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Local Clubs => DFWM => Topic started by: TresGatos on May 10, 2010, 06:55:49 PM

Title: Stitch removal
Post by: TresGatos on May 10, 2010, 06:55:49 PM
I louped em and can see where to cut and pull.
Any info on scab pre-loosening and hygenics?
Ive got a few days to go. 
Title: Re: Stitch removal
Post by: The Bearded Duc on May 10, 2010, 07:57:06 PM
I think the last time I tried to pull my own stitches it was after I was in a swimming pool for a couple hours. I just cut the stitches and pulled 'em right out. Just a slight tingling feeling.
Title: Re: Stitch removal
Post by: muskrat on May 10, 2010, 08:14:10 PM
or use vaseline to soften the skin at least several hours before - if you don't have a tub and wanna soak the knee of course.  laugh all you want but i've only had one set of stitches removed by Doc, the rest were all me.  FYI....ask for staples next time, they are easier to pull and hurt less. 
Title: Re: Stitch removal
Post by: The Bearded Duc on May 10, 2010, 08:25:40 PM
Quote from: muskrat on May 10, 2010, 08:14:10 PM
or use vaseline to soften the skin at least several hours before - if you don't have a tub and wanna soak the knee of course.  laugh all you want but i've only had one set of stitches removed by Doc, the rest were all me.  FYI....ask for staples next time, they are easier to pull and hurt less. 

Unless the staples are in your head.
Title: Re: Stitch removal
Post by: Ronr on May 10, 2010, 08:30:20 PM
I pulled 'em all out of my shoulder, no big deal.



Vaseline....pfffft  [roll]
Title: Re: Stitch removal
Post by: Pinocchio on May 11, 2010, 12:12:24 AM
Before you start, Dan, how does the wound look? It should not be puffy, weeping serous fluid.
If it's not looking bad, but the stitches aren't starting to get looser, either, it's probably too soon to remove them.
If you've got any signs of infection (redness, local tenderness, local warmth, purulent drainage), see a doctor.

If none of the above, I would still advise waiting until 10 days after suturing to remove.
First, wash your hands thoroughly.
If you've got scabbing in the way you may use some hydrogen peroxide sparingly on a sterile gauze pad to dissolve some of it. Only clean enough to be able to see the knots; and dab, don't scrub the stuff that comes off. Allow the site to air dry afterward. You need sterile suture scissors and tweezers, I recommend you get a suture removal kit from a good drugstore, try Dougherty's. Now prep the area around the wound with Betadine, or povidone prep pads (a prep pad will come in the kit). Work in a spiral from the wound going out about an inch all around.  Allow to air dry. Cut as close to the knot as possible and grasp the suture by the knot with sterile tweezers to remove. Cover the site in clean or sterile gauze and tape around, not over it, so that the wound can dry out. Don't wash the wound for a couple of days, bag your knee in the shower, until the wound is dry = no serous weeping and has a good, thick scab over it. [thumbsup]
Title: Re: Stitch removal
Post by: TresGatos on May 11, 2010, 04:55:59 AM
Thanks for the advice!! 
Title: Re: Stitch removal
Post by: muskrat on May 11, 2010, 06:37:08 AM
long instructions.  just grab a bottle of your favorite poison and yank after cutting.
Title: Re: Stitch removal
Post by: Ronr on May 11, 2010, 08:03:46 AM
John Wayne would use grain alcohol, scissors (or large knife) and pliers
Title: Re: Stitch removal
Post by: The Bearded Duc on May 11, 2010, 08:40:08 AM
Quote from: Pinocchio on May 11, 2010, 12:12:24 AM
Before you start, Dan, how does the wound look? It should not be puffy, weeping serous fluid.
If it's not looking bad, but the stitches aren't starting to get looser, either, it's probably too soon to remove them.
If you've got any signs of infection (redness, local tenderness, local warmth, purulent drainage), see a doctor.

