Types Of Sutures

Write a brief answer on types of sutures.

Answer. Following are the types of sutures:

Interrupted Sutures

Interrupted sutures are most common type of suture and are universally used.

Used to close oral mucosal incisions and skin wounds.

“Absorbable Vs Non-Absorbable Sutures”

Sutures Technique

Needle should be held two-thirds the distance from tip of needle with needle holder.
Needle is passed via one side of the flap perpendicular to the tissues and brought out along the curvature of needle.
Needle is now passed via other flp at same distance from edge of the flp and also at the same depth.
It is brought out of the flp along with suture material till 3 to 4 cm of free end of suture material is left.
Now needle should be held in the left hand and wound around the needle holder once or twice depending on the type of knot.
Free end of suture material is grasped with beaks of needle holder.
Material which is wound around the needle holder is made to slip over the beaks by slow pulling on needle end of suture material.
Free end of suture material should be pulled minimally.
Knot is stabilized in the manner that it comes to one side of the flp. It should not rest along edges of wound.
For completion of knot, hold needle in left hand and roll suture material around the beaks of needle holder in opposite direction.
Now again grasp free end of suture material and slide suture material over free end to stabilize the knot.
Hold both the free ends and needle end of suture material taut for assistant to trim them with scissors leaving 3 to 4 mm.

“Best Suture Types For Surgical Procedures”

Mattress Sutures

Horizontal Mattress Sutures

They are used in areas where there is underlying bony defect.

Horizontal Mattress Sutures Technique

Needle is fist passed via one flp and at same vertical level through other flp similar to placing ofan interrupted suture but the knot is not placed.
Needle is now passed at the distance 3 to 4 mm parallel horizontally where the needle was passed through the second flp.
Now it is passed via the fist flp at same vertical level as last bite.
In this way, the needle comes back via the same flp where it is started at a distance of 3 to 4 mm from entry point.
Now the knot is placed and is stabilized over that side.

“Applications Of Surgical Sutures In Medicine”

Vertical Mattress Suture

They are used to close skin wounds mainly in areas where edges of skin tend to invert.

Technique

In this needle is fist passed far away from wound edges and then nearer or at a more superficial level.
Needle is passed via one wound edge taking a deep bite of tissue almost 4 to 8 mm from wound edge.
It is now passed through other edge at same depth and brought out. Knot is still not placed.
Needle is now turned around and passes backward through second flp at a level closer to wound edges.
Needle is now passed via one flip at same superficial level and is brought out. In this way, both edges suture material are on the same side.
Knot is now placed and stabilized on side where the suture fist began.

Continuous Sutures without locking

They are used to suture large wounds. Intra-orally, they are used when full quadrant alveoloplasty is done.

“Comprehensive Overview Of Suture Applications In Surgery”

Continuous Sutures without locking Technique

At fist time place the interrupted suture.
While cuttng the suture ends, cut the free ends leaving the suture material with needle behind.
Needle is now passed via flaps of wound alternately to get continuous oblique sutures all along the length of wound.
At the end of wound, knot is placed by loop of the suture and the needle end of suture material.

Continuous Sutures with locking

Continuous Sutures with locking Technique

First of all an interrupted suture is placed.
Now the needle is passed through the loop made by suture material.
Assistant should be made to follow the suture by holding suture material close to the tissues where needle was last passed via the loop.
Each time needle pass through the flp and under the suture loop, assistant should hold suture material tightly close to the tissue to prevent suture material slipping and becoming loose.
At end of suture line the knot is made with suture loop and the needle end of suture material.

“Understanding The Properties Of Surgical Sutures”

Subcuticular Sutures

They are used for closing the cosmetic wounds.

Subcuticular Sutures Technique

For this type of suturing technique non-absorbable monofiament suture is used.
First the suture is passed via skin at one end of the wound such that the needle is brought in the wound.
Needle is now passed alternately through opposite wound edges completely in subcuticular layer without piercing the skin and without placing the knot anywhere in the wound.
At the end, needle should be brought again through edge of the wound through skin.
Pull the suture material tightly to get good approximation of wound edges without any bunching.
Trim the suture materials to leave long ends and taped on both ends to secure from slipping.

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