Who should be removing stitches for patients?

Question

After undergoing multiple surgeries: rhinoplasty, blepharoplasty, chin implant, and lipsuction. Post-op, should the surgeon himself approve of releasing you from the resting room? For follow up appointment, should the surgeon himself remove stitches for you or could it be any medical assistant？

John Layke, DO, FACS · Answer

Many times the answer to your questions depends on the preference of the surgeon.  Remember, ultimately the surgeon is there to perform your procedure, and discharge from the recovery room is made by a qualified nurse after meeting well-documented criteria.  A qualified medical assistant, nurse, or PA can easily remove stitches; however, many times the surgeon wants to be the first person to assess the nose as the splint comes off.  In my practice, I visit with the patient in the recovery room to ensure that the patient is comfortable and that their significant other/family member have specific post-operative instructions.   In addition, as the surgeon, I am the only one removing stitches postoperatively for the aforementioned reason.

Todd C. Miller, MD · Answer

Hi Victorialee, there is no absolute right or wrong answer to this question. In my practice I prefer to remove sutures to ensure that my patients are healing according to my standards. Several practices have highly trained surgical techs who are very skilled at removing sutures. Regardless of who removes the sutures, it is important for the surgeon to see you to ensure that everything is healing appropriately.

William Portuese, MD · Answer

In our practice, the sutures that we use for a rhinoplasty and a chin implant are all dissolvable.   We also used dissolvable sutures in the upper blepharoplasty procedure, and tissue glue on the lower eyelids. It is acceptable to have a medical assistant remove sutures when necessary, but more importantly the surgeon must be following up on the patient to monitor the postoperative  healing progress.

Fred Suess, MD (retired) · Answer

An experienced nurse or physician who has had many patients that they have removed sutures for in the past.

Dennis Barek, MD (retired) · Answer

That depends on the practice and state the doctor is in. Most states have patients discharged from recovery roomy by anesthesiologists or nurse anesthetists, and not the surgeon.Stitches, when present, can be removed by a qualified surgical tech, PA or RN.  Even a medical assistant is allowed in many states to so simple suture removal, if so trained.. But at some point the patient must be seen by the operating surgeon unless prior authorization was given to another surgeon, for follow up.

Who should be removing stitches for patients?

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