Chapter 11 Suturing Techniques
main suture that approximates the wound edges for first intention healing to occur -
ANS-Primary suture line
a primary suture line consisting of a single strand of suture placed as a series of stitches often
used for closure of long incisions - ANS-continuous or running suture
the STSR holds the lower quarter of the suture taut and away from the area of closure; keeps
tension on the suture line and keeps it out of the surgeon's line of view - ANS-"Following" or
"running" suture
to close tissues that are under a lot of tension - ANS-continuous sutures should not be used
used to close tissues under tension and to close infected tissues; interrupts the pathway of the
bacteria localizing the area of infection to a smaller part of the wound - ANS-interrupted suture
line
used to retract a structure that may not be easily retracted with a conventional retractor
instrument; a nonabsorbable suture is placed into or around the structure and the suture ends
are clamped with a hemostatic clamp; the structure is then pulled to the side of the operative
site - ANS-traction sutures
placed in a circular fashion around a structure in such a way that pulling on the suture ends
tightens and closes an opening - ANS-drawstring or pursestring suture
sutures placed to support and ease the tension on the primary suture line, thus reinforcing the
wound closure and obliterating any dead spaces - ANS-secondary suture line
large-gauge, interrupted, nonabsorbable sutures placed lateral to a primary suture line for
wound reinforcement - ANS-retention sutures
plastic devices that bridge the closed incision - ANS-Bridges
pieces of plastic or rubber tubing threaded over the retention suture ends before the ends are
tied; once tied they cover retention sutures and prevent them from cutting into the skin -
ANS-Bolsters
holes through which tendon sutures are pulled through and tied over a button to prevent tissue
damage - ANS-Buttonholes
may be clamped onto the ends of subcuticular sutures after skin closure - ANS-Split lead shots
main suture that approximates the wound edges for first intention healing to occur -
ANS-Primary suture line
a primary suture line consisting of a single strand of suture placed as a series of stitches often
used for closure of long incisions - ANS-continuous or running suture
the STSR holds the lower quarter of the suture taut and away from the area of closure; keeps
tension on the suture line and keeps it out of the surgeon's line of view - ANS-"Following" or
"running" suture
to close tissues that are under a lot of tension - ANS-continuous sutures should not be used
used to close tissues under tension and to close infected tissues; interrupts the pathway of the
bacteria localizing the area of infection to a smaller part of the wound - ANS-interrupted suture
line
used to retract a structure that may not be easily retracted with a conventional retractor
instrument; a nonabsorbable suture is placed into or around the structure and the suture ends
are clamped with a hemostatic clamp; the structure is then pulled to the side of the operative
site - ANS-traction sutures
placed in a circular fashion around a structure in such a way that pulling on the suture ends
tightens and closes an opening - ANS-drawstring or pursestring suture
sutures placed to support and ease the tension on the primary suture line, thus reinforcing the
wound closure and obliterating any dead spaces - ANS-secondary suture line
large-gauge, interrupted, nonabsorbable sutures placed lateral to a primary suture line for
wound reinforcement - ANS-retention sutures
plastic devices that bridge the closed incision - ANS-Bridges
pieces of plastic or rubber tubing threaded over the retention suture ends before the ends are
tied; once tied they cover retention sutures and prevent them from cutting into the skin -
ANS-Bolsters
holes through which tendon sutures are pulled through and tied over a button to prevent tissue
damage - ANS-Buttonholes
may be clamped onto the ends of subcuticular sutures after skin closure - ANS-Split lead shots
