Do Hemorrhoidectomy Patients Need Suture Removal After Mixed Hemorrhoid Surgery?

Patients undergoing surgical treatment for mixed hemorrhoids often wonder whether suture removal is required postoperatively. The answer depends primarily on the type of sutures used during the procedure.

In modern hemorrhoid surgery—including procedures such as hemorrhoidectomy, stapled hemorrhoidopexy (PPH), or Doppler-guided hemorrhoidal artery ligation (DG-HAL)—most surgeons use absorbable sutures. These materials—such as polyglycolic acid (PGA), polyglactin 910 (Vicryl), or polydioxanone (PDS)—are enzymatically degraded and gradually absorbed by the body over days to weeks. Because they do not require manual removal, patients avoid the discomfort and logistical burden of a separate suture-removal visit.

Non-absorbable sutures—like nylon or silk—are rarely employed in contemporary mixed hemorrhoid surgery due to higher risks of inflammation, infection, and delayed wound healing. When used selectively—for example, in certain tension-bearing closures or specialized techniques—they would necessitate clinical removal, typically between postoperative days 7 and 14, depending on wound integrity and tissue recovery.

It is important to note that suture absorption does not equate to complete wound healing. Patients must still adhere to strict postoperative care: sitz baths, stool softeners, high-fiber dietary counseling, and avoidance of straining. Clinical follow-up remains essential to assess healing progression, identify complications (e.g., secondary hemorrhage, anal stenosis, or persistent pain), and guide rehabilitation.

Ultimately, the decision to use absorbable versus non-absorbable sutures reflects evidence-based surgical judgment, individualized to anatomy, disease severity, and procedural goals—not patient preference. Surgeons routinely select absorbable materials for mixed hemorrhoid repair, making routine suture removal unnecessary in the vast majority of cases.