If none of the above, I would still advise waiting until 10 days after suturing to remove.
First, wash your hands thoroughly.
If you've got scabbing in the way you may use some hydrogen peroxide sparingly on a sterile gauze pad to dissolve some of it. Only clean enough to be able to see the knots; and dab, don't scrub the stuff that comes off. Allow the site to air dry afterward. You need sterile suture scissors and tweezers, I recommend you get a suture removal kit from a good drugstore, try Dougherty's. Now prep the area around the wound with Betadine, or povidone prep pads (a prep pad will come in the kit). Work in a spiral from the wound going out about an inch all around.  Allow to air dry. Cut as close to the knot as possible and grasp the suture by the knot with sterile tweezers to remove. Cover the site in clean or sterile gauze and tape around, not over it, so that the wound can dry out. Don't wash the wound for a couple of days, bag your knee in the shower, until the wound is dry = no serous weeping and has a good, thick scab over it. [thumbsup]

I've had more stitches than probably most can count. Just out of curiosity, how come the Dr's at the hospitals don't do that much prep when removing stitches?
It's always been just a snip and pull situation with mine. I mostly agree with the sterile tools but I have had a couple of Dr's that have just pulled a pair of tweezers out of their coat pocket to remove my stitches. I'm not a Dr so I don't know, I'm just going by my experiences. I feel like if the wound is completely healed (10 days), then there is no real risk of getting an infection. There is no longer an open wound. Personally, I would wait for the scab to come off on it's own. Scabs are a natural healing process, if you still have a scab it usually means the wound is not done healing. They fall off by themselves when they're healed.

The most important part is a sharp set of scissors. It doesn't feel good pulling a jagged-ly cut suture through your freshly healed wound.
Title: Re: Stitch removal
Post by: Pinocchio on May 11, 2010, 09:44:01 AM
Quote from: duc750 on May 11, 2010, 08:40:08 AM
I've had more stitches than probably most can count. Just out of curiosity, how come the Dr's at the hospitals don't do that much prep when removing stitches?

Because doctor's aren't nurses, and because they're usually in a hurry. Wound infection tops the list of preventable occurrences of patient harm at most hospitals, and it's usually caused by lack of handwashing and/or disregard of aseptic technique, such as you're describing.



Title: Re: Stitch removal
Post by: mstevens on May 11, 2010, 09:55:08 AM
There's no especially great need for sterile forceps in removing sutures, since the forceps will be pulling away from the wound. Personally, I've always used a suture removal kit which has sterile (but extremely crappy) plastic forceps and kindergarten-style suture scissors with the little notch that's supposed to make getting the bottom blade under the suture easier. I did use the forceps, but if the patient wasn't squirmy I preferred to use a small sterile blade pushed under the suture then pulled up.

There is a need for sterile scissors, since the cut end will be pulled through the skin. It only makes sense to clean the area with povidone ahead of time. Besides creating a sterile (or more likely "pretty clean") field, it softens the suture and de-gunks it so it pulls through more easily.

Staples do indeed come out nicely, but I've only ever used a disposable surgical staple remover since the stapler is supposed to form a complete loop of wire with the ends meeting under the skin. That would mean a lot of bending to get it out without tearing anything if not using the remover.
Title: Re: Stitch removal
Post by: muskrat on May 11, 2010, 09:56:18 AM
So docs charge more for less work?  ???
Title: Re: Stitch removal
Post by: mstevens on May 11, 2010, 10:19:02 AM
Quote from: muskrat on May 11, 2010, 09:56:18 AM
So docs charge more for less work?  ???

Nurses don't usually charge at all, so yes.
Title: Re: Stitch removal
Post by: TresGatos on May 11, 2010, 04:17:28 PM
I got some Povidone, have jeweler tools, just need to
wait for Friday afternoon and I should be done.
Thanks again for the info [thumbsup]
Title: Re: Stitch removal
Post by: muskrat on May 11, 2010, 05:56:22 PM
Quote from: mstevens on May 11, 2010, 10:19:02 AM
Nurses don't usually charge at all, so yes.

last itemized hospital bill I saw had it scheduled on there.   [laugh]
Title: Re: Stitch removal
Post by: mstevens on May 11, 2010, 06:27:59 PM
Quote from: muskrat on May 11, 2010, 05:56:22 PM
last itemized hospital bill I saw had it scheduled on there.   [laugh]

Really? That's odd. Was it a private-duty nurse or something?

