Suture Techniques

Learn seven steps for wound management in the emergency department: sterile technique, anesthesia, stop bleeding, remove foreign bodies and hair with clipping, irrigation, debridement, and antibiotic prophylaxis before closure.

Examine wound closure methods, including sutures, staples, tissue adhesive, and adhesive tapes. Learn rapid suturing for mass casualties and the opposition technique for linear wounds under 10 cm.

Learn essential suturing instruments, including needle holder, plain and tooth forceps, and scissors, and understand how to hold suture material for skin and soft tissue.

Hold instruments by using the thumb and ring finger, place the index finger in the middle, and use the middle finger to support pressure; grasp forceps like a pen.

Explore simple interrupted suturing, continuous suturing, vertical and horizontal mattress techniques, and deep dermal sutures to reduce dead space and tension in wound closure during emergencies and surgeries.

Demonstrate the simple interrupted suture to close the skin, inserting the needle perpendicular from the lateral tear, with 3–5 mm margins and equal tissue, and perform the instrumental tie.

Apply continuous suturing, starting with a simple interrupted knot. Continue the suture without cutting the main material for rapid hemostasis; contraindicated in contaminated wounds due to infection risk.

Demonstrates vertical mattress suturing to close the deep part of wounds and relieve edge tension, especially for skin near joints or loose skin where hemostasis is needed.

the lecture demonstrates horizontal mattress suturing, entering and exiting about one centimeter from the skin edge, crossing the wound horizontally, with the knot on the same side as entry.

Learn the subcuticular suturing technique, starting with a deep dermal suture for a cosmetically superior closure using absorbable or nonabsorbable materials and a straight or curved needle.

Perform deep dermal suturing by placing sutures beneath the skin to reduce wound tension and close dead spaces by approximating underlying structures.

Select suture size based on laceration location. Use four zero nylon for scalp, trunk, abdomen, chest, and extremities; face uses six zero; digits use five zero proline.

Apply interrupted ear wound sutures with 1.5–2 mm spacing to preserve lip shape. Use deep dermal suturing for inner muscles and horizontal mattress for multiple wounds to prevent deformity.

Master emergency wound management, including sterile technique, anesthesia, bleeding control, foreign body removal, irrigation, and antibiotics before manipulation. Learn suture methods—simple interrupted, mattress, and tissue adhesives—with proper instrument handling.