How to Suture a wound and understand suturing techniques
Lee T. Dresang, MD of the University of Wisconsin School of Medicine and Public Health from the Deaprtment of Family Medicine give a discussion and demonstration of suturing techniques. Before beginning a procedure, you will need consent. One should irrigate lesion before beginning. A simple interrupted suture is easy to learn and fast, but unable to withstand stress. Vertical mattress sutures provide a good eversion of skin edges, closure of dead space, and strength, but also lead to scarring and are more time consuming to place. A corner stitch approximates angled skin flaps without compromising blood supply. Continous locking allows speed, homeostasis, and divides tension equally along skin edge. Continous non - locking allows speed, less risk of tissure necrosis, and divides tension equally along skin edge. To do an simple interrupted suture with and instrument tie, start by placing the needle at a ninety degree angle and use your wrist to turn the needle through the wound. Hold the end of the suture (DO NOT PULL THROUGH!) and leave a tail of the suture long enough to tie a knot. put the instrument in the middle of the ends and use it to tie a knot and then repeat (double knot).
To do a corner stitch with a two - handed tie, start with the corner stitch. A coner stitch goes underneath the skin when there are flaps under the first, underneath the second, ending parallel form the first stitch. To do a two handed tie, start with the shorter end being held above the longer end. Cross the shorter end over you index finger and through the other end then pull. the knot should lie flat.