the possibility of healing of the damaged tissue. The risk of infection depends on the type of wound surface (open wound surface is more susceptible to infection than epidermal wound surface), medical complications, type and quality of water quality, and complications of the wound surface.

However, it is difficult to give the exact probability of suture wound infection clinically, so it is also difficult to completely determine whether swimming may really increase the probability of wound infection.

At present, there is no evidence that the wound can swim after suture.

The probability of skin infection in exposed swimming pools has increased in recent years, but the main infection is still intestinal-related infection, with Escherichia coli and Cryptosporidium being the most common pathogenic bacteria. Pseudomonas aeruginosa and Staphylococcus are the most common skin and epidermis infection bacteria in swimming pools.

At present, the literature reports that the infection occurred when swimming in the swimming pool is basically caused by injury in the water or the skin was damaged earlier and was not sutured when entering the water. However, there is still a lack of research data on whether pathogenic microorganisms in water can enter the wound surface through sutured and closed wounds.

The infection of patients’ wounds during swimming is not only affected by the bacteria content in the water quality of swimming waters and the characteristics of patients’ wounds, It is also affected by whether the patient has medical complications and the types of pathogenic bacteria. There are many medical complications that affect wound healing, including diseases that affect local wound healing (such as eczema) and systemic immune deficiency diseases (such as HIV, diabetes, etc.).

At present, there is no direct research on wound infection after swimming. According to the guidance issued by an expert guidance organization of NIH, the epidermis crawls and covers the wound within 48 hours after the wound is closed. It is relatively safe to bathe or bathe at this time. However, it needs to be clear that the time demarcation point of the above guidelines is only an expert opinion and there is no strict evidence to support it.

What should we do about the current lack of clinical evidence?

Due to the lack of high-level clinical evidence, Can reach a consensus through the joint expert opinion. Theoretically, once the wound surface has epidermis coverage, it can be cleaned and even swimming. However, the specific coverage time point of the epidermis is still unclear, so in clinical practice, patients should be informed that swimming can only be carried out after removing the surgical sutures in the wound surface.

The above methods ensure that patients have complete soft tissue coverage before swimming, thus reducing the probability of bacterial infection after entering the water. Although there are literatures that bathing within 48 hours after wound closure will not affect the probability of wound infection, clinicians should be cautious about this view.

In general, The time of removal of surgical sutures depends on the site of the wound, Usually in about 7-10 days. The removal time of absorbable sutures may be slightly later than the above time. For wounds sutured with absorbable sutures, It is necessary to ensure that there is no exposure on the skin surface before entering the water, and if there is exposure, it is necessary to remove it. For patients with medical diseases, the risk of infection is increased, so swimming exercise is not recommended for such patients before the wound surface is completely healed. Swimming exercise is not recommended for patients with open wounds or ulcers.