Wounds or cuts can also be held together in other ways such as: In the United States, suture diameter is represented on a scale descending from 10 to 1, and then descending again from 1-0 to 12-0. 2005 Oct. 31(10):1313-6. If tissue ruptured postoperatively, tension would be distributed more broadly. In addition, the entire suture should exhibit a wider base on the layer beneath the skin, forming the shape of a flask. Because the presence of foreign bodies in contaminated tissues may facilitate infection, special consideration of suture selection in these locations (eg, a contaminated posttraumatic wound) is imperative. These are sutures manufactured from chemical synthesis. If wound tension is high, smaller-diameter sutures may actually injure tissues by cutting through them. Sutures are no longer needed when a wound has reached maximum strength. This type of suture being absorbable is not to be used where prolonged approximation of tissues under stress is required and/ or in conjunction with prosthetic devices Precautions: Special precautions should be taken in patients with cancer, anemia and malnutrition conditions. Example of monofilament sutures are Nylon, Prolene, Polydioxanone (PDS). Flap tip necrosis and complications were comparable to that of standard sutures 15). You should always cover the scar with at least SPF 30 sunblock or zinc cream, wear clothing that covers the scar and stay in the shade. Modern sutures range from #5 (heavy braided suture for orthopedics) to #11-0 (fine monofilament suture for ophthalmics). If your sutures are not the dissolvable type, see a doctor or nurse when it is time for them to be removed. In these areas, tensile strength requirements tend to be less, and smaller suture sizes are preferred. The first stitch is tied in a knot but not cut, and the remaining stitches are not tied or cut at all until the last line. As the procedures improved, #0 was added to the suture diameters, and later, thinner and thinner threads were manufactured, which were identified as #00 (#2-0 or #2/0) to #000000 (#6-0 or #6/0). Once irrigated, switch to sterile gloves and cover the area with a sterile fenestrated drape. Suture materials are therefore manufactured in a variety of sizes. Disadvantages of running subcutaneous sutures include the risk of suture breakage and the formation of dead space beneath the skin surface. Dermatol Surg. Risks associated with anesthesia and laceration repair. Absorbable buried sutures are used as part of a layered closure in wounds under moderate-to-high tension. There are many other types of sutures, such as continuous locking sutures and purse string sutures. Use a high pressure, direct stream in all areas of the wound. Wade RG, Wormald JC, Figus A. Absorbable versus non-absorbable sutures for skin closure after carpal tunnel decompression surgery. The expectation of pain and the fear of stitches is no longer reality. The strength of the suture relies on inclusion of the septations from the fascial layer beneath the subcutaneous tissue. Suture sizes are defined by the United States Pharmacopeia (U.S.P.). This can be done with a 30-60cc syringe with an 18g needle, IV bag with adapter, or special irrigation apparatus. However, they have a high risk of producing suture marks if left in place for longer than 7 days. Examples of natural surgical sutures are catgut suture and silk. The running horizontal mattress suture is used for skin eversion. 2009 Nov. 35(11):1806-8. Sutures are used to close a variety of wound types. The general technique of placing stitches is simple. The horizontal mattress suture is useful for wounds under high tension because it provides strength and wound eversion. Sutures, or stitches, are a way to close an open wound to speed healing and usually to ensure the least possible amount of scarring. The vertical mattress sutures are also helpful in areas where wound edge approximation and proper “tenting” is difficult. These are known as pseudo-monofilaments. Locked sutures have increased tensile strength; therefore, they are useful in wounds under moderate tension or in those requiring additional hemostasis because of oozing from the skin edges. Suture should be carefully placed to avoid shearing through the tissue wall. These relatively painless steps are continued until the sutures have all been removed. Does it help reduce scarring? Is Amazon actually giving you the best price? Am Fam Physician. http://depts.washington.edu/uwemig/media_files/EMIG%20Suture%20Handout.pdf, Kromka W, Cameron M, Fathi R. Tie-Over Bolster Dressings vs Basting Sutures for the Closure of Full-Thickness Skin Grafts: A Review of the Literature. Scars form as a normal part of healing whenever the skin is damaged. A vertical mattress suture is especially useful in maximizing wound eversion, reducing dead space, and minimizing tension across the wound. Usually, it’s only on the face where cosmetic concerns win out and shift the balance.

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