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Need some medial adivce


slay

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we got into a fight recently while is was out with some friends and someone punched me in the face when i wasnt expecting it and i bit a hole in my lower lip (i was talking to someone else and because of that i had my mouth open). it was stitched at an emergency room and they told me to visit a local surgeon for a check up. they used suture which is supposed to decompose in a few weeks.

BUT the surgeon i was at today told me he could also pull the stiches out. the thing is, his doctor's office was very empty (i was the only one there..!) and he said everythings fine and sceduled me for 3 more meetings (!!). even though the doctor told me just to go there the day after to check if its infected or not (and it wasnt infected)

so i wanna know if its really better to get the stiches pulled even though they are supposed to decompose? pulling them is probably not very enjoyable and i dont know if its good to get them pulled a week after i got them (doesnt it take its time to heal?!?)

thanks for any help!

and btw. it didnt hurt, it only hurt in the emergency room, because they gave me painkillers and told me the doctor would be back in 2minutes and 2minutes easily became over an hour and a half and the painkillers werent working properly anymore :p my lip is just really big right now... it looks like i got lionel richie's lip transplated :D

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The best thing is to get them out after 7 days. After 7 days the wound is sufficiently healed to suffice without the stitch and the stitch merely strats to get in the way and detract from the healing process as it heals AROUND the suture. Assuming you have the dissolvable sutures then you don't HAVE to get them removed they will disappear on their own eventually.

However, I still recommend having them removed, it entails cutting the stitch and then removing it, nothing drastic and save any hassle. I have had countless stitches removed, closing on 40 I think? without any problems.

Chris

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Sorry to hear about your ordeal. It seems to me that ER used either gut or chromic gut suture. By nature, it will decomposed away. If cut/ laceration was mainly inside toward to your lower dentition, it will go away faster.

As Edge was saying, if it was silk suture, 7 day is about right and that's usual time for post op check up for removal. If it is CG or resorbable suture, and primary closure is not achieved yet, leave the suture. However, primary closure is achieved and loosening thread of suture is bothering you, it should be fine to remove it. Usually, removal is very simple and painless, most of time. I would expect swelling since it was traumatized and cut, I hope that you took some antibiotic to prevent secondary infection. I doubt that you have to go back for 3 times but since I don't know the extent of your injury, it is difficult for me to comment on that. But , most time, one week post op is must to see any sign of infection or progress of your healing.

Again, I wish you fast recovery! :)

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Quote:

back in 2minutes and 2minutes easily became over an hour and a half and the painkillers werent working properly anymore

That is so true in US also. I waited about 2 hours after car accident, Apparently, more people got into car accident with sever injury than mine! :wounded1:

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well there wanst much traffic in the emergency room, thats what made me mad. it was only me and some foolish grandpa who thought he had something in his leg (turned out it was nothing...!) and the doctor spend most of the time talking to him.

and i also have a private medical plan and not the kind most other ppl over have (a private plan is much more expensive and you usualy get a lot better treatment, since doctors can charge 3x more than on the regular health plans). if the doctor charges 3x as much as he would do for normal surgery, least thing he could do is treat me right away!

and no, they didnt give me antibiotics, they told me, if theres no infection within the next day, there wont be any.

i just thought that the doctor told me to get the stiches pulled so he can make a lot more money (i can already see the bill "pulling stiches - 500$") :p ) because his office seemed very empty. and i didnt now if everything is fine within a week (i thought it would take much longer to heal) and i feared that it might tear open a little bit when he rips the stiches out (or how does he do it?!)

and they dont look like silk, they are purple... almost blue!

Edited by slay
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so he just seems to make money of me... but what the heck, the guy who punched me will have to pay the bill anyways (dont think insurance will pay for him!) so i will just go 3 times and get them pulled :D (will definetly cost a few thousand $ all together!)

his watch looked like an IWC, maybe we can have a little bit watch conversation next time :)

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oh, and no, i'm not doing it myself lol the last time i did something "myself" ended up in a MESS. i made it even worse than it already was (watchwise AND medical wise). long story short, 2 watches are siting on my desk taken apart and i cant put them back together, and i had a serious infection on my thumb which got even worse after i tried to fix it myself :)

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If it was blue or purplish, it may be a vicryl type. Most likely 5-0. 6-0 is too thin. Anyhow, suture removal is as Nanuq described. I've seen enough patients @ ER for similar situations and sutured'em up during my GPR days. I think in US, we tend to give antibiotics more so than Europe. Don't do it yourself at home. Maybe you can take photo of lip and email it to me? :lol: Seriously, you will not need three P/Os as long as there is no sign of infection. :victory:

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I am certainly no doctor but with a number of accident prone kids I have one simple rule. If it is on your face go to a qualified plastic surgeon. I am in the U.S. so you can usually actually wait for one if you are in the ER. If you have any concerns about the aesthetics (size and closeness) of the stitching, take the money fron your future visits and go see one. I have had stitches a few times and usually you simply go back once after seven days or so. The one time I got them in my mouth they were the type that simply dissolve. But the doctor did have me come back to check for healing after some period of time. :)

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i was thinking about going to a plastic surgeon too, but the thing is, it was late at night and i had a hole in my lip. everytime i drank something it came out ontop of my lip. and most stiches are in the inside of my mouth, not really visible! and i think the surgeon did a pretty good job (he was around 50 or so)

@Highflyingclive as a matter of fact, i tried to offer free drinks to relax the situation a little bit right before i got punched in the face :p so i wouldnt reccomend that

and btw. if insurance had to pay for it, i wouldnt have gone to a checkup at all after surgery. but since the guy who punched me probably has to pay, i will go as many times as i can :)

Edited by slay
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Seriously, you can do this yourself... it's that simple. I don't recommend it though. And you don't need 3 followups unless there's an infection he wants to watch closely.

i took your advice (because the outside stiches were bothering me) and removed them myself with a pair of scissors! really, wasnt that hard, just cut the top and pull them out one by one!

now the internal stiches i will get removed by the doc, simply because its hard to cut them in the inside!

Edited by slay
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i just got back from the doc... i should have taken nanuqs advice from the beginning and had them ALL removed by myself.

first i had to wait 1,5HOURS even though I had an apointment, and then they let ppl in who came way after me. After the 4th guy went in there, i went to the counter and i was like "hello? is this a joke or something? the doc charges my insurance company 3 times as much as he does for all the others here, and i'm waiting for over 1,5hours now and you let ppl through who came AFTER me? this is definetly the last time I came here!"

I was sent in right after I complained (funny, huh?) and the doctor told the nurse to remove them and walked out.

Aparently the nurse was too stupid to remove them, cause removing them hurt a lot more than sewing them without painkillers. And it was bleeding pretty bad after she removed them.

Funny thing is, when I removed some of the outside stiches, it didnt hurt at all and there was also no blood at all.

I can already see the bill "Removing stiches, 900$"...

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