• Minimize trauma in skin handling
  • Gentle apposition with slight eversion of wound edges
  • Make yourself comfortable
  • Adjust the chair and the light

Types

Simple Interrupted SuturingZ


The trick to an instrument tie

  • Always place the suture holder parallel to the wound’s direction.
  • Hold the longer side of the suture (with the needle) and wrap OVER the suture holder.
  • With each tie, move your suture-holding hand to the OTHER side.
  • By always wrapping OVER and moving the hand to the OTHER side = square knots!!

Suturing - finishing

  • After sutures placed, clean the site with normal saline.

  • Apply a small amount of Bacitracin or white petroleum and cover with a sterile non-adherent compression dressing (Tefla).

Suture Removal

Average time frame is 7 – 10 days

  • FACE: 3 – 5 d
  • NECK: 5 – 7 d
  • SCALP: 7 – 12 days
  • UPPER EXTREMITY, TRUNK: 10 – 14 days
  • LOWER EXTREMITY: 14 – 28 days
  • SOLES, PALMS, BACK OR OVER JOINTS: 10 days

Any suture with pus or signs of infections should be removed immediately.

  • Clean the wound to remove any crusting or dried blood

  • Using the forceps, grasp the knot and snip the suture below the knot, close to the skin

  • Pull the suture line through the tissue- in the direction that keeps the wound closed.