How Long Does It Take For Sutures To Heal?

Sutures are versatile and familiar, with usage dating back to the 16th century BCE. This has made them the default choice for surgeons who may not be as familiar with newer wound closure technology. Of course, one of the questions many patients have following a procedure is, “How long does it take for sutures to heal?” It may not surprise you to learn that the answer is not cut and dried; of course, the wound heals, not the sutures, which is either absorbed into the body or removed by a physician. Even still, the time it takes for sutures to biodegrade or the timeframe in which your doctor removes them will depend on the type of sutures used, the severity of the wound or incision, and its location. 

Types of Sutures

It’s important to understand that stitches can be absorbable or nonabsorbable. The former will eventually break down and be absorbed naturally into the body with no removal necessary; the latter will require a return trip to the doctor to have them removed (never attempt to remove them yourself). There are a number of types of sutures within each category.

Types of Absorbable Sutures

Different types of absorbable sutures are used depending on wound or incision location and severity, the type of procedure, and the patient’s age. Because they’re more prone to scarring than nonabsorbable stitches, they are used internally to close the deepest parts of a wound or incision, with nonabsorbable sutures applied or adhesives applied to the skin’s surface.

• Natural. Derived from purified catgut, collagen, sheep and cow intestines, these natural sutures are used in the repair of internal soft tissue wounds or lacerations. Gut is not suitable for cardiovascular or neurological surgical procedures. Its use is generally limited to obstetric-gynecological procedures.
• Poliglecaprone (Monocryl) and Polyglycolic Acid (Dexon). This suture, a synthetic monofilament (i.e., a single strand of man-made fiber), is typically used to close deep, multi-layer lacerations.
• Polydioxanone (PDS). Another synthetic monofilament suture that is commonly used for soft tissue wound repair (e.g., abdominal closures) and pediatric cardiac procedures.
• Polyglactin (Vicryl). A synthetic braided suture often used for repairing hand or facial lacerations. It shouldn’t be used for cardiovascular or neurological procedures.

Types of Nonabsorbable Sutures

Nonabsorbable sutures can be used for most types of soft tissue repair, including cardiovascular and neurological procedures.

• Nylon, polyester, and polypropylene. Synthetic monofilament sutures often coated with teflon, polybutilate, or silicone to make them easier to handle. 
• Silk. A braided, natural suture offering high tensile strength and easy handling. However, as an animal protein, silk carries a significant risk of infection.

How Long Until an Absorbable Suture Dissolves?

The timeframe for an absorbable suture to dissolve can vary wildly, from about ten days to as long as a few months. It may depend on the surgical procedure, type of wound or incision being closed, the suture material type, and the size of the suture. 

The absorption time frame also depends greatly on a person’s own body. Absorbable sutures are treated as a foreign object that doesn’t belong in the body, and the immune system goes to work trying to destroy the perceived invasions. A person’s ability to break it down quickly may depend on their overall health.

How Long Until Nonabsorbable Sutures Are Removed?

Once again, this varies, usually depending on where they are on the body. The following, as noted by the American Family Physician, provides a good guideline:

• Face: 3 to 5 days
• Scalp: 7 to 10 days
• Arms: 7 to 10 days
• Chest: 10 to 14 days
• Legs: 10 to 14 days
• Hands and feet: 10 to 14 days
• Palms and soles: 14 to 21 days

Are There Alternatives to Sutures?

We’re glad you asked. While sutures have stood the test of time, they still present a number of challenges:

• They can be time-consuming to apply and may require a return trip to the doctor.
• They require the use of a needle, which can lead to needlestick injuries.
• They can result in significant scarring, especially in an emergency situation when scar-reduction is not a priority.
• The suture materials can cause infection.

If you’re concerned about any of the above factors, be sure to ask your surgeon about BandGrip. Resembling a typical adhesive bandage, BandGrip’s patented micro-anchors grip the skin tightly and hold wound edges together securely, which offers many advantages:

• Faster and easier application versus sutures and staples.
• Eliminates the risk of needlestick injuries.
• Results in less scarring than sutures or staples.
• Supports better mobility due to its smooth, water-resistant surface.
• Does not require a return visit for removal.

Learn more about the power of BandGrip here.

Causes, Symptoms and Treatment Options

Medically reviewed by Drugs.com. Last updated on Dec 6, 2019.

What are Sutures?

Sutures, commonly called stitches, are sterile surgical threads that are used to repair cuts (lacerations). They also are used to close incisions from surgery. Some wounds (from trauma or from surgery) are closed with metal staples instead of sutures.

What It’s Used For

Sutures may be used to close surface wounds or deep wounds. To close a deep wound, a doctor may need to sew the two edges together layer by layer, placing and leaving some sutures under the skin surface.

There are two types of sutures that are used for wound repair.

Nonabsorbable sutures are ideal for skin wounds because they are more likely to have a cosmetically appealing result. When these sutures are used in skin wounds, they are removed once the wound has healed. In most areas of skin, it takes about seven days for a bridge of connecting tissue to form between the two edges of the wound. After that, the stitches can be removed safely, and the wound can continue to heal without stitches in place. If the stitches are left in the skin for longer than is needed, they are more likely to leave a permanent scar.

Nonabsorbable sutures also are ideal for internal wounds that need to heal for a prolonged time. Depending upon what the sutures are made of, nonabsorbable sutures either are permanent or deteriorate very slowly. They hold their strength for 300 days or longer. They are made from natural fibers or from synthetic threads, such as nylon, polypropylene, polyethylene or polyester. At the end of a surgery, these long-lasting sutures are used to hold together fibrous internal tissues since these tissues do not have much blood flow and require a very long time to heal fully. When nonabsorbable sutures are used in deep tissues, they are left in place permanently.

Layers that heal quickly can be repaired with absorbable sutures. These sutures are made from materials that can dissolve gradually inside the body, such as the fibers that line animal intestines (catgut). These sutures are exceptionally strong in the first few days of healing, because they are made with multiple fibers, which makes them less likely to break. However, they lose most of their strength by the end of the first two weeks of healing. Absorbable sutures are ideal for repairing muscles, because muscles require strong sutures when they are first healing yet they heal quickly. Absorbable stitches are not removed. The body absorbs them, usually within about 60 days.

Preparation

Before suturing your cut, your doctor will need to know:

• How your cut happened — Was the cut made by a piece of glass, wood or metal that might have broken off inside in the wound? Was the wound contaminated by dirt, manure or saliva (animal or human)?
• When your cut happened — If you have waited several hours before seeking treatment, then your risk of infection is higher than average.
• Whether you are allergic to any anesthetics or antibiotics
• Your current medications — Are you taking any prescription or nonprescription drugs that could increase bleeding or delay healing?
• The approximate date of your last tetanus shot

These questions will help your doctor to know whether sutures may be an appropriate way to help your wound heal. Some contaminated wounds should not be closed with sutures because this could prevent an infection from draining. Some wounds that have been open for more than six hours also should not be closed with sutures. In these cases, the wound may be cleaned, kept open under a bandage and allowed to heal slowly from the outer edges inward.

Your doctor will check whether your sense of touch is normal around the cut. The doctor also will feel your pulse and will check whether you can move your muscles near the cut normally. This will help the doctor know whether any important nerves, blood vessels or tendons have been cut. Occasionally, it is necessary to check how deep a cut is by inserting a cotton swab or a probing instrument. The doctor will look into the wound to check for small pieces of dirt, glass, metal or other debris. If necessary, the doctor will order an X-ray that can reveal fragments of glass or metal in the wound.

