Surgical Technology: Suture Technique Technique General Interrupted TechniquesSimple Interrupted (“Baseball Stitch”)Most Fundamental TechniqueEasy & StrongHorizontal MattressMinimize TensionRisk of Strangulation/Hypoxia at EdgesVertical MattressMaximize EversionMinimize TensionDeep DermalBuried KnotUsed to Reduce Tension Prior to Skin Approximation A. Simple Interrupted, B. Horizontal Mattress, C. Vertical Mattress 1 General Running TechniquesSimple RunningLess Risk of ScarringFaster for Long RepairsRunning Locked (Ford Interlocking)Allows Each Throw More IndependenceGood for Long Laceration with a Slight CurveRunning Horizontal MattressBetter Cosmetically than Simple RunningRunning SubcutaneousRapidThrough Deeper Subcutaneous TissueRunning SubcuticularApproximate Edges to Enhance Cosmetic ResultsNo Strength – Must Not Be Under Any Tension A. Simple Running, B. Running Locked, C. Horizontal Mattress, D. Running Subcuticular 1 Edge-Inverting TechniquesLembertInverts Edges to Close Hollow OrgansDoes Not Involve Mucosa with Low Risk of ContaminationCan Produce Mild Stenosis of BowelHalsted (Interrupted Quilt)Combination Lembert & Horizonal MattressCushingBites Placed Parallel to EdgeBites Do Not Penetrate the LumenConnellBites Placed Parallel to EdgeBites Penetrate the Lumen A. Lembert, B. Halsted, C. Cushing, D. Connell 1 Other Specialized TechniquesBrooke SutureUsed to Mature an OstomyEverts Mucosa Full-Thickness & Avoids Serosal Exposure to Stoma OutputFull-Thickness of Bowel to Proximal Seromuscular Layer & Then Dermis of Abdominal WallPurse StringTo Close Hollow Organ or Round DefectsFigure-of-EightAdds StrengthCommonly Used for Bleeding Vessel Ligation Brooke Suture Purse String Suture Figure-of-Eight Suture 2 Knots Square KnotMost Basic KnotTwo Throws in Opposite DirectionsSurgeon’s KnotInitial Throw is Pulled Through TwiceSecond Throw in Opposite DirectionMore Stable than Square KnotGranny KnotTwo Throws in the Same DirectionTypically Referred to as Poor TechniqueNot as Strong as Square Knot – Can SlipSurgical Slip KnotKeeping Tension on One End the Initial Knot is Thrown Twice in the Same Direction and then Pulled TightPurposeful Granny KnotFollowing Throws in Opposite Directions to LockAllows Tightening of Knot to Ensure StrengthAberdeen KnotThrows – Suture End Partially Pulled Through Loop to Form a New LoopTurns – The Number of Times the Final Suture End is Passed Through the Final Loop“Ultimate” – 3 Throws & 2 Turns (Previously Recommended 6 Throws & 1 Turn)Benefits: Stronger, More Secure & Uses Less Suture Basic Suture Knots Aberdeen Knot Suture Removal Timing Timing by SiteFace: 3-5 DaysNeck: 7 DaysScalp: 7-10 DaysTrunk: 10-14 DaysArms: 10-14 DaysLegs: 14-21 Days References Madaktari Inc. Consultancy Medical Solutions Unit – MCMSU Dr. George LeoRusnack F. emDocs (License: CC BY-4.0)