SUTURE PATTERNS.ppt
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This document discusses various suture patterns used in wound closure. There are two main types of suture patterns: interrupted patterns, where each stitch has its own knot, and running (continuous) patterns, where there is only a beginning and ending knot. Interrupted patterns provide more precise tissue apposition but are less efficient to place, while continuous patterns are more efficient but have a risk of catastrophic failure. Some common interrupted patterns discussed are simple interrupted, vertical mattress, and horizontal mattress. Common continuous patterns include simple continuous, continuous lock, and Lembert stitches. The document provides details on the characteristics and uses of each type of suture pattern.
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6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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SUTURE PATTERNS.ppt
- 1. Suture Patterns Interrupted – simple – horizontal mattress – vertical mattress Running (continuous) – simple – subcuticular
- 2. Suture Patterns Look at on the effect on wound margins: Interrupted vs Continuous or running 1. Appositional 2. Everting 3. Inverting
- 3. Simple interrupted* (A) Vertical mattress* (A) Cruciate mattress* (A) Horizontal mattress* (E) Simple continuous* (takes care) May be everting (under tension) Appositional (approximating) Suture Patterns
- 4. Simple interrupted*(A) Vertical mattress* (A) Cruciate mattress* (A) Horizontal mattress* (E) Interrupted Suture Patterns Lembert (I) Halstead (I)
- 9. Cruciate Mattress Prevents eversion of tissue edges Forms an “X” when tied Requires ½ number of knots vs. simple interrupted pattern
- 11. Features of Interrupted Patterns Every suture has a knot More precise tissue apposition Less efficient to place
- 12. Features of Continuous Patterns Beginning and ending knots only More efficient Potential for catastrophic failure Less exact control of wound edges Less knot security on ending knot
- 13. Examples of Continuous Patterns Simple Continuous Continuous lock Horizontal mattress Lembert* Cushing* Connell* Purse - string
- 14. Simple Continuous Used frequently (on SQ tissue) Efficiently placed “Whip stitch” “Baseball stitch” Features
- 15. Continuous Lock stitch “Blanket stitch” Easier to place as solo surgeon Features
- 16. Horizontal Mattress Used more frequently as an interrupted pattern Features
- 17. Everting (edges rolled out) Horizontal mattress* Continuous lock - tension Simple continuous* - tension Everting (edges rolled out) Suture Patterns
- 18. Lembert* (interrupted & contin.) Halstead Cushing* Connell* Purse - string Parker - Kerr Inverting (edges rolled in) Suture Patterns
- 19. Lembert suture pattern Second visceral layer More commonly used as a continuous pattern Features
- 20. Lembert suture pattern Similar to vertical mattress, except suture above tissue Continuous used more often Not used on skin Far-near-near-far pattern Features
- 21. Halstead suture pattern Eight tissue penetration points Far-near-near-far- far-near near-far Two Lemberts side - by - side Features
- 22. Cushing First visceral layer Parallel purchases in tissue Non - lumen penetrating pattern Features
- 23. Connell First visceral closure Parallel tissue purchases Lumen penetrating pattern Features
- 24. Cushing Connell
- 25. Purse String Used to temporarily close a lumen (e.g., anus) Features
- 26. Parker Kerr Oversew Used frequently (on SQ tissue) Efficiently placed “Whip stitch” “Baseball stitch” Features
- 27. Guidelines for Day of Removal Body Region Removal (days) face 3-4 scalp 6-8 chest 8-10 abdomen 8-10 penis 8-10 ear 10-14 back 12-14 extremities 12-14 hand 10-14 foot/sole 12-14
- 28. Corner/flap
- 29. QUESTIONS?