Suturing Techniques

~Subcutaneous sutures:
1.Simple subcutaneous suture:This technique is used to free tension from
the wound surface to make the healing of skin easy. Surgeon should always try to put the
knots on the deeper part of the wound.
The sutures suitable for this technique :
*Short-term absorbable multifilaments.
when the wound is high tension , other sutures can be used instead, like:
*Mid-term absorbable multifilaments.
*Mid-term absorbable monofilaments.

2.Continous subcutaneous suture:This technique is an alternative to the

simple subcutaneous suture.
Advantages: its more resistant and faster than simple subcutaneous suture
Disadvantage: the risk of wound dehiscence when suture breakage
The sutures suitable for this technique :
*Short-term absorbable multifilaments.
when the wound is high tension , other sutures can be used instead, like:
*Mid-term absorbable multifilaments.
*Mid-term absorbable monofilaments.

3.Continuous subcutaneous interlaced suture:This technique is a

variation of a continuous subcutaneous suture. Advantages :it will provide extra
resistance, retain most of the tension and act as antislippage suture. The higher friction
provides a stronger hold, ensures that the stitch does not sag . This type of sutures has a
high tensile strength, so thats useful in wounds under tension and highly vascularised
tissues ,but not advisable in tissues with poor vascularization.
The sutures suitable for this technique :
*Mid-term absorbable monofilaments.
~ Skin sutures:
1.Simple skin suture:This technique is the most common to close a wound,
separated stitches are used will hold the wound's edges together.
Advantages: its easy to place, provide great tensile strength and less likely to compromise
blood circulation.
Disadvantage: it needs longer time to be placed and has a higer risk to cause scars.
The sutures suitable for this technique :
*Non-absorbable monofilaments.
other sutures can be used instead, like:
*Mid-term absorbable monofilaments.

2.Continuous skin suture(running suture):This technique is used with

tensionfree wounds.
Advantages: they cause less scarring because of less knots are performed, quite fast to
place Compared with simple skin sutures.
Disadvantage: there is a higher risk of dehiscence if the suture breaks .
The sutures suitable for this technique :
*Non-absorbable monofilaments.
other sutures can be used instead, like:
*Mid-term absorbable monofilaments.

3.Continuous intracutaneous non-absorbable suture:This

technique is used in areas with minimal stress, it gives aesthetic results to the scar.
It consists of a monofilament running within the skin, with no parts of the suture coming in
and out of the wound sides, then strips should be placed over the wound. The suture
should be removed by pulling on one of its ends when the healing skin has reached
enough strength to keep the wound closed by itself.
The sutures suitable for this technique :
*Non-absorbable monofilaments.

4.Continuous intracutaneous absorbable suture:This technique is

performed by absorbable sutures, so there is no need extract the suture because it will
slowly degrade by tissue, strips should be placed over the wound once the intracutaneous
suture has been completed.The foreign material remaining in the wound will affect the
healing process of the wound.
The sutures suitable for this technique :
*Mid-term absorbable monofilaments.

~Other sutures:
Algoewer suture:This technique reduces the risk of wound dehiscence. The suture
will close the subcutaneous space, so strong sutures are used to provide a firm hold. This
technique is avoided when a good cosmetic result is important.
The sutures suitable for this technique :
*Non-absorbable monofilaments.

Donati suture:At this technique, the suture crosses the skin at 4 points for each
stitch, that provide a firm hold, but the risk of poor aesthetic results is increased.
The sutures suitable for this technique :
* Non-absorbable monofilaments.
Mattress suture: This technique is used when the edges of the wound are far from
each other or areas where the edges of the wound tend to reflect (such as a wound on a
concave surface).
Disadvantage: Superficial scars occur due to increased tension across the wound and the
suture enters the skin 4 times in each stitch.
The sutures suitable for this technique :
*Non-absorbable monofilaments.

Corner suture: A technique used when the edges of the wound are irregular or
crooked (corner). The corner suturing must be done in the correct way to avoid tissue
necrosis.
The sutures suitable for this technique :
* Non-absorbable monofilaments.