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Sutures are medical aids used by doctors to close wounds on the skin or tissues. They make use of a needle attached to a length of thread to stitch the wound shut. In other words, suturing refers to the process of stitching together any two surfaces on the body by sewing them with the help of a thread or wire. The thread is secured with surgical knots and is one of the most used approach post injury or surgery to seal the cut or wound.

Suturing is also used for aesthetic enhancements such as cosmetic, reconstructive and plastic surgeries. Surgical sutures have an important role to play in these as well. The result of the surgery is as much linked to the sutures as to the actual surgery process. Therefore it becomes absolutely essential that the suturing techniques used by doctors are perfect and without any faults. As a medical procedure, suturing perhaps has one of the greatest inter-surgeon variability. Suturing techniques range from combinations of running and interrupted sutures to the use of multiple interrupted sutures and double running sutures.

Why is suturing technique important?

Suturing is an important skill that doctors from all fields require to learn and master. Acing this technique of wound suturing and closure is important in order to:

Support and strengthen the would until it completely heals
Reduce the dead spaces
Reduce te risk of bleeding and infection developing in the wound or cut
Approximation of the skin edges to minimise the scarring

What is a good suture technique?

A good suture technique would be one that in an efficient and clean manner closes the wound so that it leaves minimal or no visible scarring. According to the Stanford University’s Stanford Medical guide to the perfect suturing procedure, it is a 4 step microsurgery process. It breaks down suturing into 4 steps that allow you to remain organised and focused on the task at hand. These 4 steps include:

Handling the needle: Grasping the needle might be a bit tricky as it tends to jump around. However, what helps here is to catch hold of the thread with your other hand and then hold the needle just behind its midpoint. Holding it too near to the thread will make it point upwards and too close to the tip will make it point downwards, not providing you the right angle to work with.
Passing the needle through: The needle needs to pass through the tissue at a perpendicular angle for the suturing to be accurate. The best way to ensure this is to place the tip of the left hand forceps at the underside of the tissue where the needle will enter the tissue or skin and then gently push the edge upwards. Use your right hand to bring the needle in contact with the tissue and then press it downwards. Remember to not grab the tissue with your left hand as it might damage the intima.
Pulling the suture: To pull the suture through make use of the tip of the right hand needle driver as a guiding pulley while you pull the needle through. It is advised to keep the suture parallel to the direction of the entry and exit line for the thread.
Tying the knot: For this the first step is to pick up the thread with the left hand forceps. Grab the suture a bit above the incision point with your left hand and make a loop. Turn the suture into a loop around the tip of the needle holder. Now, pick up the short end and complete the knot.

This guide was specifically designed by the university to ensure that suturing techniques get the required attention of a medical practitioner. This is important for those who work in emergency medicine and closing of any wound. It is also important to ensure that the proper technique is followed in order to minimise the scarring.

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