How It’s Done

First, the doctor will numb the area around the cut using a needle to inject a local anesthetic. Then, he or she will gently clip away any hairs near the edges of the wound. The doctor will flush the wound with saline (a salt solution) and remove any obvious dirt or dead tissue.

Next, the skin around the wound may be painted with an antibacterial liquid. A sterile cloth or paper drape can be placed around the area of the cut to protect it from bacteria and other contamination while it is repaired.

If necessary, the doctor first will repair the deeper layers of the wound and later, the surface skin. To place stitches, the doctor will use an instrument (a “needle holder”) to grasp a curved, threaded surgical needle. After passing the needle and thread through the tissue, the doctor will pull the thread tight, tie a knot and snip the ends of the thread with scissors.

Usually, newly repaired wounds are coated with an antibiotic ointment and covered with a bandage.

If your last tetanus shot is not written in your medical records and you are not sure if you have had a tetanus shot within the last five years, most doctors will recommend a booster shot. If it has been more than 10 years since your last tetanus shot, then you definitely need a booster. It is safe to get a booster shot even if you have had one more recently than five or 10 years ago.

Follow-Up

Once you get home, if you have a newly sutured wound on an arm or a leg, you should try to keep the injured area elevated above the level of your heart during much of the first day of your recovery. This will make it less likely that the wound will swell, so it can heal more easily. You also should make sure that the bandage stays clean and dry, especially for the first 24 to 48 hours.

For lacerations on most parts of the body, stitches can be removed in about seven days. For lacerations on your face, stitches can be removed earlier (in three to five days). Early removal can help to minimize the scar. For lacerations over a joint, your doctor may recommend leaving stitches in place for as long as 14 days, because it requires a longer time for a wound to heal strongly enough to withstand the repeated pulling and stretching that skin endures when it is near to a joint.

Risks

The skin is a natural barrier that prevents infections. A cut can become infected, even when it is cleaned properly and stitched. Even if a cut appears clean before it is sutured, the doctor may give you antibiotics, especially if your cut is on the hand.

Other problems can arise after wound repair:

• You may have a permanent scar. Suture scars fade slowly.
• A sutured area of skin may move less easily than the surrounding skin, creating a pulling sensation.
• A bulging scar called a keloid may form. Keloids occasionally cause itching or discomfort, and they can cause cosmetic concerns.
• Internal tissues occasionally pull apart without healing well, and this can go unnoticed. In the abdomen, poor healing internally can allow the formation of a hernia, a bulge of intestines through layers of a wound that did not seal.

When To Call A Professional

Call your doctor or the emergency department if:

• The skin around the wound becomes red, swollen, hot or painful.
• The edges of the wound leak blood or pus.
• You have a fever.
• You notice red streaks in the skin around the wound.
• A suture pops open, and the edges of the wound pull away from each other.

External resources

U.S. Food and Drug Administration (FDA)
5600 Fishers Ln.
Rockville, MD 20857-0001
Phone: (301) 827-6242
Toll-Free: (888) INFO-FDA (1-888-463-6332)
http://www.fda.gov/

American College of Physicians/American Society of Internal Medicine (ACP/ASIM)
190 North Independence Mall West
Philadelphia, PA 19106-1572
Phone: (215) 351-2600, ext. 2600
Toll-Free: (800) 523-1546
http://www.acponline.org/

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

History of Sutures – Health Beat

Sutures (also known as stitches) have been around for thousands of years and  are used to hold wounds together until the healing process is complete. They were first described as far back 3000 BC in ancient Egyptian literature. For centuries they were made from plant materials like hemp, or cotton or animal material such as tendons, silk, and arteries. The material of choice for many centuries was catgut, a fine thread woven from sheep intestines.
In the 1800’s it became apparent that it was a good idea to sterilize the catgut before using it to suture wounds, In the 1860’s the physician Joseph Lister devised a technique for sterilizing catgut and it was perfected finally in 1906. Eventually, sterilization took place by exposing the suture material to radiation which was more effective than previous techniques.  Each development helped to reduce the risk of infection.
Early in the 20th century synthetic materials were developed that could be used for suturing. These synthetic materials, still used today, were categorized as “absorbable” or ‘non-absorbable’ depending on their ability to be absorbed during the wound healing process.
Absorbable sutures usually dissolve anywhere from 10 days to eight weeks and are made from:
• Silk
• Catgut
• Polyglycolic acid
• Polylactic acid
• Monocryl
Non – absorbable sutures  don’t dissolve naturally and are usually removed after the wound has closed. They are made from:
• Nylon
• Polyester
• Stainless steel
• PVDF
• Polypropelene
Additional new technology has added laser technology and surgical glue to the tools available to physicians for wound healing.  These new materials help the process go quicker and also make the scars less visible. However, even with all the new modern techniques for suturing a wound, many of the basic concepts used today were first developed thousands of years ago.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

This entry was posted in Fun Fact Friday, Health, Surgery, Trauma by Andrew Rubin. Bookmark the permalink.

Stitches or Staples| PhysicianOne Urgent Care

Stitches and staples are both used to close surgical incisions and wounds. With that said, they each have specific benefits and limitations that make them more – or less – appropriate for certain situations.
Understanding Stitches
Stitches are silk, nylon, or polypropylene (prolene) threads which are sewed through skin to bring a wound together. Generally, the patient will wear stitches for a certain number of days, until the wound has healed enough to have them removed. In some cases, however, doctors will use absorbable stitches, which the body breaks down over time. Absorbable sutures are typically part of a more complex, multi-layer wound closure, which require the need to be absorbed since they are buried in a deeper tissue level. These stitches are usually derived from specially processed animal products or synthetic polymer materials, such as polydioxanone (PDS), polyglyconate (Maxon), polyglycolic acid (Dexon) or polylactic acid (Vicryl).
Understanding Staples
Comprised of metal, staples are usually necessary to close deep lacerations, which aren’t appropriate for ordinary stitches. Usually comprised of stainless steel or titanium, they can also be made from materials such as nickel, chromium, plastic or iron. They may also be curved, straight or circular and are generally used during procedures that must be performed quickly, or in areas of the body that are difficult to stitch. Staples may be used on the abdomen, legs, arms, scalp or back; however, they should not be used on the neck, feet or face.
Stitches or Staples: The Advantages of Each
Although they differ in many ways, staples and stitches are cosmetically equivalent when it comes to scarring. Usually, a physician will determine the choice of materials and technique based on his or her experiences and preferences. In most cases, staples are easier to remove and allow for quick wound closure with minimal inflammation. That said, staples require a special tool for removal, while stitches require a simple pair of scissors. Staples also generally require two healthcare professionals – one to align skin using a forceps, and one to apply the staples. On the other hand, it usually only takes one health care professional to close a wound using stitches.
In general, staples offer a few advantages over stitches, including:

• Quick placement: Stapling is about three to four times faster than traditional suturing.
• Fewer Infections: Stapling is associated with lower tissue reaction and a lower risk of infection when compared to stitches.

On the downside, staples are more expensive than stitches. It can also be somewhat difficult to align the edges of a wound for stapling, and some patients may have adverse psychological responses to the idea of stapling.
When to Seek Medical Attention
Most lacerations benefit from being closed with staples or stitches, especially if the wound exceeds a half-inch in length. In addition to reducing the likelihood of infection, treatment can restore appearance, stop bleeding and restore normal function.

