Equis ISSN 2398-2977

Surgery: suture patterns - basic patterns

Contributor(s): Stephen Adams, Debbie Archer, Graham Munroe

Simple interrupted

Uses
  • Most widely used including:
    • Skin.
    • Subcutis.
    • Fascia.
    • Blood vessels.
    • Nerves.
    • Gastrointestinal tract.

Advantages

  • Secure closure with precise application of tension possible.
  • Simple and quick to perform.

Disadvantages

  • Excessive tension   →   inversion.

technique

  • See diagram   Surgery: suture patterns - simple interrupted  .
  • Insert the needle and suture at a variable distance from the wound edge depending upon its thickness (less for thin skin).
  • Cross the wound at right angles and insert through tissue on the other side - work from right to left if a right-handed surgeon.
  • Tie knot .
  • Tension on the suture at tying should appose the wound edges only, with the knot offset to the incision.
  • Spacing of sutures depend upon wound tension, but every 1 cm is usual - there should be no gaping between sutures.
  • The suture can be modified to allow intradermal skin closure by placing the suture upside down in the dermis.

Simple continuous

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Interrupted horizontal mattress

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Interrupted vertical mattress

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Less common patterns

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