Stitch removal

[TresGatos]

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. 

[The Bearded Duc]

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.

[muskrat]

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. 

[The Bearded Duc]

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.

[Ronr]

I pulled 'em all out of my shoulder, no big deal.



Vaseline....pfffft 

[Pinocchio]

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.

[TresGatos]

Thanks for the advice!! 

[muskrat]

long instructions.  just grab a bottle of your favorite poison and yank after cutting.

[Ronr]

John Wayne would use grain alcohol, scissors (or large knife) and pliers

[The Bearded Duc]

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.

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.

[Pinocchio]

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.

[mstevens]

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.

[muskrat]

So docs charge more for less work? 

[mstevens]

So docs charge more for less work? 

Nurses don't usually charge at all, so yes.

[TresGatos]

I got some Povidone, have jeweler tools, just need to
wait for Friday afternoon and I should be done.
Thanks again for the info