Suture or Staple Questions | Advocare Main Line Pediatrics

Is this your symptom?

• This topic covers common questions about sutures (stitches) and staples

Some Basics…

• Stitches and staples are used to keep wounds together during healing.
• They need to be removed within 4-14 days. The specific removal date depends on the location of the stitches or staples. Removal should not be delayed.

When Should Sutures or Staples Get Removed?

Here are some general guidelines for when stitches or staples should be removed.

• Face: 4-5 days
• Neck: 7 days
• Scalp: 7-10 days
• Chest, stomach, and back: 7-10 days
• Arms and back of hands: 7 days
• Legs and top of feet: 10 days
• Fingers and toes: 10-14 days
• Palms and soles: 12-14 days
• Over a joint: 12-14 days

Is It Normal for the Skin to Feel Numb Around the Sutures or Staples?

There are three reasons why the skin near sutures or staples might feel numb.

• Local Anesthesia: the doctor may have injected the skin to make it numb. This way there is no pain when the doctor puts in sutures or staples. How long this lasts depends on what type of local anesthesia was used. Numbness can last from 1-8 hours.
• Numbness from the Cut Itself: some people have numbness after getting a cut. There is numbness just along the edges of the wound. This is from cutting nearby tiny nerves at the same time. Numbness can last 1-3 weeks. These tiny nerves will grow back in 2-3 weeks. The numbness will go away.
• Nerve Injury: sometimes a cut can be deep enough that it cuts a larger nerve. Numbness that is not just around the wound and that lasts more than 8 hours is a clue. For example, numbness that does not go away, just on one side of a cut finger may mean there has been a digital nerve injury. A person with a possible nerve injury should see his or her doctor.

When to Call for Suture or Staple Questions

Care Advice

Stitched or Stapled Wound

1. What You Should Know:
   • Stitches and staples need to be removed within 4-14 days. The specific removal date depends on the location of the stitches or staples. Removal should not be delayed.
   • You should take care of stitched or stapled wounds at home.
   • Here is some care advice that should help.
2. Treatment – Normal Stitched or Stapled Wound:
   • Keep the wound dry for the first 24 hours. Use a sponge bath, if needed.
   • After 24 hours, it is OK to take a short shower.
   • Avoid direct pressure of water on the wound. Gently pat the wound dry with a towel.
   • Apply a small amount of petroleum jelly (Vaseline) on the wound daily. You can buy this at the store. This helps protect the wound and limits scarring. Exception: if your doctor recommended an antibiotic ointment, use that instead.
   • Clean the wound with warm water 1 time per day or if it gets dirty.
   • Change the wound dressing if it gets wet or dirty.
   • You do not need a dressing after the edges of the wound have closed. This most often happens after 48 hours. You may still need a dressing to stop stitches from catching on your clothing.
   • Avoid baths and swimming until the sutures are removed. Water can interfere with healing.
3. When Should Stitches or Staples Be Removed? Your doctor will have told you when to get your stitches removed. Here are some general guidelines for when stitches or staples should be taken out:
   • Face: 4-5 days
   • Neck: 7 days
   • Scalp: 7-10 days
   • Chest or stomach: 7-10 days
   • Arms and back of hands: 7-10 days
   • Legs and top of feet: 10 days
   • Back: 10 days
   • Palms and soles: 12-14 days
   • Over a joint: 12-14 days
4. What Happens If You Leave Stitches (or Staples) in Too Long?
   • Get your stitches out at the right time.
   • Stitches that are left in too long can leave skin marks and sometimes cause scarring. Delays also make it harder to take the stitches out.
5. What Happens If Stitches (or Staple) Fall Out Early?
   • If the stitches or staples come out early, the wound might open up.
   • You can reinforce the wound with tape or butterfly adhesive bandages (Band-Aids).
   • Call your doctor.
6. Treatment – After Your Stitches (or Staples) Have Been Removed:
   • Protect the wound from injury during the next month.
   • Avoid sports that could re-injure the wound. If you must play a sport, put tape on the wound before playing.
   • Let the scab fall off on its own. Do not try to remove it.
7. Pain Medicine:
   • You can take one of the following drugs if you have pain: acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve).
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   • Use the lowest amount of a drug that makes your pain feel better.
   • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old.
   • Read the instructions and warnings on the package insert for all medicines you take.
8. Call Your Doctor If:
   • Wound looks infected
   • Fever
   • Pain or tenderness at the wound site worsens after 48 hours
   • Stitches or staples come out early
   • You think you need to be seen
   • You get worse

Preventing Scars

1. What You Should Know:
   • Scarring is a natural part of the healing process after a cut or wound.
   • Serious injuries and larger wounds are more likely to have scarring.
   • Most cuts that need stitches, staples, or skin glue will have some scarring.
   • Some people are more likely than others to get scars.
   • Here is some care advice that should help.
2. Prevention:
   • Be certain to get the stitches removed when your doctor told you to. If you leave them in too long, they can leave marks.
   • Avoid getting sunburn on the wound area for 2 months.
   • Avoid re-injuring this area.

And remember, contact your doctor if you develop any of the ‘Call Your Doctor’ symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Stitches (for Kids) – Nemours Kidshealth

Everybody gets cuts, and some cuts are bigger than others. That’s why a lot of kids need stitches at one time or another — usually on their face, chin, hands, or feet.

Stitches aren’t for scratches. They’re for bigger cuts that probably wouldn’t heal well on their own. You might take a fall and hit your head or step on something sharp — ouch! Or you might have surgery and get an incision, a cut a doctor makes.

That’s where stitches come in. They join the sides of the cut together so that it can heal. If you need stitches, you don’t need to worry, but you do need to take care of the stitches until the skin heals.

What Are Stitches?

Stitches are loops of thread that doctors use to join the edges of a cut on your skin. It’s a lot like sewing fabric together. But after a few days or a week, the skin heals and the stitches come out.

Once the edges are touching, the doctor ties a knot in the thread so your skin will stay that way until it heals. Doctors have many different kinds of thread, called sutures (say: SOO-churz), including some made of nylon, silk, and vicryl (say: VY-kril). Vicryl thread actually dissolves in your skin, so you don’t even need to get those stitches removed. This kind of thread is used mostly on the lips, face, or in the mouth.

Another way of closing a cut is to use glue! Sometimes, if a cut isn’t too deep or wide, and is on a flat area like the forehead, the doctor will use special skin glue to keep the cut’s edges together until it heals. It usually dissolves by itself in 7 to 10 days.

Another option for tiny cuts is a small sticky strip called a butterfly bandage. It keeps the edges of a shallow cut together for a few days, and then it usually comes off in the bath.

Page 1

How Does a Doctor Put Stitches In?

If you need stitches, the nurse or assistant will usually start by putting a numbing gel on top of the cut. When the skin is numb, he or she will begin cleaning your cut with sterile water, which is squirted into the cut to remove harmful germs and dirt. You’re probably wondering if this will hurt. Actually, you won’t feel much pain at all during the cleaning and sewing of the cut.

Sometimes a liquid numbing medicine will be put into the skin with a small needle. These substances, called anesthetics (say: an-es-THEH-tiks), may numb the area so you feel hardly any pain at all. It’s a lot like the medicine used to numb your mouth when you have a cavity filled.

The doctor also will make sure that whatever cut you (such as a piece of glass) isn’t still in the cut.

