Suture technique

Question 1

when to close

Answer 1

fresh wounds (hrs old) 
large clean wounds 
over cartilage or bone 
reduce scarring in cosmetic areas 
reduce bleeding
surgically debrided and irrigated wounds

Question 2

Dont close

Answer 2

old(days) or contaminated wounds (unless its in a cosmetic area)
abscess that are drained
wounds that have opened after previous repair
foreign bodies in the wound

Question 3

local anaesthetics for abscesses

Answer 3

do not work well due to the generally acidic environment

need to do a more proximal nerve block

Question 4

stitch for large abdominal wounds

Answer 4

use a running lock suture

Question 5

vertical mmattress

Answer 5

1 shallow and 1 deep stitch
placed at place of greatest tension

limits tension around wound edges

Question 6

pulley stitch

Answer 6

variation of the vertical mattress

used in areas of great skin tension, esp in people with more adiposity

Question 7

horizontal mattress

Answer 7

good for use in fragile tissues (lips, bw fingers, skin grafts, vasculature

Question 8

running subcuticular

Answer 8

completely invested in the tissue
best for cosmetic areas,

to avoid puckering, do not go straight across, go back a little

Question 9

tip stitches for wedge shaped wounds

Answer 9

use horizontal sutures NOT interrupted stitches

avoids limiting blood flow to the tip of the triangle

Question 10

how long do sutures stay in

Answer 10

face: 3-5
scalp- 7 
chest and extremities: 8-10
high tension areas: 10-14
back 10-14