Suture Patterns (Veterinary)

Front 1

interrupted

Back 1

each suture has its own knot
distance from wound edge = thickness of tissue
offset the knot
appositional
common uses: skin, SQ, GIT

Front 2

continuous

Back 2

knots only at each end
suture line perpendicular to incision
material advances forward on wound surface
quick to place
appositional
common uses: SQ and linea alba

Front 3

advantages of interrupted pattern

Back 3

each suture is separate entity
adjust tension along wound
easy to place
failure of one knot usually unconsequential

Front 4

disadvantages of interrupted suture

Back 4

more time to place
more foreign material
poor suture economy

Front 5

cruciate mattress suture

Back 5

easiest of mattress sutures
appositional
avoids ischemia and eversion
half number of knots as simple interrupted
common uses: skin

Front 6

horizontal mattress

Back 6

two simple interrupted placed in opposite directions
(visible suture is parallel to incision)
difficult to place properly
appositional
if too tight, can cause marked eversion

Front 7

vertical mattress

Back 7

suture perpendicular to incision
resists tension better than horizontal
2 vertical mattress joined together = Halstead suture
common uses: skin, fascia in high tension areas

Front 8

advantages of continuous suture

Back 8

fewer knots
less foreign material
quicker
better seal
better suture economy

Front 9

disadvantages to continuous suture

Back 9

less control of wound tension and apposition
disastrous if suture breaks down
handle suture material very carefully

Front 10

ford interlocking (blanket stitch)

Back 10

passage of suture material through tissue is partially locked
greater security if broken
uses a lot of suture material
common uses: skin, long wounds on ventral midline, LA

Front 11

intradermal (subcuticular)

Back 11

continuous horizontal mattress pattern
no need to remove suture
appositional
excellent cosmetic result
buried knots at each end
not for high tension wounds

Front 12

buried knots

Back 12

knots in subcuticular tissue
prevents wicking of bacteria from surface
prevents irritation of skin

Front 13

lembert suture

Back 13

inverted continuous vertical mattress
bite taken through serosa, muscularis, and submucosa
used to close hollow viscera

Front 14

Cushing

Back 14

inverting continuous horizontal mattress
bites are parallel to incision (lembert perpendicular)

Front 15

connell

Back 15

inverting continuous horizontal mattress
bite penetrates lumen
first layer of a two layer closure

Front 16

parker kerr

Back 16

modified cushing/lembert
used to close the stump of hollow viscus
(hardly used because cases excessive tissue eversion

Front 17

purse string

Back 17

circular variation of lembert
uses: closure of hollow stump, securing tubes and catheters, placed around the anus during perineal surgery

Front 18

tendon sutures

Back 18

resist tension caused by weight bearing
used to suture ends of tendon or attach tendon to bone
1. three loop pulley
2. bunnell
3. far near near far

Front 19

skin staple

Back 19

fast
evert wound edges
8mm apart
expensive

Front 20

tissue adhesives

Back 20

cyanoacrylates
non-absorbable synthetic adhesives
apply to dry wound
strong, flexible wound
bio inert
closure of skin incisions
bad: toxic degradation products, persistence can lead to granulation/fistula