Nursing is typically included in the daily rate or in procedure rates.
Title: Re: Stitch removal
Post by: muskrat on May 11, 2010, 06:40:42 PM
Baylor back in November here in frisco
Title: Re: Stitch removal
Post by: TresGatos on May 11, 2010, 06:50:32 PM
Quote from: muskrat on May 11, 2010, 05:56:22 PM
last itemized hospital bill I saw had it scheduled on there.   [laugh]
They tend to add it on with complainers [roll]
Title: Re: Stitch removal
Post by: muskrat on May 12, 2010, 02:55:27 AM
Yeah but not that night, worst bronchitis ever and I couldn speak
Title: Re: Stitch removal
Post by: Duc L'Smart on May 12, 2010, 01:11:27 PM
Maybe Malynn can help... WiWa mentioned something about a nurse's outfit [thumbsup]
Title: Re: Stitch removal
Post by: Pinocchio on May 12, 2010, 06:00:12 PM
Quote from: muskrat on May 11, 2010, 05:56:22 PM
last itemized hospital bill I saw had it scheduled on there.   [laugh]
Baylor can itemize nursing/tech charges all they want; no third-party payor is going to pay them. Only self-pay patients will get stuck with them. Are you self-employed? :-[
Title: Re: Stitch removal
Post by: TresGatos on May 12, 2010, 06:13:06 PM
Quote from: Duc L'Smart on May 12, 2010, 01:11:27 PM
Maybe Malynn can help... WiWa mentioned something about a nurse's outfit [thumbsup]
Hmmm.  I better not go there. I can't run fast
yet ;D
Title: Re: Stitch removal
Post by: muskrat on May 12, 2010, 06:26:45 PM
Quote from: Pinocchio on May 12, 2010, 06:00:12 PM
Baylor can itemize nursing/tech charges all they want; no third-party payor is going to pay them. Only self-pay patients will get stuck with them. Are you self-employed? :-[

nope.  you ladies quit arguing with me.....I have proof!  either way it doesn't matter, it's expensive and that's that.
Title: Re: Stitch removal
Post by: dallas2r on May 14, 2010, 11:06:40 AM
Quote from: TresGatos on May 12, 2010, 06:13:06 PM
Hmmm.  I better not go there. I can't run fast
yet ;D

you're a smart man; glad to see your cognitive abilities weren't injured.  [coffee]
Title: Re: Stitch removal
Post by: muskrat on May 14, 2010, 01:24:22 PM
but the Tard can go off road.....just saying
Title: Re: Stitch removal
Post by: TresGatos on May 14, 2010, 05:40:50 PM
Quote from: muskrat on May 14, 2010, 01:24:22 PM
but the Tard can go off road.....just saying
Hmmmm.  I can ride it now.
The Monster too! [moto]

spending the afternoon at AMS may become an off-day
thing for me. And Bucks Prime makes a mean grilled
chicken sammich and the cow muscle burger is
pretty good too [thumbsup]
Title: Re: Stitch removal
Post by: fastwin on May 14, 2010, 05:53:17 PM
The Crowley criminal court crowd used to hit Bucks Prime also. Good stuff for sure!!
Title: Re: Stitch removal
Post by: TresGatos on May 15, 2010, 06:44:35 PM
It never occured to me that I could not use the
right hand to get the stiches out of my right forefinger [roll]

1- hold the loupe to see where to cut
2- use scalpel to hopefully cut where needed
3- pull on knot
4- if suture won't budge, go to 1 else go to 5
5- pull out stitch

went like clockwork. Broken clock but it went ;D
Title: Re: Stitch removal
Post by: GeorgeInDallas on May 18, 2010, 07:03:58 AM
Vinegar.
Title: Re: Stitch removal
Post by: ♣ McKraut ♣ on May 18, 2010, 07:34:50 AM
Quote from: GeorgeInDallas on May 18, 2010, 07:03:58 AM
Vinegar.

sea salt?
Title: Re: Stitch removal
Post by: TresGatos on May 18, 2010, 09:39:45 AM
Just two scabbe up ones left in the knee :)
Title: Re: Stitch removal
Post by: Cher on May 18, 2010, 01:44:31 PM

Very glad to hear you're back on the bike  [thumbsup]
Title: Re: Stitch removal
Post by: TresGatos on May 18, 2010, 03:08:13 PM
Quote from: n2f on May 18, 2010, 01:44:31 PM
Very glad to hear you're back on the bike  [thumbsup]
Thanks!  I like the new Dunlops on the Hyper.
Sportmax Q2 dual compound [moto]