Which action is involved in safely removing retention sutures?

• A. Cut the suture at the end nearest to the knot.
• B. Cut the suture as farthest to the skin edge as possible.
• C. Pull the visible part of the suture above the skin through underlying tissue.
• D. Clip suture materials nearest to the skin edge on one side, and pull from the other side.

Answer: (D)

Retention sutures sit under tension across the wound and exit the skin at two points, so removing them safely means minimizing tissue trauma during withdrawal. The best method is to clip the suture material right where it lies against the skin edge on one side, then gently pull from the opposite side. This lets the suture slide back through the tract without dragging skin or wound edges, reducing the risk of tearing and discomfort and preserving the wound as it heals.

Why the other approaches aren’t ideal: cutting close to the knot or leaving a longer tail can still pull on tissue or snag on clothing or hair, increasing trauma or patient discomfort. Pulling the visible part through underlying tissue without clipping the entry point risks dragging tissue through the wound. The chosen method targets smooth, controlled removal with minimal traction on the wound.