Is there any halachic problems with a religious doctor giving stiches or surgical sutures on shabbos? Might it be considered koshair or tofair since the surgeon would be considered a professional and stitches stay in a while?
This question has been widely discussed among authorities.
Shemiras Shabbos Kehilchasah (24:4; 24) writes that although one should not give stitches on Shabbos where it is possible to wait until after Shabbos, it is permitted, where there is a need, to give stitches on Shabbos. The reasoning behind this leniency is that there is no prohibition of tofeir in a human body, and with regard to the prohibition of tying the knot, the knot is not considered a permanent knot, and therefore it is only a rabbinic prohibition.
A similar ruling is given by Tzitz Eliezer (20:18) and Rav Yechezkel Avrahamsky (cited in Nishmas Avraham 340:7). Rav Elyashiv (cited in Nishmas Avraham, loc. cit) wrote that the knot would involve a Torah prohibition if it was only cut later, and only if the know will be untied would it involve a rabbinic prohibition alone.
However, Nishmas Avraham (340:7) quotes a lengthy and ongoing dialogue with Rav Shlomo Zalman Auerbach on the topic, in which the final conclusion (after several to’s and fro’s) was that the actual stitches would involve a Torah prohibition, and would therefore be prohibited in a non-life threatening situation, but it is permitted to use other adhesive techniques (including butterfly stitches), because they only serve as a preventative measure.
Rav Elyashiv is quoted as being stringent with regard to all forms of stitches and adhesives, as being a potential Torah transgression, and therefore prohibited in non life-threatening situations, whereas Shevet Halevi (9:74) is in doubt concerning adhesives, because they do not acutally attach one part of the skin to the other, but merely allow the skin to attach of its own accord.
See further in Nishmas Avraham (loc. cit.) concerning whether one has to be careful in life-threatening circumstances to give the minimal number of stitches required to avert danger, or whether one may give the full set of stitches.