General Surgery

Suturing lab

Suture may define as Any strand of material used to ligate blood vessels or to approximate tissue

1. Absorbable: Suture that is completely broken downby the body (dissolving suture)

2. Non-absorbable: Suture is not broken down (permanent suture)

2 basic types

Needle

Needle holder

Tissue forceps

Needle holder

grasping

Instrument handling

Suturing technique

The simple interrupted suture is the gold

standard and the most commonly employed suture.

same depth on each side of the incision or wound, otherwise the edges will overlap.

Sutures are usually placed approximately 5 to 7 mm apart and 1 to 2 mm fromthe skin edge,

Simple Interrupted Suture

Vertical mattress sutures may be

used when eversion of the skin edges is desired and cannot be accomplished with simple sutures alone.

Vertical mattress sutures tend to leave the most obvious and unsightly cross-hatching if not removed early

Vertical Mattress Suture

Horizontal mattress sutures

also provide approximation of the skin edges with eversion.

They are particularly advantageous in thick glabrous skin (feet and hand).

Horizontal mattresssuture

known as running simple sutures

can be placed rapidly but depend on the wound edges being more-or-less approximated beforehand.

A continuous suture is not nearly as precise as interrupted sutures

Continuous Over-and-Over Suture

Skin staples are particularly useful

as a time saver for long incisions or to position a skin closure or flap temporarily before suturing.

Staples must be removed early to prevent skin marks and are ideal for the hair-bearing scalp

Skin Staples

Skin tapes can effectively

approximate the wound edges, although buried sutures are often required in addition to skin tape to approximate deeper layers.

Skin tapes can also be used after skin sutures are removed to provide added strength to the closure

Skin Tapes

Skin adhesives have been developed,

and may have a role in wound closure, especially in areas where there is no tension on the closure, or where strength of closure has been provided by a layer of buried dermal sutures. Adhesives, by themselves, however, do not evert the wound edges.

Skin Adhesives

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