Using a very tiny needle, the doctor will sew your cut together with the sutures. Although the area will be numb, you might feel a tug as the doctor pulls the stitches together. Stitches are done the same way at the end of surgery. If you get these at the end of surgery, you won’t feel it — you won’t even be awake!

Page 2

How Does a Kid Take Care of Stitches?

Your doctor will tell you how to care for your cut after it has been closed. It’s important to follow the directions carefully with your mom’s or dad’s help. Different kinds of materials — sutures, glue, and butterflies — need different kinds of care.

The doctor probably will tell you to keep your cut dry for at least 1 to 2 days. Most stitches should not get wet. Some cuts with stitches need to be covered with an antibiotic (say: an-ty-by-AH-tik) ointment and a bandage to prevent infection. Glue, on the other hand, shouldn’t be coated with ointment. It’s important that you don’t tug or pull on the stitches, even if they get itchy. And don’t ever try to take the stitches out by yourself.

If you notice that you’ve popped or torn a stitch, or if your cut is hot, red, swollen, or oozing pus (a yellowish or greenish thick liquid), be sure to tell a parent. You may need to see the doctor to check if the cut is infected.

Getting the Stitches Out

Dissolving stitches, glue, and butterflies come out or off on their own. The doctor or nurse has to remove other kinds of stitches. The stitch is cut at the knot, and the little thread is pulled out. You may feel a bit of pulling, but it won’t hurt. It takes a lot less time to remove stitches than it does to put them in. And once the stitches have been removed, your skin will be fine!

The doctor will tell you how to care for your skin after the stitches have been removed. You may be told to avoid getting direct sun on the area of skin for a while. Sunscreen will be recommended whenever you go in the sun. The doctor also might give you a cream for your skin to make the scar better. Before long, it will probably be hard to see the place where your cut used to be. Most important, your skin will be totally healed!

Types of Sutures: Different Types of Sutures & Their Uses

Surgery of any kind involves several different components and apparatus. Typically, doctors have to tend to and close the wounds, especially after invasive surgery. The wound usually takes several days to recover, and the doctor closes it in such a way that it prevents bleeding and infection. This triumph is achieved with the help of surgical equipment and procedures broadly categorised as surgical sutures.  This article explains the different types of surgical sutures.

What Is A Surgical Suture?

A surgical suture is one of the most common medical devices used by doctors during surgeries. The suture helps in holding body tissues together after a surgery or an injury. The application of a suture essentially involves the use of a needle along with an attached thread. Today, doctors have access to a wide variety and types of surgical sutures of different sizes, shapes and thread materials.

Most people often confuse the word suture with stitches. However, a suture is simply the name of the medical device used by the doctor to repair the wound, whereas stitching is merely the technique the doctor uses to close the wound.

Classification of Surgical Sutures – An Overview

Surgical sutures may be classified in several different ways. Firstly, the material of the suture material is categorised as either absorbable suture or non-absorbable suture. The enzymes in the body tissues can naturally digest the absorbable suture, which is why doctors do not need to remove them. However, the non-absorbable sutures are usually removed after a few days of the surgery. They may also be left in the body permanently, based on the type of surgery that the patient has undergone.

A suture is also classified based on the actual structure of the suture material. For instance, a monofilament suture comprises a single thread that allows the suture to pass through the tissues easily. In contrast, a braided suture consists of many small threads which are braided together. While it is more secure, a braided suture also increases the potential for infections.

Finally, sutures are also categorised as being made of synthetic or natural material, but it doesn’t make much difference since all suture materials are sterilised. Now let us look at the types of sutures in detail.

Absorbable Sutures

Here’s how absorbable sutures are classified:

• Catgut Sutures

  A catgut suture is a natural, monofilament absorbable suture which has good tensile strength. The suture retains optimal strength in order to hold tissues together. Catgut is a smooth and flexible suture with good knotting, and based on its size, it completely disappears between 60 to 120 days. The eventual disintegration of this suture makes it good to use in healing tissues rapidly.

• Polydioxanone Sutures

  A type of synthetic monofilament suture, the polydioxanone suture or is used to repair various kinds of soft-tissue wounds, abdominal closures. Surgeons also use this suture during paediatric cardiac procedures.

• Poliglecaprone Sutures

  The Poliglecaprone suture is a synthetic monofilament suture, generally used to repair soft tissues. It is commonly used for the purpose of subcuticular dermis closures on a patient’s face, and as a ligature. These sutures promote scar-free, aesthetic healing. The suture material is used in case of vascular anastomosis procedures that connect blood vessels.

• Polyglactin Sutures

  The Polyglactin Suture comprises a synthetic braid, which is good to repair lacerations on the face and hands and is the most preferred option for general soft tissue approximation. Like the Poliglecaprone suture, this suture too is used in of vascular anastomosis procedures. Polyglactin sutures typically have a mild tissue reaction, for the duration of the absorption process but are a better alternative to catgut sutures as the absorption level of this suture is more predictable. Also, this suture exhibits little to no tissue reaction.

Non-absorbable Sutures

While speaking about the types and uses of surgical sutures, we must also mention non-absorbable sutures. These sutures are made up of special silk, or synthetics like polyester, poly propylene or nylon. Non-absorbable sutures may or may not include coatings that enhance their performance characteristics and are typically used to close skin wounds. The suture is removed after a few weeks.

These sutures are typically used in heart surgeries like vascular anastomosis procedures (due to the constant movement and pressure on the heart). Non-absorbable sutures usually cause less scarring since they provoke a much lower level of immune response, which is why they are also used in surgeries where the cosmetic outcome is significant. These sutures may be left in permanently or removed after a while, depending on the intensity of the wound.

With Meril Endosurgery, surgeons can provide patients with a one-stop solution to an extensive portfolio of products comprising various absorbable and non-absorbable sutures. We also provide tissue sealants, absorbable hemostats, hernia repair and other state-of-the-art devices.

The Process and Techniques Involved in Suture Selection

The suture materials used by surgeons and physicians are essentially graded as per the suture strand and diameter. The material is then attached to a suture needle. Doctors use different types of suture needles of varying sizes and shapes, and the needles are chosen as per the surgery being performed. For instance, a suture can have a cutting edge or a non-cutting edge. A large suture needle closes more tissues with every stitch, while smaller needles help to reduce scarring. Let us understand the varying suture techniques and the different types of suture needles.

Types of Suture Techniques:

There following are the different types of surgical sutures techniques:

A continuous Suture is a surgical technique which involves several stitches wherein the doctor uses a single strand of the suture thread material. This technique is applied rapidly while placing a suture. It is also strong as it allows the tension to be evenly distributed throughout the suture strand.

The interrupted suture is a technique that uses many strands of the suture material in order to close a wound. Once the stitch is made, the doctor cuts off and ties the material. The interrupted suture technique enables the doctor to close the wound so securely that even if one stitch breaks, the remaining ones can still hold the wound together

Yet another type of surgical suture technique is the deep suture technique. Here, the doctor places the suture under the tissue layers, which are deep below the skin. The sutures can be either interrupted or continuous and are often used in procedures in which the facial layer has to be closed.

The buried suture technique is applied by doctors such that the suture knot is found inside, i.e. within or under the area that has to be closed off. This type of surgical suture is not removed typically. It is often useful when large sutures are used in the deeper corners of the body.

A type of continuous suture, the purse-string suture is placed around the infected area. It is typically tightened in a pattern that resembles a drawstring attached to a bag. This suturing technique is used to reduce the surface area of a circular wound, with the aim of obtaining minimal scarring.

