Suturing Best Practices

Sutures close skin and other tissue wounds to support and strengthen them as they heal. It’s a centuries-old practice that helps minimize bleeding and infection. While the techniques and materials have evolved since its origins, suturing remains an essential wound closure method for patient safety and aesthetics.

In this article, we’re covering some of the best practices for honing your suturing prowess, starting with an overview of suturing techniques and finishing with hints for assembling the best suture practice kit.

Suturing Techniques

To become the best suture practitioner possible, consider practicing several suturing techniques both in and outside of sim lab, including:

• Continuous – Marked by a series of stitches with a single strand of suture material
• Interrupted – Uses many strands of suture material for securely closing a wound
• Deep – Placed under tissue layers most often used to close fascial layers
• Buried – Used for large sutures deep in the body in an area to be surgically closed off
• Purse-string – Used for tightening like a drawstring bag, such as around the intestines for securing an intestinal stapling device
• Subcutaneous – Uses short stitches in the dermis tissue layer parallel to the wound and anchored at either end
• Horizontal Mattress - most useful for high tension wounds especially when the edges are fragile or frayed

Suturing 101

While suturing best practices will vary depending on your technique, you can sharpen your skills with the following general principles:

1. Thoroughly cleanse and sterilize the laceration.
2. Use a needle holder tool to grasp and position the needle vertically and longitudinally perpendicular to the holder.
3. Gently stabilize the tissue using forceps or skin hooks.
4. Place the first suture on the wound edge farthest away and sew toward you.
5. Penetrate the skin with a needle at a 90° angle 1-3 mm from the wound edge, depending on the skin thickness, and ensure the needle exits perpendicular to the skin’s surface.
6. Secure the suture with a knot, such as a square knot or surgeon’s knot.
7. Tighten the suture enough to pull the wound edges together without tissue constriction.
8. Square successive ties so that each one is perfectly parallel.
9. After completing the desired number of throws, cut the suture material, or place the next suture.
10. When suturing a live patient, follow appropriate suture removal best practices or leave them in place if you’re using dissolvable suture material.

How to Assemble The Best Suture Practice Kit

When practicing suturing, equip yourself with tools that provide a realistic experience. The best suture practice kit will contain the following essentials:

• Tissue pad – Use a four-layer tissue pad that realistically mimics the epidermis, dermis, fat, and muscle for basic closure techniques. Or go for a five-layer tissue pad that includes a subcuticular layer for practicing basic and subcutaneous suturing techniques on a surface that feels and responds like real human tissue.
• Suture material – The best suture practice kit will also contain the suture material you anticipate using most often. If you’re not sure, consider one of the common general use materials for soft tissue repair, such as Poliglecaprone (MONOCRYL), Polypropylene (Prolene), silk, or nylon.
• Needle – Include a cutting needle in your practice kit to practice skin sutures. As opposed to a taper-point, a cutting needle penetrates dense, irregular, or thick tissue.
• Needle holder – The best suture practice kit for skin sutures will include a needle holder. Also known as needle drivers or needle forceps, needle holders are stainless steel instruments that hold your suture needle in place.

To learn more about assembling the best suture practice kit for your needs, contact our responsive team for advice on our cost-effective and USA-made physical anatomical models for realistic practice.