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Sutures

Simple buried suture

David Salim med. stud., Christoffer Bing Madsen med. stud., Magnus Avnstorp MD.

Application

This technique is best used in areas under moderate tension and it remains a classic standard must know technique. It has many applications and can be used in facial and truncal skin. Though it is especially useful where inversion is needed

Suture material choice

5-0 absorbable suture: face 4-0 absorbable suture: distal extremities 3-0 absorbable suture: on the back

Step by step guide

  1. The wound edge is reflected back using surgical forceps or hooks.
  2. While reflecting back the dermis, the suture needle is inserted at 90 degrees into the underside of the dermis 2 mm distant from the incised wound edge.
  3. The first bite is executed by following the curvature of the needle and allowing the needle to exit in the incised wound edge. The size of this bite is based on the size of the needle, the thickness of the dermis, and the need for and tolerance of eversion. The needle’s zenith with respect to the wound surface should be between the entry and exit points.
  4. Keeping the loose end of suture between the surgeon and the patient, the dermis on the side o the first bite is released. The tissue on the opposite edge is then gently grasped with the forceps.

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Procedures

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