The suture that is usually placed in the patient’s dermis, i.e. the layer of tissue which lies below the skin’s upper layer, is known as the subcutaneous suture. In this type of suture, the doctor places short stitches in a line, parallel to the wound. The doctor also anchors the stitches on either end of the wound.

Description and Types of Suture Needles

Doctors use suture needles to place the sutures within the tissues. The needle carries the material through the wound with minimal residual trauma. Typically, these needles are rigid enough and can resist distortion, but also flexible enough, such that they can bend before breaking. Depending on the wound being repaired, the doctor also uses a slim needle that can minimise trauma. At the same time, it should be sharp enough so that it can penetrate the tissue with negligible penetration. The needle should be stable so that it permits accurate placement. Suture needles are usually made of stainless steel and are composed of the following elements:

• The needlepoint which gently pierces the tissue, starting at the body’s maximal point and running at the needle’s end. It can be sharp or blunt.
• The blunt suture needles are designed to penetrate into muscle and fascia. It can be used to reduce the risk of potential blood-borne infections arising due to needle-stick injuries.
• The sharp suture needle pierces and spreads the tissues with little cutting and is used in areas in which leakage needs to be prevented.

The shape of the different types of suture needles varies as per the curvature and is described in proportion with the circle completed. The most commonly used curvatures include ¼, ½, 3/8, 5/8, etc.

Final word: Meril Endosurgery products are used in over 100 countries worldwide. At Meril Academy, we also provide hands-on training sessions to aspiring surgeons across the globe. Surgeons trained at Meril are taught about the use of surgical sutures. They also take several factors into account while choosing the types of sutures and materials, which include the patient’s personal preference, the tissue type, and the infection risk.

Read More About : Meril Endo surgrical devices and its wide variety of Meril sutures

90,000 Types of stitches – learning to sew with A. Corfiati

Types of machine seams and their application

In this tutorial, we will go over the details of the stitches that can be sewn on the sewing machine. Machine seams are divided into 3 main groups – connecting, finishing and edge. Having studied the types of machine seams, understanding how each of them is performed and practicing on samples, you will ensure that all seams in your products will be perfectly executed.

back to contents ▴

Machine joining seams

Stitch machine seams are used to grind parts of a product, and are the most common when sewing products.Seams are sewn with a simple machine stitch. The stitch length depends on the fabric and the purpose of the seam.

Fig. 1. Types of machine seams – connecting

back to contents ▴

Machine stitch seam “on the edge”

To form a machine seam seam, two parts are folded on the edge with the front sides inward, the cuts are equalized and a machine line is laid at a distance of 0.5–2.0 cm from the edge.

The seam can be made both without landing, and with the landing of one of the sewn part.When performing a seam with a fit, the upper part is seated. A rib stitch is used when joining sleeves with armholes, burlap pocket details, as well as when making other stitching seams.

back to contents ▴

Machine stitch seam “iron-on”

When performing a machine stitching seam, the stitching is first performed on the edge, then the allowances are ironed on and both allowances are ironed on one side. A stitching stitch is used to join the side, shoulder and other seams of delicate fabrics.

back to contents ▴

Machine stitch seam “iron-on”

When performing a stitching seam in ironing, first, a machine stitching seam is performed on the edge, then the line is ironed, the allowances are ironed in different directions. This machine stitch is used to join the side, shoulder and other seams of products.

Fig. 2. Types of machine seams – connecting overhead

back to contents ▴

Machine overlap with open cut

To make a patch seam with two open cuts, the parts are laid on top of each other with the front sides up and grinded at the same distance from the cuts. Slices are left open. The width of the allowances is 0.2–0.7 cm. This type of machine seam is used when sewing products from fabric that does not require processing – loden, sheepskin fabrics, parts of gaskets, etc.

back to contents ▴

Machine overlay seam with one closed cut

When sewing a patch seam with one open cut, first sew a seam seam per edge. Then the line is ironed, the seam allowances are ironed onto one of the parts, along which a finishing line is laid on the front side.The distance from the seam to the overcast line depends on the model 0.5–1.0 cm.

If the model has two finishing lines, the distance from the sewing line to the first sewing line is 0.2 cm. The distance from the first line to the second is 0.5–0.7 cm.

Machine overlay seam with one open cut is used to join parts (for example, a yoke with a shelf) in the manufacture of clothing.

back to contents ▴

Machine overlap with two closed cuts

a) To perform a machine overhead seam with two closed cuts, the edges of the cuts are folded to the wrong side or swept by 0. 5-0.7 cm.One edge is placed on the other and a line is laid at a distance of 0.1–0.2 cm from the folded edges. This seam is used to process belts, straps, cuffs, etc.

b) The second way to make a machine overhead seam with two closed cuts is to bend both cuts by 0.5–0.7 cm, put on the product and stitch at a distance of 0.2 mm from each edge. Applied when performing the wings.

Fig. 3. Types of machine seams – connecting underwear

back to contents ▴

French seam

To perform a French or double seam, the parts are folded inside out and grinded with a seam width of 0.3–0.5 cm.Then the part is turned inside out to the front side and the seam seam is straightened so that it is located along the edge. The second line is laid at a distance of 0.5-0.7 cm from the fold so that the cut of the seam is sealed inside. This type of machine seam is used when sewing clothes from loose and transparent fabrics.

back to contents ▴

Seam

To make a seam seam, two parts are folded with the front sides inward, an allowance for one part is cut off to 0.5 cm. Then the parts are grinded.The allowances are bent towards the part so as to cover the smaller cut. The cut of the larger allowance is folded over and the second line is laid at a distance of 0.1–0.2 cm from the folded edge. The width of the sewing seam is 0.7–1.0 cm. The machine sewing seam is used for the manufacture of bed linen, as well as in products made of fine fabrics without lining, denim clothing.

back to contents ▴

Seam “in the lock”

Machine-made seam “in the lock” is similar in design to the sewing one, but it is made a little differently.First, a patch seam is made with two open cuts. Then each part is turned off for a cut and adjusted according to the allowance. The machine seam “in the lock” is very durable and is used when sewing products where reinforced stitching is required – work clothes, backpacks, etc.

Fig. 4. Types of machine seams – finishing

back to contents ▴

Machine topstitch

To carry out a machine topstitching seam, first perform a stitching seam, then the seam allowances are laid out in different directions and two finishing lines are laid on the front side at the same distance from the stitching stitching.The distance from the sewing line to the detaching line depends on the model (0.2-0.5 cm), from the seam cut to the detaching line – 0.2-0.5 cm. not allowed, for example, in leather goods.

back to contents ▴

Machine overhead stitch

To make a machine stitching, mark the required fold width, lay a fold along the markings and stitch. The seam is used to make folds on products.

Open cut stitch

To sew a machine stitching seam with an open cut, it is necessary to grind the part along the markings, turn it to the front side and topstitch along the edge. The seam allowance remains open. This seam is used when processing pockets, yokes, etc.

back to contents ▴

Closed-cut stitching stitch

It is carried out in the same way as an open cut topstitch, but the seam allowance is cut off and stitched inside with a finishing seam.This seam is used when making pockets, yokes, etc.

Fig. 5. Types of machine seams – finishing

back to contents ▴

Machine patch seam with piping

Insert edging between the details according to the markings, stitch on. Place the line at a distance of 0.3–0.4 cm from the edge of the piping. Turn the parts to the front side, lay the allowances on one of the parts, press them down. It is used when finishing seams on the front side of products and on the lining.

back to contents ▴

Machine overcast with piping

Fold the edging with the detail of the product, stitch it.Turn the details to the front side, press them down. This type of seam is used for finishing pockets, collars, bed linen, etc.

