President Obama’s Injury: What Does “12 Stitches” Mean?


Simple interrupted suture (scheme)

Interrupted Sutures

Yesterday, the President caught an elbow during a basketball game and suffered a lip injury.  News reports stated that he had 12 stitches applied under local.  Does that mean anything?  Sort of, but not really.  Everyone is always fascinated by the number of stitches needed to fix a cut.  You will get this question almost every time you sew somebody up in the emergency room (if you do that sort of thing).

Of course it is important for reporters to determine what the injury is, how serious it is, and so forth.  Stitch counts are not going to go away, but they are not that meaningful.  Here’s why:  the number of sutures required for a cut can vary widely, and are largely arbitrary.  Some surgeons put them in very close together, others farther apart.  This depends on the surgeon’s background, experience, habits, suturing technique, and so forth.  So a “12 stitch” cut isn’t necessarily bigger than a 6 stitch cut, or smaller than a 20 stitch cut.  (I am guessing that being the President will get you about 20% more stitches.  That doesn’t mean a better outcome).

So how should the cut be described?  I suggest length and location.   Those are better and more informative.  You can also give the depth, but that is getting overly technical.  “The President suffered a two-inch cut to his upper lip that was fixed with stitches.”  Or, “a one inch scrape to his cheek that did not need stitches.”  Note I did not use the metric centimeters (preferred in actual medical discussions but not suited to news articles).

From the AP:
The medical unit that treated Obama used a smaller filament than typically used, which increases the number of stitches but makes a tighter stitch and results in a smaller scar

Sounds reasonable, but you don’t really want the closure “tight”, and the length of the scar will be affected only minimally.  Its possible a running subcuticular (under the skin) suture was used to keep the closure short.

No word yet on what happened to the guy who elbowed him!

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