06 October 2010

subcuticular stitches

When closing the skin after abdominal surgery, one has two options: staples or subcuticular stitches. Staples are quicker, but subcuticular stitches leave a prettier scar. Subcuticular stitches are also one of the few things a medical student may be allowed to do in the OR causing an interesting phenomenon: the surgeons are artists within the body. They do an amazing job and while you may feel better, you will likely not be able to see their work. On the other hand, the medical student's skin stitches will be on display for you and others for the rest of your life. The least experienced person in the room is doing the most aesthetically relevant portion of the procedure (under supervision, of course).

I was recently allowed to do the subcuticular stitches on a women after her abdominal sacrocolpopexy and right-salpinooopherectomy. I am slow at them, but I do a decent enough job. The following morning when I went to pre-round on the patient, she told me she married her husband while he was in medical school. She looked straight at me and asked, "did they let you close?" I nodded. She replied "let's get this dressing off and see if you're any good." I convinced her to wait until the resident joined us for work rounds and he took the dressing off. As he peeled it off, she peered at her abdomen. "I approve." The resident looked puzzled and I was beaming. Excellent start to the day.

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