Question

Peter Smith is a 73-year-old male with a history of mild depression. He arrives at the clinic holding a bloody towel over his left forearm. He is taken immediately back to the treatment area. He states that he cut himself with a large knife while cutting a pineapple. You take his vital signs while waiting for the physician. You notice the blood is leaking through the towel. You need to control the bleeding.

You put on PPE, most importantly gloves, and apply a large dressing over the area, holding firm pressure. The physician arrives, examines the patient, and determines that the patient will need sutures. While you are preparing Mr. Smith for his wound repair procedure, he tells you that he recently started swimming for exercise and is going to the Bahamas for a snorkeling trip in 2 weeks. He wants to know if this will ruin his trip.

Discussion Questions:

1. What is the medical assistant’s role during this minor surgical procedure?
2. Why is it important to document the number of sutures Dr. Buckwalter uses to close Mr. Smith’s wound?
3. How should you answer Mr. Smith’s question about his trip to the Bahamas?
4. Knowing that Mr. Smith started swimming last week, what should you tell him about protecting his sutures?

Answer 1

• The role of medical assistant during this minor surgical procedure are;
• To assess whether all the needed equipment are ready for doing surgery such as appropriate size suture material , anesthetic agent for giving regional anesthesia, scissors, dressing set, gauze piece as well as cotton for cleaning the wound, sterile gloves, gown, mask and all the personal protective equipment etc.
• Note all the vital parameters of the client and note whether any elevated BP or heart rate is there before the surgery.
• Provide a pre anesthetic check up with an anesthetist if any general anesthesia is needed during the surgery.
• It is important to note the number of sutures because it is a major factor in wound healing.
• Also only if the number of sutures are counted then only we can determine how many sutures have to be removed during the time of suture removal.
• Mr. Smith can travel to Bahamas with some important precautions such as to apply pressure on the suture area to prevent wound dehiscence ( breaking of sutures).
• He should also take care to prevent bleeding from the site so he must carry some gauze and cotton needed to manage if any bleeding occurs.
• Also heavy weight lifting has to be completely avoided and manipulation of the hand has to be reduced.
• He has to make sure that the wound is not contaminated by any means.
• Even if any signs of infection such as redness or secretions occur then he must have to seek the doctor's help.
• In order to protect his sutures while swimming he can wear some protective devices or a plastic covering over the sutures to prevent the water to enter the wound and chance of infection can be prevented.

Note: sutures are done to maintain the integrity of the skin when a break in the skin happens. But with the appropriate precautions the patients can do their activities as before.