Effect of simple interrupted suture spacing on aesthetic and functional outcomes of skin closures. The main reasons for placing a suture are to stop bleeding and inhibit infections from making. Section ii attempts to unravel the mystery of placing and tying sutures. Suturing techniques and common surgical procedures. The knot should be positioned away from the incision see simple interrupted above. Over the years, research on acute wound healing has resulted in the development of technologies such as staples and adhesives e. This suture will be the anchor for the rest of the suture line.
To view the videos, you must have real player installed on your computer. The second video is a demonstration of three of the most common errors i see students and resident make as they learn to. The suturing materials and techniques used to reconstruct the planes can thus have a direct and determinate influence on the phases of healing, making an indepth and detailed knowledge of the physical, chemical and technological properties of suturing materials an absolute necessity. For our ophthalmology residents, learning these basic concepts of suturing. Meyle suture materials and suture techniques figs 10a and 10b approximation of the wound edges after tooth extraction by overlying, crossedover mattress stitch. An overview on current techniques for knotting and suturing.
The key instruments and materials used for intraoral suturing are presented. Suturing is a term used to describe the closing of a wound, artery, or part of an organ using a specific needle and thread. Polyglactin 910 vicryl it is a synthetic heteropolymer consisting of 90% of glycolide and 10% of lactide. Other suture techniques the technique for a mattress suture is shown below. Suturing techniques indications and contraindications here are some guidelines for the inexperienced to help you decide on which suturing technique to use.
Sutures and wound closure techniques introduction this booklet is intended as an introductory guide to sutures and suturing techniques. To demonstrate the basic principles of suturing for the closure of cutaneous surgical wounds. Among these novel techniques, interrupted oblique intradermal suture ois is recognized for its simplicity 6 which increases its potential of becoming one of the standard suturing techniques in. The line of stitches is completed by tying a knot after the last pass at the end of the suture line. This easytonavigate procedural skills activity is designed to help family physicians perform the most common suturing techniques.
There are many circumstances in which sutures are used to repair tissue and facilitate healing. These techniques demands the proper selection of needles that can be passed through ports without damaging the port sleeve or distorting the shape of the needle as it passes through. Types of suturing techniques simple interrupted suture. These sutures are braided, multifilament, coated, absorbable synthetic sutures. A disadvantage of this technique, as for all running sutures is the risk of wound dehiscence in case of suture breakage. The time to suture removal depends on the location and the degree of tension the wound was closed under. The downside to this technique is the worsening of cosmetic results. Approaches to surgical wound, laceration, and cosmetic repair. Instructional video on how to perform simple interrupted sutures, interrupted subcuticular sutures, vertical mattresses and corner stitches. The biomechanical study of rupture of achilles tendon and repair by different suture techniques.
Basic suturing skills and techniques boston college. Successful suturing techniques require careful attention to both function. These include wound tension, desire for wound edge eversioninversion, desired hemostasis, repair type, patients ability to care for the wound and return for suture removal, skin integrity, and wound location. Surgical suture is a medical device used to hold body tissues together after an injury or surgery. These create increased wound eversion and tensile strength which can be useful for refractory bleeding wounds and for complex wounds. From simple tissue pads that look, feel and suture like human, to complete technical skills packages for knot tying, injection, instrument handling and general suturing practice, simulab has solutions that help 70% of u. Sutures and suturing techniques strength remains with polyglycolic acid suture, in contrast to 0% of surgical gut suture. The choice of suture materials gen erally depends on whether the wound closure occurs in one or more layers. Stoecker a, blattner cm, howerter s, fancher w, young j, lear w. The techniques for a mattress suturing are shown below. The simplest and most common suturing technique usually used to close skin, but is suitable for almost all wound types. Most simple suture to use and suitable for almost all situations. The amount of tension that the wound will receive postoperatively. Suturing techniques simple interrupted running or continuous vertical mattress horizontal mattress subcuticular running or continuous buried suture.
Sutures should be evenly spaced, and tension should be evenly distributed along the suture line. Figs 9a to 9h simple interrupted suture on phantom flesh. Techniques of wound suturing basic and advanced suturing one of the most important components of wound care and management, repairing of moderate to serious lacerations andor wounds resulting from surgery or other procedures is the. In its pages, the author shares his vast expertise and it is his intention to help physicians across many specialties to improve outcomes for patients. Simple interrupted suture most simple suture to use and suitable for almost all situations needle is inserted in one side of the wound and out through the wound itself suture should extend through. In eye surgery, due to the lack of elasticity of the tissues and the influence of sutures on the visual. A historical glimpse of suturing the apprentice doctor. Residents ssutures and suturing techniques in skin. To learn the basics of suturing prior to trying these out click here. In addition, continuous suturing can be performed in a faster way than simple stitches.
