Getting Stitches on Koh Phangan: Aftercare Guide

What happens when a wound is stitched ?

The area is numbed with local anaesthetic, the wound is cleaned thoroughly and explored to check what lies beneath, any foreign material is removed, and the edges are brought together with sutures. You leave with a dressing, aftercare instructions, a tetanus check and a removal date.

How many stitches and what type depends on the wound rather than its length. Deeper wounds sometimes need a layer beneath the surface as well, and the material used differs by site — what suits a scalp is not what suits a hand. Whether a cut needs closing at all is covered in our guide to deciding on stitches.

How do you look after stitches here ?

1. Keep the dressing dry for the period you are told, usually the first day or two.
2. Shower rather than bathe, and cover the area where you can.
3. Change the dressing as instructed, or come in for it.
4. Keep it out of the sea, pools and hot springs entirely until the stitches are out.
5. Avoid stretching the area — that includes the movement that opened it in the first place.
6. Keep it out of direct sun once it starts healing, which reduces the eventual scar.

The swimming restriction is the one people negotiate with, and it is the one that causes most of the problems the clinic sees afterwards. Water softens the wound edges and introduces bacteria into a closed wound, which is precisely how a neat repair breaks down into an infected one.

What should normal healing look like ?

Itching around day five is normal and is a reasonable sign things are going well. Pain that increases after the first couple of days is not, and it is the single most reliable early signal of infection.

When do stitches come out ?

It varies by where the wound is. Areas that move or are under tension need longer; the face generally needs less, because leaving sutures in longer there produces more visible marks.

You will be given a specific date, and both leaving them in too long and taking them out too early cause problems. If you are travelling on, say so at the time of the repair — our clinics on Koh Tao and in Lamai can remove them, and stitch removal across islands is routine rather than a complication.

Dressings in this climate

A dressing that performs well at home can fail within hours here. Humidity lifts the adhesive, sweat loosens it from underneath, and a dressing that has peeled at one edge is worse than useless because it traps moisture against the wound while letting dirt in.

Waterproof dressings hold up better than fabric ones, and changing a dressing that has become wet or lifted is better than leaving it until the scheduled change. If you are getting through dressings faster than expected, that is normal here rather than a sign something is wrong — ask for spares rather than rationing them.

What about diving ?

Not until the stitches are out and the wound has fully closed, and then only once a doctor has looked at it. There are two separate problems: water immersion, which is the same issue as swimming, and equipment pressure, since a wetsuit or a strap over a healing wound can reopen it.

If you are mid-course, tell your dive school rather than hiding it. Schools deal with this regularly and would far rather rearrange than have a student get in the water with a fresh repair. The broader rules on sitting a day out are in our guide to when not to dive.

What to do if you lose the dressing in the sea

It happens, usually to someone who intended only to paddle. Rinse the wound with clean fresh water rather than leaving salt on it, dry the surrounding skin properly, and apply a fresh dressing as soon as you can.

Then come in rather than waiting for your scheduled appointment, particularly within the first week. A wound that has been immersed has been recontaminated, and the useful thing is to have it looked at before the consequences appear rather than afterwards. Nobody will tell you off.

What reduces the scar ?

• Keep it closed. A wound that opens and heals twice scars more than one that heals once.
• Keep it out of the sun for several months, since UV darkens a new scar permanently.
• Do not pick at scabs or at the stitches themselves.
• Moisturise once it has closed and the stitches are out.
• Avoid stretching the area during the first weeks.
• Be patient — a scar continues maturing for a year, and the pink raised stage is not the final result.

Sun protection is the one most people skip and the one that matters most on a beach holiday, where a healing scar is likely to be exposed daily. The NHS guidance on scars is a sound reference.

Alcohol, sun and the healing wound

Two things worth stating because they come up constantly on this island. Heavy drinking affects healing and, more immediately, affects judgement about keeping a wound dry — most wounds that get immersed against advice do so during a night out rather than deliberately.

Sun matters from the moment the wound closes rather than from some later point. A fresh scar exposed daily on a beach will darken permanently, and that happens over weeks rather than months. Cover it with clothing where you can, which is more reliable than sunscreen on a body part that is in and out of water.

Should you come back in ?

• Increasing pain after day two → same day
• Spreading redness, pus, red streaks or fever → same day
• Wound has opened or a stitch has come out → same day
• Dressing soaked through → same day
• Due for removal and travelling on → any of our three clinics
• Itchy, settling, looking better daily → keep it dry, come back on your date