| A suture is a stitch, or a series of stitches, used to close the edges of a wound (laceration) or a surgical incision. Sutures may also be used to hold intravenous lines and surgical drains in place. Several types of suture material, techniques for placing the sutures, and needles to hold the suture material may be used.
Choice of suture material and technique may depend on several factors including the purpose, wound configuration, location, and depth of the wound. Suturing may be percutaneous or dermal (subcuticular). Percutaneous closure passes through both the epidermal and dermal layers of the skin, while in dermal closure, the outermost layer of the skin (epidermis) is not entered. Sutures may be placed either as a continuous stitch (running) or as an interrupted suture in which every stitch is knotted and cut.
There are a variety of suture materials and sizes available. Because suturing can result in inflammation and scarring, the smallest size suture that will maintain closure is chosen. Suture materials may be either absorbable (synthetic, plain gut, chromic gut) or non-absorbable (nylon and polypropylene, Dacron, metal, silk, and cotton). |
Source: Medical Disability Advisor
| Sutures secure the edges of a wound (laceration) or surgical incision, and promote healing of the injured area. Suturing removes "dead space" inside the wound where bacteria and secretions can accumulate, stops excessive bleeding, and provides physical strength to a skin surface that has been injured or cut. Closing the skin also helps prevent infection to the tissue inside. The edges of the wound will seal together, which prevents infection, in about 6 hours if the edges are carefully aligned (opposed) and have not been disturbed following suturing.
Lacerations and cuts as a result of trauma require cleaning and trimming of tissue that cannot be preserved (debridement). Cleansing and debridement decrease the chance of infection and may lessen scarring.
Sutures may be used to hold deep intravenous (IV) lines and surgical drains in position. IV lines inserted into the large, deep veins near the heart (central venous catheters) may be placed in critically ill individuals with life-threatening medical conditions, or trauma as a result of automobile accidents, burns, or any other severe injury, who require long-term hospitalization and intravenous nutrition (total parenteral nutrition). Specialized IV lines may be positioned into arteries (arterial lines) for blood pressure monitoring in individuals who are critically ill or for monitoring and blood drawing during anesthesia. Arterial lines may be sutured to the skin to help maintain placement. Drains placed during surgery may also be secured to the skin with stitches. |
Source: Medical Disability Advisor
| Suturing can be performed under local or general anesthesia. For traumatic wounds, the wound is cleansed and irrigated with an antibacterial solution, and any tissue that will not survive is removed (débrided). In the case of traumatic wounds, underling structures, nerves, and tendons are assessed for proper functioning prior to suturing. Suture placement will vary with the techniques used, but in general the threaded needle passes into one edge of the skin, through the full depth of the wound, and out the other skin edge. All tissue layers are aligned together as carefully as possible (approximated). Skin sutures are removed after the wound has healed. Internal sutures, made of absorbable material, are used to close subcutaneous (under the skin) tissues. They are left in place permanently and are eventually dissolved by the tissue fluids. |
Source: Medical Disability Advisor
| The predicted outcome of suturing is generally good. Suturing allows skin to return to the pre-surgery or pre-injury state, with minimal scar formation. |
Source: Medical Disability Advisor
| Rehabilitation is not generally needed following suturing. Rehabilitation will depend on other associated injuries or conditions. |
Source: Medical Disability Advisor
| Complications of suturing may include local inflammation, infection, scarring, and tearing of the skin resulting in separation of the incision (dehiscence). |
Source: Medical Disability Advisor
| Work restrictions or accommodations depend on the type of work responsibilities and the work environment. The sutured area must remain clean and intact in order to prevent the wound from becoming infected or reopening. If suturing is placed over a joint, mobility may be impaired until healing is completed. |
Source: Medical Disability Advisor
| Owings, William O. "Wound Management." Saunders Manual of Medical Practice. Ed. Robert E. Rakel. 2nd ed. Philadelphia: W.B. Saunders, 2000. 1310-1312. |
Source: Medical Disability Advisor