Interrupted sutures are sutures that are placed and tied individually. It may be used to effect hemostasis or to close off a structure to prevent leakage. Although suture materials and aspects of the technique have changed, the primary goals remain the same. As suturing skills are so fundamental to all of surgical practice, it will be important to continue to practice these suturing techniques beyond the surgical skills laboratory session. Whilst sutures create conditions for primary healing, inappropriate selection and technique can have an adverse effect by increasing infection risk, impairing local circulation or causing further tissue injury. For the inexperienced this is the preferred technique due to its ability to close a wound cleanly and securely. Table 1 are placed into subcutaneous tissue to eliminate dead space and into the dermis to minimize tension during wound healing. Participants will have the opportunity to demonstrate basic suturing techniques. Contentsintroduction history definition goals of suturing suture materials introduction requisites of ideal suture classification selection of suture material absorption of suture material biological response of body to suture. The modules below consist of stepbystep instructions and streaming video demonstrations of basic knot tying and suturing techniques. Approaches to surgical wound, laceration, and cosmetic repair by.
Successful dental suturing ororal surgery is dependent on accurate coaptation of the. Suturing definition of suturing by the free dictionary. Professor magdy amin riad professor of otolaryngology. This varies between surgeon and situation, but as a. Amongst its advantages is that continuous techniques are more resistant to simple stitching. Application generally involves using a needle with an attached length of thread. The downside to a mattress technique is the worsening of cosmetic results. Objecti esobjectives provide basic information on commonly used suture materials. Most surgical skills laboratories will make available synthetic skin or pigs feet for independent practice to improve both technique and speed of suturing. Approaches to surgical wound, laceration, and wound repair presents the building blocks of suturing and wound repair in an ataglance, economical atlas format.
Suturing has come a long way since its conception and suture kits offered today contain top sterile equipment and materials to perform wound stitching properly which significantly reduces both infection and scarring. Mayo clinic school of continuous professional development. Dental suturing materials and techniques juniper publishers. This is an important issue, as it will determine the number of throws needed to hold the knot.
Holding the needle with needle holders, place a simple interrupted suture and knot it, but only cut the end of the suture material that is not attached to the needle. Basic suturing techniques by cape town emergency medicine. The amount of weight required to break a suture divided by its crosssectional area. In any surgical field, the importance of suturing is self evident. The techniques that you use, the suture material you use, and the specific type of needle you use will vary depending on whether you are closing a simple laceration on the foot, a complex laceration on the face, a gastrointestinal anastomosis, a vascular anastomosis, or closing a median sternotomy. Suturing techniques procedural online access package. However, learning the various suturing techniques can be a trying experience.
Closing dead space supporting and strengthening wounds until healing increases their tensile strength approximating skin edges for an aesthetical. Ophthalmic microsurgical suturing techniques extras springer. Hemostasis and inflammation days 15 vasoconstriction and platelet aggregation angiogenesis occurs in 48 hours poor tensile strength wound closure and healing dependent on. Needle is inserted in one side of the wound and out through the wound itself. Basic suturing and wound management school of medicine. Under this subheading, youll find links to some of the more advanced suturing techniques employed for wound closure in emergency medicine practice. Endoscopic surgery requires suturing within closed spaces or body cavities. Figs 9e and 9f then the ends of the thread are joined together using a surgeon s knot. The horizontal mattress is most commonly used in ed.
Mattress sutures create increased wound eversion and tensile strength. Simple interrupted suturing is the most basic and most important of the suturing techniques. Tensile strengththe load per crosssectional area unit at the point of rupture, relating. As a method for closing cutaneous wounds, the technique of suturing is thousands of years old. A doctors guide to surgical knots and suturing techniques used in the departments of surgery, emergency medicine, and family medicine m. Suture should extend through the full depth of the dermis. The basic suturing workshop covers instrument basics such as suture types and selection, proper loading of the needle, wound assessment, local anesthesia, aftercare, and documentation. This suture causes the wound edge to evert and is mainly used for mobile skin or skin which is not wellsupported, for example the skin on the shin. Explore suturing kits, pads, instruments, video curriculum and more. Suture materials and suture techniques perio periodontal.
Suturing techniques different types of suture with videos. Interrupted sutures continuous sutures the sutures material and structure. Ain shames university senior lecturer in otolaryngology university of dundee ligatures a suture tied around a vessel to occlude the lumen is called a ligature or tie. Learn how to knot and suture with your partner in surgery. The parameters for measuring the strength of normal body tissue are. This can be useful for the refractory bleeding wounds and complex wounds that are seen in the ed. Careful consideration of these factors and proper execution of suturing techniques can lead to excellent cosmetic results. A number of different shapes, sizes, and thread materials have been developed over its millennia of history. Suturing in the mouth further complicates the situation.
1052 222 706 379 1543 731 1085 3 1018 201 300 260 598 817 1031 155 540 1003 893 1553 1256 1363 1072 197 1182 1213 990 987 470 139 1308 453