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Types of sutures
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Assessment of the suture line: ¨ Stitched too tight or too loose ¨ Too many or too few stitches ¨ Suture holes not equidistant for the edges so that the bite is not uneven, or uneven spacing between sutures ¨ Inversion or eversion of tissue edges ¨ Edges of tissue overlapping and heaped on each other.
Types of stitch:
Simple interrupted suture Inserted singly through each side of the wound and tied with a surgeon’s knot. Several of these may be used at short intervals ( 4—8mm apart) to close large wounds and share tension. Easy to keep clean, can be replaced singly and will evert edges of the flap.
Horizontal mattress suture Evert the mucosal or skin margins, thereby bringing greater areas of raw tissue into contact. Useful for closing wounds over bony deficiencies such as oro-antral fistulae or cyst cavities.
Vertical mattress suture Specially designed for use in the skin. Pass through at two levels: (i) Deep—provides support and adduction of wound surface (ii) Superficial—draw edges together and evert them
Continuous suture Disadvantaged that if they cut out at one point the whole suture will slacken. Advantage—only two knots present. ¨ Simple continuous— applies pull on the wound obliquely ¨ Continuous blanket stitch—more firm and stable. Gives traction on the wound edges at right angles to the wound ¨ Purse string suture—useful as a deep suture for wounds of the skin of the face.
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