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what causes stiches to open up after punch excision?

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Don't want to be rude but think about it?

Law of Physics. The weight of your skin is pulling and changing all the time. Sometimes a few little stiches aren't enough to counter the pulling and pushing effect.

I have had stiches bursting open but not on my face.

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I think the reason some excisions pop open is because (I'm hoping) the derm did not do the procedure properly. In preparation for my own excision tomorrow, I've done a lot of research on this and it seems like the excision should be sort of football shaped, so as to close up linear and healthy, if the area to be taken out is big enough and the skin at the midpoint of either side (the skin that will have to stretch the most) is too far apart, then the the skin of the wound edges will need to be "undermined"(like subcision) in order to free it from the underlying tissue so that it can stretch farther, and hence not be pulled in 2 opposite directions at once (both toward the tissue it is bound to and also toward the sutures) It also sounds like that interior stitch is often necessary so that all layers of the skin heal together, rather than just the top layer which would otherwise just be cinching the deeper layers together (hence more pressure on the surface). Finally, I am planning to use steri-strips (that tape with fibers funning through it) after the stitches are removed to continue to add the "tensile" support that newly (re-) scarred skin will need. I know this all sounds very elaborate, but I do think these are the best precautions to take to avoid popping open. Just my thoughts, and what I have found through my reading. There are some good sites if you google "excision" "wound repair," "scar correction," and stuff like that. I will keep you updated after my surgery tomorrow (about which I'm excited but also pretty nervous)



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