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Suture Patterns

Some suture patterns

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loverpes604
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94 views

Suture Patterns

Some suture patterns

Uploaded by

loverpes604
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Surgical suture patterns

By Dr.Radhwan R.K. AL-Ajeli


Department of Veterinary Surgery
College of Veterinary Medicine
It is meaning these methods or techniques are
used for connecting (sewing) the tissues together.
these patterns can be classified into various types
according to different criteria.
Classification of suture patterns
1. According to the number of passages through tissue
on each side of incision,

A. Simple: -
Directly apposes tissues by a single passage through the
tissue on each side of the incision and after that it is tied.
B. Mattress: -
Apposing tissues by double (2) passages via the tissue on
each side of the incision after that it is tied.
2- According to the position of wound edges following suture
placement: -
A- Apposing patterns: -
Bring the wound edges in direct apposition.
B-Everting patterns: -
Usually tend to turn the wound edges outward (to outside).
C-Inverting patterns: -
Turn the tissue edges inward (to inside).
D-Overlapping patterns: -
One edged of the wound will become over the other edge.
3. According to the number of knots within the tissue

A. Interrupted suture patterns: -


There are many knots within the tissue (more than 2 knots),
that are shortly or quickly severed and tied separately
B. Continuous suture patterns: -
There are only 2 knots within the tissue, they are not shortly or
quickly, and they begins from point(beginingof wound) to
end point and then cut and tied.
Interrupted suture patterns Continuous suture patterns

1 Time consuming. Less time consuming.

2 Large amounts of suture materials. Fewer amounts of suture materials.

3 Presence of additional amounts of suture Less suture materials within the tissue.
materials within the tissue.

4 Ability to maintain strength and tissue Unable to maintain, if one knot is


position if part of suture line fails or slipped, fail or tear out the entire
tears. suture line become loosened.

5 Provide more accurate edge to edge Difficult to gain accurate edge to edge
apposition. apposition.

6 Less scar tissue formation in the healed More scar tissue formation.
wound.
4- According to the type of tissue to be sutured: -
A-Internal suture patterns: -
means these techniques which are used for suturing of
internal hollow organs which their walls consist of 4
layers (mucosa, submucosa, muscularis, serosa) such as
GIT, urinary tract, uterus…..etc.
B-External suture patterns: -
Include these techniques which are used for suturing of
skin, subcutaneous tissues, fascia, peritoneum and
muscles.
C-Special suture patterns: -
Include these sutures that are used restrictedly for
suturing of specific organs such as tendon which usually
sutured by bunnell suture technique.
Interrupted suture
patterns
1. Simple interrupted suture technique:
Each suture in this technique is individually tied and cut ; each
suture is a unit.
Advantages
A- Its ability to maintain strength and tissue position if part of
suture line fails.
B-Easy and rapid technique.
C-Decreased tissue edema following closing compared with
continuous suture patterns.
D-Produce tissue apposition.
Disadvantages;
A- Greater amount of suture materials.
B- Time consuming.
C- Presence of additional suture materials within tissue in
forms of knots.
D- Have minimum holding power against

Simple interrupted suture technique


2. Horizontal mattress:
It’s a tension suture, useful in suturing the skin
Advantages;
A- Small amount of suture materials.
B- Rapidly applied.
C- Tension type of suture patterns.
Disadvantages;
A- Causing excessive eversion of skin.
B- Its tendency to decrease blood supply to skin edges.
Horizontal mattress pattern
3. Vertical mattress:
Also it’s a tension suture pattern, it’s stronger than
horizontal technique. Vertical mattress is precise edge to
edge apposition with slight eversion of edges when the
suture is tied.
Advantages;
A- Tension type suture.
B- Provide tissue apposing.
Disadvantages;
A- Time consuming technique.
B- Required increased amounts of suture materials.
C- Cause more inflammation owing to 4 penetrations by
needle.
Vertical mattress pattern
4. Cross mattress suture (the X mattress):
Its modification of mattress suture; it’s resemble 2 simple
interrupted sutures joint together.
Advantages;
A- Tension type suture patterns that provide strength.
B- Bringing tissues into apposition.
Disadvantages;
A- Large amounts of suture materials.
B- Time consuming technique.
Cross mattress pattern
Continuous suture patterns
1. Simple continuous suture pattern:

Consist of series of simple interrupted sutures that are tied at the


beginning and end but are continuous between these points.
Usually is used in tissues that required minimal holding also
Used for closure of subcutaneous tissue and fascia in non-tension
areas because it is undesirable for wound that are under tension
Advantages;
A- Rapid and easy technique.
B- Minimal amounts of knots within tissue (only 2 knots).
C- Minimal amounts of suture materials.
D- Easy removed after wound healing.
Disadvantages;
A- The success of whole pattern is depending on each of its
parts so knot slippage or break is likely to cause failure of
the entire suture line.
B- Increase wound edema.
C- Decrease blood supply to the wound edges.
D- Have low tension strength.
Simple continuous suture pattern
2. Lock-stitch, Ford interlocking suture,
Reverdin’s suture technique:
It is modified of simple continuous suture technique.
Advantages;
A- Tension type suture techniques.
B- Greater stability in the event of partial failure (failure of
knot is not necessarily result in failure of the entire suture
line).
Disadvantages;
A- Large amount of suture materials used and left in incision.
B- If it is applied to skin there is slightly difficult to remove.
Lock-stitch suture technique
3-Subcuticular suture or closure:
This technique is used to eliminate scars formation in
tissue especially the skin so it is usually used in cosmetic
surgery.
Advantages;
A- Rapid technique.
B- Utilize very little suture materials.
Disadvantages;
A- Does not have good strength.
B- Usually subjected to removed by biting, licking or
scratching by domestic animals.
Subcuticular suture technique

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