As some of you know I used to see patients at Saddleback San Clemente and take care of some of their emergency business. As I dropped off staff January 1st I figured I was done with emergencies for a while.
Less than 3 weeks following my staff resignation however I received a frantic call from a patient who had been seen in the emergency room in San Clemente. She was worried about how her newly closed eyebrow and forehead wound might scar. She said the staff in the emergency room promised her no scar. I would not have promised that. She indicated that she had asked for a plastic surgeon, but the emergency room doctor had closed the wound.
After a few minutes on the phone the woman asked if there was anything I could do. Well I needed to see the wound, but indicated most healed without much scarring. I ended up seeing her the following morning when I returned to San Clemente.
To make a long story short, I revised about 2/3rds of the wound where the exposed nylon was more likely to result in train track scars. I indicated to the patient that I might be able to reduce the scar, but nothing would eliminate it entirely. Removal of the black nylon sutures at areas not covered by eyebrow hair was advisable in my opinion. Alternative support was placed. That’s the plastic surgery part.
When you go to the emergency room, there will not always be a plastic surgeon available. When I saw patients in that San Clemente emergency room, about half would disappear when the bill came around. This tendency has made plastic surgeons less willing to take emergency room call. The emergency room doctor is exactly that. Understand that when you go.
John Di Saia MD
Originally posted 2011-01-19 10:00:35.