Suturen

Suturen is the medical technique of closing wounds or surgical incisions with sutures (stitches). It aims to restore tissue integrity, promote healing, and reduce infection risk. Sutures may be absorbable, which dissolve over time, or non-absorbable, which may need removal after healing. The procedure can be performed by surgeons, physicians, and trained clinicians.

Materials include natural and synthetic fibers: absorbable examples such as polyglycolic acid, polydioxanone, and polyglactin; non-absorbable options such as nylon, polypropylene, and silk. Choice depends on tissue type, healing time, infection risk, and cosmetic considerations. Sutures come with curved needles swaged to the suture or with an eyed needle.

Techniques include interrupted sutures, continuous running sutures, vertical or horizontal mattress sutures, and subcuticular closures. In areas under tension, mattress or layered suturing may be used. For skin closure, subcuticular sutures or adhesive methods may minimize scarring. Proper knot-tying (e.g., square knot) and secure tension are essential.

Procedure basics: after cleaning and debridement, tissue edges are approximated with gentle, even tension. Sutures are placed at appropriate intervals to align edges without gap formation, and knots are tightened to approximate tissue. The ends are trimmed and a sterile dressing applied. Aseptic technique reduces infection risk.

Complications include wound infection, dehiscence (reopening), suture reactions, granuloma formation, and scarring. Proper material selection and technique minimize risk. Alternatives to sutures include tissue adhesives and staples, used in suitable contexts such as skin closures or mucosal surfaces.

Suturing has ancient origins and remains a core skill in modern surgery. Techniques and materials have evolved with advances in asepsis and biomaterials, improving outcomes and cosmetic results.