The Importance Of Removing Sutures
Here is a fascinating little article. Commentary from one surgeon as to why it is so important for the doctor who placed the sutures to be the one to remove them. Why? Two main reasons. First, it permits the physician to learn the cosmetic results of his work. AND, it allows patients to seek additional information that they may have missed in the fracas of the postoperative setting, or to pose questions that have occurred to them about the healing process.
Why do I find this article so interesting? Two reasons. First, there is a general trend among surgeons in many specialties to have suture removal done by a Nurse or Physician Assistant. While increasing the efficiency of the use of the physician’s time, this trend eliminates the important feedback and communications experiences described above.
The second is based on a recent personal experience. TMI, but during a routine body scan by my Dermatologist in December, Dr. Hall expertly detected a sneaky little growth under my left sideburn. A biopsy revealed that it was melanoma. Off I went to have that puppy removed by Dr. Joel Cook, the leading Mohs surgeon in South Carolina. As expected, Dr. Cook did a marvelous job during my day-long visit to his beautiful clinic. As he closed the wound, Dr. Cook told me to go home to Hilton Head Island and have Dr. Hall remove the sutures in a week. Part of me was relieved that I would not need to make the four hour round trip back to Charleston to have Joel remove the sutures. BUT. Part of me wanted to have Dr. Cook take another look at his handy work, and to have the opportunity to ask him about the healing process.
Imagine my surprise when I went back to Dr. Hall’s office as instructed, and in walked one of her associates, a woman I had never met, to remove the sutures. I had no idea what her credentials were to do suture removal, but she did a fine job. BUT. Dr. Cook didn’t get to see how his handiwork turned out, and I certainly had no opportunity to ask questions or get advice about after care.
Bottom Line. Why do I think any of this is important? Simple. As the practice of medicine becomes increasingly fragmented in the name of efficiency, physician and patient alike wind up being denied the ability to “close the loop.”
I think that is a shame!!!