The wound depth should be established before closure, as one of the key principles of suturing is to close dead space in which bacterial colonisation could occur (Atiyeh et al, 2002). suture material in wound management largely depend on factors such as the number of tissue layers involved in wound closure, tension across the wound depth of suture placement, presence of oedema, expected time of suture removal, possess adequate strength, … Fig 9g The knot is tightened. Successful Suturing •Correct needle holder grasp and needle placement: 2/3 rule •Running sutures for long incisions save time and create equal tension •Retention sutures for extra strength •Good, square knot tying •Consider suture removal •Children, location of wound, type of suture An advantage of suturing as a method of wound closure is that it can be used on both deep and superficial wounds (Richardson, 2004). It is often helpful to use a no. 159 PRINCIPLES OF SUTURE REMOVAL Ethicon 1985 • check area distal to wound for neurovascular + motor damage, skin colour temperature, and distal pulses. ous suturing techniques, including simple, running, and half-buried mattress (corner) sutures. Monofilament S t eMonofilament Suture Grossly appears as single strand of suture material; all fibers run parallel Mi i l iMinimal tissue trauma Resists harboring microorganisms Ti thlTies smoothly Requires more knots than multifilament suture Possesses memoryPossesses memory Examples: Table—Principles of Suturing General Guidelines Sutures are usually placed distal to the last tooth and in each interproximal space. A circular form of needle is used because of the restricted space in the mouth. Principles of Wound Management There are four main principles of wound management • deal with priorities first ABC. 23 explorer to help lift the sutures if they are within the sulcus or in close opposition to the tissue. It may include links to online content that was not created by UMHS and for which UMHS does not assume responsibility. Although suturing is the preferred method ... mon principles, regardless of … Suture Care Post-Operative Instructions - 2 - Disclaimer: This document contains information and/or instructional materials developed by the University of Michigan Health System (UMHS) for the typical patient with your condition. Suture Materials and Suture Techniques Figs 10a and 10b Approximation of the wound edges after tooth extraction by overlying, crossed-over mattress stitch. Sutures should always be inserted through the more mobile tissue flap first. Atlas of Suturing Techniques: Approaches to Surgical Wound Laceration and Wound Repair goes beyond the scope of other texts which often limit their focus to either general operative principles or the specific use of flaps in particular reconstructive areas such as facial and nasal reconstruction. A sharp suture scissors should be used to cut the loops of individual or continuous sutures about the teeth. This will avoid tissue damage and unnecessary pain. • Decrease likelihood of infection • Promote optimal healing which may require suturing Wound Cleansing Emergency and Essential Surgical Care (EESC) programme www.who.int/surgery 1 | MODULE 2 Basic surgical skills 2.

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