How do they take the Stitches out?

[Tokyo2008]

Hi,

I had my graft done in July 2008. I still have a significant amount of astigmatism and when I went to the hospital in January I was told that they would take some stitches out at my next visit, which was last tuesday. I went to the appointment expecting to have to sit in a chair really still while they pulled some stitches out however when I finally saw the consultant (2 hours after I arrived for my appointment) I was told that the stitches need to be removed in the operating room and I got the impression they were going to take them all out (I think I have about 12).

Anyway I was so suprised that I wasn't getting them out there and then, and so eager to get out of the hospital that I forget to ask any appropriate questions? For example:

Will it be done in a day or will I need to stay the night?

Will I need a general or a local anasthetic (honestly I never want to have another general anasthetic in my life!)?

Will I need time off of work (I went back to work much too soon after my graft, another thing I don't want to do again)?

Will I need to take any more drops (I'm still on Maxidex)?

I know these are all the questions to ask the consultant but I would be grateful if you would share your experiences with me, including anything I haven't thought of.

Thank you

Leanne

[GarethB]

Leanne

Welcome to the forum.

Generally speaking if only a couple of stitches are taken out a local anaesthetic eye drop is used and you barely feel a thing. Well I didn't.

If more are taken out a genral anaesthetic is used but only a light dose because it is so quick at removing the stitches and with so many removed your eye might be sore for a few days. It seems more common now for eye drops to be used longer and the whole thing is done as a day patient. I think the only time you would stay overnight is if there was a problem or there was no one take take you home and keep an eye on you.

When I had this done 20 years ago it was just an antibiotic cream 2 or 3 times a day for a week. Time off work however would be dependent on the type of work you so is best discussed further with you consultant as is the medication you wold use and the frequency.

When I had the stitches out from my second graft, the recovery from the aneasthetic was so quick I was deemed well enough to drive home, I'd only been in hospital for the Friday afternoon and I was back at work the middle of the following week as I'd taken time off to spend time with my family. I'd probably have been discharged sooner if my consultant hadn't been dealing with so many people that afternoon.

Hope this helps.

[rosemary johnson]

Fully empathise with your feelings on GAs!!!!
If you don't want one, refuse. Whole transplant ops are routinely done under local at some hospitals, or so I gather.
Only trouble you might find is a consultant who wants to insist on giving you a sedative.
Personally, there is no way under the sun I would ever agree to a sedative. Your mileage on that one may vary.
I'm at the stage of starting to ask eager questions about when I can get rid of this wretched stitch - the question of "how" will be the next hurdle. SO do keep us posted.
Rosemary

[Andrew MacLean]

Leanne

Welcome to the forum

In my case, they used suture removal as an aid to management of my post operative astigmatism. Removal involved a hospital admission and theatre visit. a light local anesthetic (eye drops) was administered and I got to join in the theatre banter.

There was music playing, but nobody asked me what I wanted to listen to. Still, they were there all day and I was only in for ten minutes. At least it wasn't as offensive as the music they play in some elevators.

I was dimly aware of some activity in the area of my eye, and worked out that I could tell when a suture was being removed. On the first occasion they removed 8. Next time they removed the other 8. With my second eye they removed all 16 in one go.

Andrew

[Vic]

I had a mixture of interrupted stitches and one continuous stitch that went all the way round the graft. When I had some of the individual stitches removed as a 'planned' thing, I would have up to 6 at a time removed at the slit lamp with some local anaesthetic drops. Unfortunately, my stitches seemed to have a habit of coming undone of their own accord at the most inopportune times, which usually necessitated a trip to eye casualty and the removal of the isolated offending stitch. Late one night (why is it always late at night?!) I felt the familiar feeling of something jabbing into my eyelid, and casualty confirmed it was my long continuous stitch that had come undone. A fairly junior SHO sat and removed the whole thing at the slit lamp; it took quite a while and the regular reapplication of anaesthetic drops, and he seemed as visibly relieved as me once it was successfully removed! Afterwards it was just the regular post-stitch removal course of chloramphenicol, and all was fine. I'm not sure whether, had I presented at a different time of day and there was someone more experienced on call that night, they might not have chosen to do it at the slit lamp. But I was perfectly happy with the care I got and having had it done in that way. I took one day off the next day because I hadn't got home from the hospital until the early hours and my eye was expectedly sore, and perhaps in retrospect I could have done with a second day off too, but otherwise that was all. Whilst it doesn't rate very highly for entertainment value, it certainly doesn't hurt and is just a bit fiddly, uncomfortable and time consuming (I think it took him about 45 minutes to get the whole of the long stitch out). Individual stitches are certainly much quicker to remove. I can genuinely say I would much rather go through that stitch removal at the slip lamp again than go to the dentist...

[ChrisK]

I had one continuous stitch.

When it came out I had to sit in the chair whilst he first cut all the joins and then using a small pair of tweezers pulled all the strands out.

Afterwards I was on a dose of eyedrops, I believe pred forte for a month. Started at a high dose and cut it down each week.

Glad I didn't have to go back to theatre to have mine removed. I didn't know on the day they were coming out either, it was a routine visit where he decided it was time to take them out.

[rosemary johnson]

ChrisK mentioned cutting all the joins:
How many were there??
I presume that means, places where one piece of thread finishes and the next starts, and there is a tiny knot where the ends and tied together?
I've spotted one little black lump which I presumed was a knot where he tied the beginning and end of the thread together,but only one. Maybe there are others further round where I haven't seen them yet.....!
Glad to hear some people posting about having stitches out at slit lamp, as thought I'd heard of this before, and certainly would rather not have to go back to a ward and theatre.
Rosemary

[tneedham]

I had a popped stitch removed at casualty 2 weeks post graft,

it was done under a slit lamp with anaesthetic drops. at that point i had no idea what my stitches looked like but now that i have taken some up close photos, i can see that the knot is on the inside of the graft (i have 16 (now 15) individual stitches)

I have 2 questions about this
1 - how do they remove it when the knot is on the inside?
2 - How on earth did they tie it in the first place????

Tom

[Andrew MacLean]

don't know the answer to your first question, but when I was at university one of my friends was a post graduate medical student, interested in cardio-vascular surgery. He is now a quite eminent heart transplant surgeon, whom I shall not embarrass by revealing his name. We were sitting in his flat one evening drinking wine and watching the election results. His girl friend (now his wife) got up and went to make some tea. Running her hand through her hair she realized that he has tied neat little knots in it while she thought he was lovingly stroking her hair.

So, the answer to your second question, is 'they practice'.

Andrew

[rosemary johnson]

At a guess...... they tie neat little knots onthe outside, and the stitches wriggle themselves round so the knot ends up on the inside.
They presumably them have to snip the plain thread outside and tug the knot free.
Rosemary