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    PBL Suturing Techniques

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    Marie Chapman
    This document discusses various suturing techniques used in oral surgery. It defines sutures as stitches used to approximate surgical or traumatic wounds. The main purposes of suturing are to provide adequate wound closure tension, maintain hemostasis, permit proper tissue positioning for healing, reduce pain, and prevent bone exposure. Suture materials can be natural or synthetic, absorbable or non-absorbable, and monofilament or multifilament. Common suturing techniques described include simple interrupted, simple continuous, simple continuous with locking, vertical mattress, horizontal mattress, and figure of 8 sutures. The appropriate technique depends on factors like wound tension, tissue eversion needs, and anatomical site.

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    © All Rights Reserved
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    PBL Suturing Techniques

    Uploaded by

    Marie Chapman
    130 views21 pages
    This document discusses various suturing techniques used in oral surgery. It defines sutures as stitches used to approximate surgical or traumatic wounds. The main purposes of suturing are to provide adequate wound closure tension, maintain hemostasis, permit proper tissue positioning for healing, reduce pain, and prevent bone exposure. Suture materials can be natural or synthetic, absorbable or non-absorbable, and monofilament or multifilament. Common suturing techniques described include simple interrupted, simple continuous, simple continuous with locking, vertical mattress, horizontal mattress, and figure of 8 sutures. The appropriate technique depends on factors like wound tension, tissue eversion needs, and anatomical site.

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    Pbl Suturing Techniques

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    This document discusses various suturing techniques used in oral surgery. It defines sutures as stitches used to approximate surgical or traumatic wounds. The main purposes of suturing are to provide adequate wound closure tension, maintain hemostasis, permit proper tissue positioning for healing, reduce pain, and prevent bone exposure. Suture materials can be natural or synthetic, absorbable or non-absorbable, and monofilament or multifilament. Common suturing techniques described include simple interrupted, simple continuous, simple continuous with locking, vertical mattress, horizontal mattress, and figure of 8 sutures. The appropriate technique depends on factors like wound tension, tissue eversion needs, and anatomical site.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    130 views21 pages

    PBL Suturing Techniques

    Uploaded by

    Marie Chapman
    This document discusses various suturing techniques used in oral surgery. It defines sutures as stitches used to approximate surgical or traumatic wounds. The main purposes of suturing are to provide adequate wound closure tension, maintain hemostasis, permit proper tissue positioning for healing, reduce pain, and prevent bone exposure. Suture materials can be natural or synthetic, absorbable or non-absorbable, and monofilament or multifilament. Common suturing techniques described include simple interrupted, simple continuous, simple continuous with locking, vertical mattress, horizontal mattress, and figure of 8 sutures. The appropriate technique depends on factors like wound tension, tissue eversion needs, and anatomical site.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 21

    SUTURING TECHNIQUES

    DEFINITION

     Suture is a stitch/series of stitches made to secure apposition of the edges of a


    surgical/traumatic wound. (Wilkins)
    PURPOSE

     Provides an adequate tension of wound closure without dead space but loose
    enough to obviate tissue ischemia and necrosis.

     Maintain hemostasis

     Permit proper flap position and primary healing

     Reduce post operative pain

     Prevent bone exposure resulting in delayed healing and unnecessary resorption


    CLASSIFICATION OF SUTURE MATERIALS
     1. Natural and Synthetic

     2. Absorbable and Nonabsorbable

     3. Monofilament and Multifilament(Wicking effect)

     4. Diameter
    Diameter

    Face normally 5-0, 6-0


    PRINCIPLES OF SUTURING
     The needle should be grasped at approximately 1/3rd the distance from the
    eye and 2/3rd from the point.

     Needle should enter tissues perpendicular to tissue surface.

     Needle should be passed through the tissue along its curve.


     Suture should be passed at an equal depth and distance from the incision
    on both sides.

     Suturing should always be from a movable to fixed tissue, deeper to


    superficial tissue, thinner to thicker tissue.

     Tissue must never be closed under tension. Suture should be tied only to
    approximate the tissues, not to be blanched.
     The knot should never lie on the incision line.

     Avoid retrieving the needle from the tissue by the tip as it will dull the
    needle.

     An adequate tissue bite is required to prevent the flap from tearing.


    Simple Interrupted Sutures

     AKA “Solitary sutures”.


     Simplest and most frequently used type
     May be used in all surgical procedures of the mouth

    Indications
    - Vertical incision
    - Tuberosity and retromolar areas
    - Bone regeneration procedures with or without guided tissue regeneration
    - Edentulous areas, osseointegrated implants
    - Partial or split thickness flaps
    Advantages
    - Successive sutures can be placed to fit individual requirement
    - The loosening of one suture will not produce loosening of other suture
    - When required, selected sutures may be removed without interfering each
    other.

    Disadvantages
    - Time consuming as many individual sutures has to be placed to close the entire
    flap
    - Many knots have to be placed.
    Simple Continuous Suture

     Have a long span & close the entire distance of the flap
    Indications
    - Long wounds
    - Wound tension is minimized
    - Approximation of wound edges are good
    - Split or full thickness skin graft
    Advantages
    - Less scaring occurs
    - Quicker placement and more rapid reapproximation of wound edges
    - Can include as many teeth as required
    - Water tight closure

    Disadvantages
    - possible crosshatching
    - risk of dehiscence if the suture material ruptures
    - difficulty in making fine adjustments along the suture line
    - puckering of the suture line when the stitches are placed in thin
    skin
    Simple Continuous with Locking Suture

     Variation of simple continuous suture

    Indications
    - have increased tensile strength; therefore, moderate tension
    - requiring additional hemostasis because of oozing from the skin
    edges.
    Advantages
    - Relative maintenance of suture strength

    Disadvantages
    - Increased risk of impairing the microcirculation
    - Cause tissue strangulation if placed too tightly
    - Useful on the scalp or in the postauricular sulcus
    Vertical Mattress Suture

     One of the best available suturing techniques to ensure eversion of wound


    and minimize significant wound tension.

    Indications
    - Maximising wound eversion
    - Reducing dead space
    - Minimising tension across the wound
    Advantages
    - Reduce the risk of scarring
    - Eversion produced by the mattress sutures is valuable when closing sites with
    edges that tend to roll under

    Disadvantages
    - Risk of crosshatching is greater
    - Takes time to apply
    - Caution must be taken not to place sutures too tight.
    Horizontal Mattress Suture

     useful for wounds under high tension because it provides strength


    and wound eversion.

    Indications
    - High tension
    - Stay stitch to temporarily approximate wound edges allowing
    placement of simple interrupted or subcuticular stitches.
    - Sutures may be placed before a proposed excision as a skin
    expansion technique to reduce tension
    Advantages
    - Effective hemostatic sutures on vascular tissues
    - Reinforces the subcutaneous tissue
    - Relieves tension from skin edges better
    - Close extraction sockets

    Disadvantages
    - They have a high risk of producing suture marks if left in place for
    longer than 7 days.
    - High risk of tissue strangulation and wound edge necrosis if tied
    too tightly.
    Figure of 8

     To close extraction sockets


     Adaptation of gingival papilla around the teeth
     When packing the socket with hemostats or bone grafts

    Advantages
    - Rapid closure

    Disadvantage
    - Due to its orientation, it is difficult to remove and it leaves a significant
    amount of suture threads inside the socket
    THANK YOU

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