Suturing Techniques

This chapter describes suture techniques employed most often during the surgical care of the pediatric patients. Modifications exist for each suture type, and familiarity with the basic suture techniques will enable appropriate decision-making when planning a closure. Loading the suture requires placement of the suture needle into the jaws of the needle driver. Tissue stabilization is achieved by everting the free margin of the wound edge for adequate visualization and planning of suture placement. Prior to suture placement, it is also important to ensure that the wound edges, wound bed, and surrounding tissue are appropriately prepared for closure. The goal of the instrument tie is to support free wound edge approximation with tension evenly distributed across the wound. If superficial sutures are placed asymmetrically, wound edges may be visible, indicating improper dermal-epidermal alignment.