Insoluble soluble suture removal

Step 1: apply lidocaine (sharp scratch, followed by mild burning)
Step 2: poke around with syringe
Step 3: poke around with a blade
Step 4: apply more lidocaine 
Step 5: use forceps to forcibly remove insoluble soluble suture 
Step 6: squeeze and stretch the area enthusiastically to ensure the objectionable material is gone
Step 7: poke around with all tools again
Step 8: close the wound with a single stitch 
Step 9: dress.

Ze Stuart

Ze Stuart