Applications of surgical sutures

During the application of surgical sutures, the following principles of suturing should be observed. 

Tissues should be handled gently and wound edges protected from contamination, drying, abrasion, or crushing. 

Hemostasis should be meticulous, but beware of overuse of diathermy, particularly at the skin edges, as burning of the skin may occur, causing both a delay in healing and an increase in the size of the scar. 

Contaminated and devitalized tissue should be excised. If severe contamination exists then the wound should not be sutured, but left open to heal by secondary intention. 

Choose the correct size and type of suture for the task, bearing in mind the healing characteristics of the tissue in question and the tensile strengths involved. Do not use sutures that are larger than necessary, and avoid implanting nonabsorbable materials where possible. 

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