Should plastic surgeon's nurse do stitches during surgery?

Question

I recently had a consultation for a tummy tuck & breast lift & the surgeon said his nurse helps do the stitches. Not sure if he was referring to internal stitches or closing stitches as didn’t think to ask at the time but wondering if this is common or should the surgeon be the one doing them?

Timothy M. Bradley, MD · Answer

It is very common for surgeons to utilize an assistant for surgery. A competent surgical assist is essential to both help the surgeon perform the procedure as well as decrease the operative times for procedures. Decreased operative time is always a good thing for patient safety issues, and less time in the OR translates to possible financial savings for the patient as well.The surgical assist will usually only do what the surgeon feels is appropriate and safe. Simple suturing is certainly within the realm of a competent, experienced first assistant and no need to worry. The scar will look as nice as if the surgeon did this part of the procedure himself. Your surgeon most likely will be performing "internal" suturing so that all the tissues safely approximated and properly aligned, making the surgical assistant's suturing a simple and safe task.However, This scenario can be a completely different story if one has their surgery in the highly discounted, high volume cosmetic centers in some areas of the US where super discount prices & high volume of surgery is the basis of their business model. These places place profit over patient safety and quality of outcome. If the price of the surgical procedure is markedly cheaper than most surgeons for the apparent same services, beware: in these super discounted practices the surgical assist may be doing most of the case, if not the entire case, and the surgeon of record is simply shuffling the patient's paperwork, not actually performing the procedure. Unsettling I know, but true. Do your homework , ask questions so that you feel completely at ease. There is no "discount" price a person can place on their well being

Sugitha Seneviratne, MBBS, FRACS (Plas), FACCS · Answer

Hi,The key to the due diligence you seek is the qualifications of the Nurse assisting your surgeon. Qualified Nurse assistants have undergone formal training, have appropriate qualifications and are therefore appropriate to undertake your suturing.

Daniel Barrett, MD · Answer

Dear Exuberant584968,
in case of my surgeries, I do the stitches alone. It is very important to do the sutures correctly in order to get the best results. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ajaya Kashyap, MD · Answer

Thank you for your question. It is not uncommon for a surgeon’s assistant to  do some of the less consequential sutures under the direct supervision of the surgeon. The entire surgery and important suturing is usually all done by the surgeon. The entire process of surgery  is your surgeon’s responsibility. Please discuss your concerns with your surgeon who can clarify all your doubts. All the best!

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi
Almost all plastic surgeons have an assistant (which may be a doctor or nurse) that does assisting which includes some of the skin stitching. It usually does not include the deep stitches. Some surgeons train (and pay extra for) their nurses specifically so the operation goes more smoothly and the surgeons individual practices are more precise. It is a common practice.RegardsDamien

Daniel Park, MD · Answer

Thank you for your question. It is a pretty common practice for surgeons to have a First Assist RN or a Physican Assistant to assist in cases that require a large amount of sewing. These assistants are highly trained in sewing and are under the direct supervision of the Plastic Surgeon. They shouldn't be the ones doing the procedure or all of the sewing but assisting the surgeon in minor sewing. This can be a great way to keep you safe by reducing your time under anesthesia especially for cases like breast lifts, breast reductions, tummy tucks, and combined procedures. You may inquire about the credentials of the facility that your surgery will be performed in and inquire about the qualifications of his assistant. 
Daniel Park, MD
Diplomate, American Board of Plastic Surgery
Diplomate, American Board of Surgery

Chad Robbins, MD · Answer

Hello and thank you for your question.  Many plastic surgeons have what we call First Assist RN's who are specially trained in the OR and assist the Surgeon.  Teaching hospitals have Resident's do a lot of their sewing as well.  If there is a lot of sewing required, PS does the deep and superficial suturing while the assistant only does the superficial.

Should plastic surgeon's nurse do stitches during surgery?

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