Basic Principles of Suturing & Different Suture Methods
It is necessary to ensure the good alignment of the sutured wound or wound. Suture should be carried out in layers, according to the anatomical level of the tissue, so that the tissue layer is tight, do not involve or sew into other tissues, do not leave residual cavity, and prevent fluid accumulation, blood accumulation and infection. The distance between the wound edge and the needle distance of the suture must be uniform, so that it looks beautiful, and more importantly, the force and shared tension are consistent and the suture is tight, so that no leakage occurs.
Pay attention to the tension at the suture. The tightness of the ligation suture should be based on the closeness of the incision edges, and it should not be too tight. Tension-reducing sutures should be performed when the wound is under tension. If the defect is too large, transfer flap repair or skin grafting may be considered.
The selection of suture thread and suture needle should be appropriate. Silk thread can be used after debridement, disinfection and cleaning for sterile incisions or wounds with mild contamination. Absorbable sutures can be used for wounds that have been infected or severely polluted. For anastomosis of blood vessels, corresponding types of non-invasive needles and threads should be used.
There are many suture methods, and there is no unified classification method. According to the involution relationship of the tissue, it is divided into three categories: simple suture, valgus suture, and inversion suture; each category is divided into two types: intermittent and continuous suture according to whether the suture is continuous or not; The positional relationship between tissues is divided into horizontal suture and vertical suture; sometimes the above conditions are combined and named. According to the shape of stitching, it is divided into U-shaped stitching, 8-shaped stitching, T-shaped stitching, Y-shaped stitching, etc. In addition, there are sutures made for special purposes, such as tension reduction sutures, intradermal sutures, and suture hemostasis.