Fig. 6. Types of machine seams – edge

back to contents ▴

Machine open cut edge seam

When sewing a seam, the bias tape is attached to the part of the product at a distance of 0.5 cm from the edge, folded to the front side and adjusted 1 mm to the right of the edge of the tape. The inner cut remains open and may be covered with a lining or left open, depending on the product.

back to contents ▴

Closed-cut machine edging stitch

When sewing a seam, the bias tape should be stitched to the seam allowance at a distance of 0.5 cm from the edge, the seam allowance should be wrapped with an inlay, the edge of the tape should be tucked and stitched at a distance of 0.2 mm from the edge. It is used when edging sections of products without lining.

back to contents ▴

Tape piping

Closed-section tape is used for edging with tape. The width of the tape is determined by the model. To make a seam, the edge of the part is wrapped with a tape bent in half, a seam is laid along the edge of the tape.It is used for edging pockets, collars and other details.

back to contents ▴

Machine hemmed stitch

To sew a seam, an oblique facing must be bent in half, ironed. Apply the facing along the markings, sew a seam, bend the facing, press it on. This type of machine seam is used when processing framed pockets.

Machine overhead stitch “Split”

When making a machine overhead seam in a split, first perform a seam “on the edge”, then turn the parts to the front side, straighten the seam so that it is located along the edge.The machine seam is used when processing chords and other double-sided parts.

back to contents ▴

Machine overcast seam “to the edge”

When making a facing seam “in a split”, first perform a seam seam “on the edge”, then the parts are turned to the front side, the seam is straightened with the formation of an edging on one side. The machine stitch is used for hemming, collars, cuffs and other garments.

Fig. 7. Types of machine seams – edge

back to contents ▴

Machine overcast with closed piping

To sew a seam, bend the inlay in half, stitch to the detail of the product along the edge at a distance of 0.5 cm from the edge, turn the inlay to the front side and topstitch along the edge.Such a seam can be used for processing the bottom of parts and sleeves, facing pockets, etc.

back to contents ▴

Machine overcast with double piping

To process a seam, it is necessary to stitch one side of the inlay along the edge of the part, turn the inlay to the front side, bend over the edge and topstitch at a distance of 0.2 mm from the edge of the inlay.

Fig. 8. Narrow edge seams

back to contents ▴

Moscow seam

To make a Moscow seam, the allowance must be turned up by 0.5 cm and at a distance of 0.2 mm from the edge, place a line.Cut off the excess allowance, bend the edge of the part by 0.3 mm and lay the second line over the first. The Moscow stitch is used for processing the edges of delicate fabrics – scarves, shawls, etc.

back to contents ▴

Machine seam zig-zag

To sew a machine zig-zag seam, bend the cut and stitch along the edge. The width and frequency of the stitching are determined by the model. Cut off excess allowance. Such a seam is used for processing the edges of flounces, sewing knitwear, etc.p.

back to contents ▴

Machine Hem Stitch, Open Cut

A machine seam in a hem with an open cut is performed as follows: the cut of the seam is processed with an overlock seam, the allowance is folded over and adjusted. Such a seam is used when hemming the bottom and sleeves of products.

Machine Hem Stitch Closed Edge

When sewing a machine seam in a hem with a closed cut, the cut of the seam is folded by 0.5–0.7 cm. The seam is sewn at a distance of 0.2 cm from the edge.

See also:

Construction joints: purpose, design, sealing

During and after construction, structural elements of concrete structures change their geometry under the influence of temperature, soil settlement and other external factors. Even the smallest and visually imperceptible changes cause stresses in the structure. Expansion joints in buildings and reinforced concrete structures compensate for stresses. If they are designed correctly, the inevitable cracking occurs in the given direction and at an acceptable scale.

What is an expansion joint and why it is made

There are different types of construction joints – external interpanel, butt, movable, connecting, insulating, shrinkage, construction, anti-seismic and others.

The expansion joint of a building structure is a planned movable rupture in a monolithic or reinforced concrete element. Its task is to compensate for the stresses resulting from the deformation of the building.

The device of expansion joints depends on their location and purpose.Let’s consider the main ones.

Sedimentary – expansion joints in walls, ceilings, foundations. Cuts are made in all parts of the building to compensate for shear stresses from settlement.

Temperature – expansion joints of the building in the above-ground parts, from the base of the foundation to the roof. They relieve stress from temperature extremes.

Shrinkage – expansion joints for floors, blind areas. Eliminate chaotic cracking of the element during hardening and shrinkage of concrete or mortar.

Structural joints – joints to compensate for small horizontal movements. It is optimal if they coincide with the shrinkage ones.

How many meters are expansion joints made

The location and parameters of the seams depend on the purpose and dimensions of the structure. In the calculations, the basic recommendations for expansion joints are used:

• external expansion joints are made with a step of 2-3 m, the area of ​​a single piece should not exceed 9 m ² ;

• blind area is cut with transverse lines, the optimal step is equal to twice the laying width, but not more than 6 m;

• Internal screed must be divided if its area exceeds 30 m ² , with an aspect ratio of more than 1: 1.5 and always with a side length of more than 25 m.

Consider the location of the shrinkage lines in advance, since the expansion joint of the slab must be made immediately after pouring the concrete – within 24 hours. Otherwise, chaotic cracks may appear due to shrinkage. Sedimentary and expansion joints are calculated at the design stage and must be coordinated in the architectural and construction supervision.

Sealing construction joints: how to seal cuts and joints

All seams must be protected from chemical, mechanical and other types of stress.The most effective methods are sealants. These are pasty compositions with universal properties. They provide waterproofing and also allow the joint to move. The sealant is easily applied with a construction grout gun. In addition to convenience – economical consumption and, accordingly, reduction in sealing costs.

Compositions with increased plasticity are optimal for sealing expansion joints in building walls, screeds, foundations, blind areas and other structural elements.For example SikaFlex ^® Precast is a polyurethane construction joint sealant. Easily withstands seam movement up to 25%, lengthens up to 4 times.

When choosing an insulating compound, one must take into account the type and location of the seam. Polyurethane expansion joint sealant in concrete is versatile. Most of them can be used internally and externally on any porous substrate. Silicone compositions have high water-resistant properties and good adhesion to smooth materials.For example, Sikasil ^® Pool perfectly insulates pool joints, while Sikasil ^® Universal adheres firmly to aluminum, glass, and ceramics.

How to properly seal construction joints: operating procedure

• Clean seams of dirt and dust with a brush or vacuum cleaner.
• Prime and dry joint surfaces to full depth.
• Apply sealant with a construction gun.

Important: Poor quality insulation will reveal the seams over time, so you cannot save on protection. We recommend the use of Sika ^® products. Reliable sealants for joints – moving, external, internal, plumbing and others – effectively and permanently isolate cavities, prevent their destruction and cracking of the entire concrete element.

art that does not require sacrifices, but helps to avoid them – GOLNIT

The operation is completed – the surgeon sutures the tissue.All the most important and difficult things are behind us. But don’t underestimate these few stitches. Both the aesthetics of the patient’s body and the degree of risk of complications depend on the “sewing” skill of the doctor. .

