The correct answer is D.
For a clean and dry surgical site, the appropriate steps for suture removal are as follows: Clean the incision with antiseptic cleanser → Use forceps to lift the suture → Slip the suture scissor beak under the stitch and snip → Repeat until all sutures are removed.
The site should always be cleansed with antiseptic prior to pulling sutures through the skin. Remember that the visible sutures may contain bacteria so you don't want to pull them through the skin until they are sterilized.
Wrong Answers:
Option A. The question stem points out that these are nonabsorbable sutures and therefore these sutures will not dissolve on their own.
Option B. This is a clean and dry surgical site. This amount of redness seen is common and caused by irritation by the nonabsorbable sutures. Prior to scaring a patient about a possible wound infection, you should consult the physician and have them make a diagnosis of wound infection. Any draining pus, excess erythema (redness) or wound dehiscence (splitting) should be brought to the attention of the physician prior to cleansing the area. An infected surgical site should be cultured prior to cleansing with antiseptics and ideally prior to starting antibiotics.
Option C. Even for a clean incisions, antiseptic cleanser should be used prior to suture removal. Visible sutures may contain bacteria so you don't want to pull them through the skin until they are sterilized.
Learning Point: At the suture removal appointment, physicians will typically evaluate the surgical site prior to suture removal. Once you are seasoned at evaluating incisions, you may be asked to assess incisions and perform suture removals on your own without the physicians input. You should not only recognize signs and symptoms of possible wound infections, but also understand proper suture removal techniques as to not create a wound infection from improper suture removal technique.
