The Suturing Techniques Guide – Medarchitect

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The Suturing Techniques Guide

Simple Interrupted


  • Do the pass technique, two loops around the needle holder, then grab the tail and do the knob.
  • Indications: Single tooth extraction, third molar extraction flap, biopsies, implants, ...etc.
  • Advantages: It is the most commonly used technique, preferred in urgent situations and it is easy to remove. Failure of one is inconsequential of the others.
  • Disadvantages: It does not bring all surfaces into contact and less supportive for healing of flap margins.


Simple Running


  • Start it with simple interrupted suture. Practice with Medarchitect best suture pad.
  • Then you cut the tail off and leave that last piece loose then you can do your loops.
  • Indications: Bone graft, removal of mandibular tori, tuberosity reduction and where esthetics are not important
  • Advantages: It is very easy to produce and offers a more water tight closure
  • Disadvantages: If you cut one part of it, you lost all of it.


Subcuticular Running


  • The needle is introduced 10mm distal to one wound end and taken from alternating sides of the wound working towards the other wound apex.
  • Indications: It is used to close the deep portion of surgical defects under moderate tension.
  • Advantages: It is the minimal epidermal puncture points allowing the suture to be left in place longer without suture-track scarring.
  • Disadvantages: The risk of suture breakage and the formation of dead space beneath the skin surface.


Vertical Mattress


  • The far far, near near technique.
  • Indications: Where the wound edges tend to evert
  • Advantages: Greater closure strength and better distribution of wound tension
  • Disadvantages: Scar formation and the formation of edge necrosis.


Horizontal Mattress


  • The strongest type of sutures, very far away (8mm from the edge).
  • Indications: Large distances between tissues, bone grafts and implants, and closure of extraction socket.
  • Advantages: Good for hemostasis, less prominent scarring.
  • Disadvantages: Leave a gap between flaps and it is difficult to remove.