Sutures are used in surgery – during operations to connect skin tissues during incisions, as well as the walls of internal organs. They are also used in traumatology – when treating wounds resulting from injuries. Suturing stops bleeding and prevents infection.Depending on the damaged organs, tissue characteristics, wound depth and other nuances, different techniques, materials, technologies can be used.

Handicraft is a special art

It would seem that innovation always wins. And new technological ways of joining fabrics during surgery should gradually replace manual seams.

For example, joining the edges of a skin wound with titanium staples. Or, as this method is also called, a skin stapler.There is also a special device for removing these clips. Staples are also used, which dissolve by themselves.

Special endoscopic staplers are also used. Some of them allow you to carry out all the manipulations with just one hand. All these technologies significantly reduce the time of operations and facilitate the work of surgeons and assistants.

But the use of expensive equipment and materials is not always available and cannot always replace traditional suture material.The surgeon’s hands are a versatile and reliable device. An experienced doctor will always ideally select the needle and thread for each specific case, correctly tie the knots. All this affects the outcome of the operation. Moreover, the negative results of an unprofessionally executed seam can be felt both immediately and after a long time.

For this reason, manual suturing is still the basic technique.

Is the seam beautiful or reliable?

If we talk about the seams that connect the edges of the wound, then there are several ways.Skin sutures always have cosmetic consequences for the patient’s appearance. And usually doctors take this into account.

The most gentle in terms of preserving the skin is considered to be a continuous intradermal cosmetic suture.

Metal staples are often used – they do not leave transverse stripes on skin at healing time.

There are special seams for connecting tissues of internal organs, for example, tendons, blood vessels, liver, etc.Interestingly, they differ in technique depending on the type of organ.

Based on the location of the suture, the characteristics of tissues and organ, as well as the importance of appearance for the patient, the surgeon chooses a certain technique.

Knot for memory

A securely tied knot is not just the final point in the operation. This is a significant part of her success. The professionalism of the surgeon in performing this technique determines how well the tissues will grow together and how safe the recovery process will be.

One seam can have any number of knots. The more there are, the higher the reliability. If the thread breaks in one place, the other stitches will remain intact and hold the fabric tightly.

It is important not to overtighten the tissues at the junction, so that necrosis does not develop. But at the same time, provide the necessary density.

The knot must be tightened the first time, otherwise the wound will disperse.

Surgical sutures: a variety that would be the envy of needlewomen

There are a lot of types of surgical sutures now.They differ in both brands and characteristics. There are several classifications:

1) Absorbable and non-absorbable. The first ones are excreted from the body by themselves and are used if the tissues grow together in a short time – up to 120 days. Or to connect internal organs. But again, in the case when long-term or even permanent tissue bonding is not required.

• Natural and synthetic. Natural threads from silk, linen, cotton and catgut, as practice has shown, have many disadvantages.

In synthetic tissues, the time of biodegradation is more precisely determined – the ability to independently be excreted from the body. It is important to know exactly how long a given material can hold the fabrics taut. If the thread looses or breaks before the tissue heals, it can be extremely dangerous. Catgut, for example, is unpredictable in this regard. But flax and cotton, due to their naturalness, can be conductors of microbes in fabric, so they also practically ceased to be used.

Synthetic suture material can also be of several types, depending on the material. There are polyamide (nylon), polyester (lavsan), polypropylene, polymer, fluoropolymer, etc. As with the technician, the surgeon chooses the suture based on the situation and personal preference. This choice is usually not discussed with the patient.

3) According to the structure, the threads are divided into monofilament (monofilament) and braided. Simply put, braided yarns are several strands that are interconnected by twisting or weaving.Monofilament is more gentle to fabrics, but less durable. The rope or pigtail is tighter but stiffer.

Interestingly, new technologies are leading the way when it comes to material selection, as opposed to innovative suturing techniques. Doctors are actively switching to modern types of suture material, realizing their clear advantages, safety and reliability.

Sharp topic – surgical needles

When the word “needle” is used, most people think of a straight, shiny tailoring needle.But in surgery, most needles are bent to some degree. More curved needles are used to suture tissue deep into the wound. The sharpness and shape of the tip of the needle depends on the area of ​​application. For example, needles for connecting vascular tissues are especially sharp and require special sharpening.

A curious fact – sometimes black needles are found. So, with long-term operations, the load on the doctor’s eyes is less.

In the 80-90s of the last century, atraumatic suture material appeared.The thread rolled into the tip of the needle does not injure the tissue during passage, since its thickness coincides with the thickness of the needleless needle. Also, the thread does not fold. This invention was a real breakthrough in surgery.

A good suture – a sterile suture

Along with innovative materials and technologies, simple rules for adherence to antiseptic and aseptic requirements play a huge role in the success of suturing. All surgical procedures should take place in rooms where regular aseptic cleaning is performed on a regular basis.

Most materials and instruments come to surgery sterilized and are intended for single use. All this significantly reduces the risk of infection when applying and processing sutures.

The last chord – remove the stitches

If there are no complications, the stitches are removed by a paramedic or nurse. The presence of a surgeon is not required. Usually, the stitches are removed in a week and a half after the operation. In older people, this period may take longer, since the tissue does not heal as well.

The seam is pretreated with disinfectants such as iodine. The thread is cut and pulled out, after which the seam is processed again.

This procedure is not completely painless. Feelings may differ depending on the type and complexity of the operation, on how well the wound has healed.

It is important to closely monitor the suture after surgery and suture removal. If it seems to the patient that something is going wrong, that the wound does not heal so quickly, if it begins to fester, one should not hesitate and be sure to consult a doctor again.

BMJ Best Practice

Practical Suturing Techniques – Animated Examples

Equipment Required

• Sterile Gloves

• Sterile Antiseptic Skin Preparation (Povidone Iodine or 906 Chlorhexidine 908

  5) 9000

• Surgical drape

• Surgical swabs, gauze

• Sterile syringes and needles

• Local anesthetics

• Suture materials

  5

• Suture materials

  5

• Scissors

• Scalpel

• Wound dressing.

Contraindications

In general, there are no absolute contraindications for suturing, but delayed closure may be the best option for infected wounds or if some time has passed since the injury.

• Interrupted suture – to close the skin, the interrupted suture is only suitable in places where the edges of the wound are under low tension. If the tissue is under a higher tension and additional strength is required, you will need to apply a deeper layer of absorbable sutures to the dermis.After you have closed the wound using this method, you can use the interrupted stitches to close the skin.

• A vertical mattress suture, compared to a simple interrupted suture, is more durable and less likely to stretch or cause ischemia of the wound edges. However, necrosis of the edge of the skin will still occur in the event of excessive tension, and other techniques such as an absorbable deep suture and / or fold of the edge of the skin may be required.The selection is based on clinical considerations. Seek help if unsure.

• Horizontal mattress seam – avoid using it in more aesthetically important areas. Suitable for wounds with low tension, but necrosis at the edges of the skin will still occur if the tension is increased, and then other techniques such as absorbable deep suture and / or fold of the edge of the skin may be required. The selection is based on clinical considerations. Seek help if unsure.

• Continuous subcutaneous suture – Continuous subcutaneous suturing is not indicated for traumatic wounds where the edges of the skin are irregular, of uneven length, torn or injured. It is not used when there is a significant risk of wound infection (for example, when the wound is contaminated), since the application of a continuous thread means that the infection will lead to complete dehiscence of the wound.

• Continuous suture – do not use to close skin (used to close connective tissue) or if there is a risk of wound infection.

