Equis ISSN 2398-2977

Surgery: suture patterns - overview

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

Introduction

  • A large number of suture patterns are available for use under different circumstances.
  • The experienced surgeon will only utilize a minimum of these patterns and will be familiar with their advantages and disadvantages.
  • Choice should be based on the basic concept of providing the wound with maximum security with minimal alteration to healing.
  • Sutures may be placed in two main types of patterns   Surgery: suture patterns - basic patterns  :
    • Interrupted.
    • Continuous.
  • Interrupted:
    • Provide more security from suture breakage.
    • Increased surgery time.
    • Greater volume of material left in wound.
    • Less holding power against wound stress.
  • Continuous:
    • Prone to dehiscence if any portion of suture line fails.
    • Quicker to place.
    • Leave less suture material in wound.
    • Superior in wound-bursting strength (surprisingly!).
  • Suture patterns may be:
  • Wounds should be sutured with just enough tension to bring the edges into light apposition.
  • Tension sutures:
  • Wounds with large defects or tissue loss are difficult to close without excessive tension which can   →   cut through or cause tissue strangulation ultimately   →   wound breakdown:
    • Should be used to redistribute the tension.
    • Used to close traumatic lacerations and surgical wounds over bone plates.
    • Placed away from the wound edges to prevent strangulation.
    • Used to draw the wound edges closer together.
    • Simple interrupted sutures   Surgery: suture patterns - simple interrupted  can then be used to complete the closure without excessive tension.
  • Types of tension sutures:
    • Interrupted vertical mattress   Surgery: suture patterns - vertical mattress  .
    • Horizontal mattress   Surgery: suture patterns - horizontal mattress  .
    • Walking sutures   Surgery: suture patterns - walking  .
    • Quilled sutures.
    • Stent sutures.
  • See:

Staples

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Knots

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