human body muscles: SUTURE MATERIALS AND SUTURING TECHNIQUE

Sunday, March 15, 2015

Materials required

Skin suturing

Wound should be closed with minimum tension
Edges of skin should gape slightly to allow swelling due to inflammation. If wound is closed tightly edge necrosis may occur
Needle should be held at a point 2/3rd from tip of the needle
Needles are inserted at right angles to the skin for simple suture using a supination pronation movement of the wrist
Entry and exit points should be nearly the same distance from the wound edge as the thickness of skin being closed

The edge of wound is gently lifted with forceps while the needle is inserted
Edges should be everted slightly. If suture is enters and exits from the skin at an acute angle wound may become inverted with poor healing
As the suture is tightened, knot should be drawn to one side to facilitate suture removal
When a non-absorbable suture is to be removed, it is cut immediately beneath the knot and pulled out by knot. This results in contaminated part of suture material being lifted away without being drawn through the wound

The ends of knot should be left long enough to be easy to grasp while removing yet not too long to get tangled with nearby structures
As a general rule each suture should be separated by a gap that is twice the thickness of skin
Stay sutures should be applied in wounds with curves or zigzags for correct orientation
Non absorbable skin sutures should be removed when wound has healed to prevent scarring, infection and irritation. It is removed from face after 3-5 days, 5-7 days from scalp, 7 days from back, 10 days from abdomen and 10-14 days from limbs
Any suture with pus or signs of infections should be removed immediately

Types of wound closure

Simple interrupted– most commonly used, good for shallow wounds without edge tension

Continuous (running sutures)– good for long wounds with minimal tension

Locking continuous - useful in wounds under moderate tension or in those requiring additional hemostasis because of oozing from the skin edges

Subcuticular – good for cosmetic results

Vertical mattress – useful in maximizing wound eversion, reducing dead space, and minimizing tension across the wound

Horizontal mattress – good for fragile skin and high tension wounds

Tension suture – for support in wound under very high tension