Indications

• Restoration of functional integrity of skin or other tissues

• Minimization of scar formation

• Control of bleeding.

Broken suture:

Designed for easy wound closure when the edges of the wound are under low tension. In the operating room, they are also used to consolidate deeper tissues such as muscle layers, mesentery, and fascia.If the tissue is at a higher tension, additional strength is required, then you will need to apply a deeper layer of absorbable sutures to the dermis. After you have closed the wound using this method, you can use the interrupted stitches to close the skin.

Vertical mattress seam:

Used for simple closure of wounds, including contaminated wounds after trauma. They are especially useful when the wound requires more tension to connect the edges of the skin, or for thin skin where this method helps to effectively pull the edge of the skin.In the operating room, they can also be used for hand-stitched bowel anastomoses. Compared to a simple interrupted suture, a vertical mattress suture is more durable and less prone to stretching, and less often causes ischemia of the wound edges.

Horizontal mattress seam:

Horizontal mattress seams are especially useful when the wound is under some tension and in an area considered relatively less aesthetically important. This technique dissipates tension at each suture and ensures that the wound edge is turned up securely, which promotes healing.

Continuous subcutaneous suture:

Continuous subcutaneous suture is used to repair a straight, clean wound that can be closed without tension. Its main use is for operated wounds where there was no contamination. If performed correctly, this method leads to an excellent cosmetic result, since the integrity of the skin is preserved, and the seam is hidden and invisible under the skin.

Continuous suture:

Continuous suture is usually used to close layers of connective tissue.It is quick and easy to apply, and it distributes stress evenly. Examples of the use of a continuous suture are the closure of the white line of the abdomen after laparotomy or the closure of the external oblique aponeurosis during hernia repair or open appendectomy. Thin vascular anastomoses are also constructed using the continuous suture technique.

Complications

• Infection

• Hematoma

• Wound gaping

• Scars.

Aftercare

Stitch Removal:

Non-absorbable stitches are removed after:

• Face and scalp – 5 days

• Extremities – 7-10 days

• Trunk and back – 10 14 days.

When additional tension arises during healing due to swelling or loss of skin, the mattress sutures should be left a little longer until adequate healing occurs.

Antique hand stitches.Books. The originals. The stitches in my works.

Seam stitching

(now the seam: manual stitch is called – my note)
– this is the name of a seam for a needle if there is no gap between the stitches.

The needle is driven into the same hole from which the previous thread comes out.
And it is pulled at a distance equal to the next stitch.
This seam must be very correct, and this is achieved first by counting the threads of matter

****
( attention !! My note.How petty it was! ).
*
The stitch takes one or two threads, depending on the thickness of the fabric. With a straight stitch for linen, a thread of thin fabric is pulled out where the seam should be, the pulled out thread is replaced by a seam. If the line should go obliquely or on thick matter, then, so that the line is straight, they make a basting with a thread that is different from the color of the matter.

——

Technique of seams from

“Complete encyclopedia of women’s needlework”

Quote from this book (encyclopedia):
“Body position:
Before moving on to explaining stitches and seams, note that whatever your job, you need to take care of a comfortable posture.
… …
You should never pin the work to the knee: the posture that the body takes at the same time is ugly and non-hygienic.
The work should be pinned to a pillow with a heavy base so that this pillow cannot bend on the stitches. ”

And further:

“The position of the hands when sewing with a pad.

– Stick the material to the pillow and hold it with your left hand. But the left hand should not rest on either the pad or the table.
The thumb and forefinger of your right hand should grab the needle halfway.

The middle finger, on which the thimble is put, rests on the eye of the needle and pushes it into the fabric far enough so that the thumb and forefinger can grab it below the stitch and stretch it along with the thread.

The thread passes between the 4th and 5th fingers and forms a loop on the last one, which must be pulled gradually so that no knot is formed. “…

Next is the drawing of this pad: so small, attached to the table.
But there were also devices, such as a clamp, that simply clamped the end of the fabric.

Simple scar

( is now an over-hemmed seam, or blindfold – my note .)
– in order for the scar to come out well, you must first bend the matter along a straight thread, if the matter is stiff, like linen, nansuk or calico, then first, to make it softer, rub it between your fingers.

The first fold is made at the largest by 2 mm along the entire length at the seam.
Then a second fold is made (as wide as needed) the edge of the material is hidden between the two folds.Only scars wider than 1 cm are noticed, and the first bend is made only of such width that the matter does not spill out.

Stitch length grab one thread of fabric under the scar (now we call it a seam – my note.) And pass the needle slightly obliquely, two threads above the bend of the scar. The space between the stitches is two threads.

The stitches must be in a straight line. It is not recommended to pull out the thread for this. Because matter from this loses strength.
Woolen fabric does not keep the fold, and therefore it has to be folded gradually, or swept.

This stitch is used when a folded seam is to be made. The needle should go into the bottom fabric and into the middle (folded) layer, but the stitches should not be visible from the side that lies on the left hand.

My note : in this way a straight neck was processed at shirts, and a “lock” was made at the end of the cut – these are several looped seams as when processing loops. The seams are arranged in a fan.

The end of the cut could also be processed with a corner (this is clearly seen in the photo from the museum on Paul’s shirt – see.post above), or sew on a triangle of white leather.

Flagellum suture.

-Very thin materials are cut not with an ordinary scar, but with a flagellum. The edge of the fabric is gradually twisted with the thumb and forefinger of the left hand and immediately collect this edge on a needle, the threads are pulled through 4-5 stitches.

Matter is pushed onto the needle with a little assemblage.
( The picture shows that the needle goes over the edge of note ).

Round stitching

( is also a seam over the edge – my note.)
-The threads for this must be very strong.

It is never necessary to pull the lace, it is better to let it loose, because it shrinks on the first wash.
Sew tightly over the edge to the hem and prevent the lace from wriggling. To do this, you need to make sure that the threads that braid the lace are guided in a straight line.

Once in a conversation, I made a reservation that I could make an old butt seam so that no one would even notice the seam itself.
How to do it:
We read from the same book a translation from French:

“

Seam over the edge .

– This seam is used to join two edges.
For correctness it is better to sweep the seam first.
The needle is injected from behind, one thread from the edge.

The next seam is made to the left, through two threads. You don’t have to pull the thread too much to get the stitches free. When the seam is brought to the end, the pieces of fabric are unbent and the seam is straightened from the inside out with a thimble. The edges should fit edge to edge, but not overlap.

————————————————– ———-

Top seam for top dress –

For upper things and patches, a seam over the edge is also used, and the needle goes from left to right, but sticks not towards itself, but from itself.

It is best to first sweep and hold the fabric with only your thumb and forefinger, so as not to stretch out any side. ”

“

Invisible darning on the cloth –

– Despite the complexity of this work, very few people know it. This work is painstaking, requiring a lot of patience and accuracy, but it is very easy to understand it.
A needle is taken very thin and sewn with hair, which is less noticeable than silk or thin thread, and at the same time stronger than threads pulled from the cloth.

Red and white hair is stronger than all others. Needless to say, the hair must be thoroughly wiped, washed and de-greased before starting work.

First of all, the edges of the cloth from the face are carefully cut with a razor in a perfectly straight line. Scissors can remove too much lint to mask the seam.
When the edges are ready, a patch is applied to them and it is rarely swept over the edge. Then they take a needle, thread the hair with a spine into it and pierce the fabric 2-3 mm from the edge.

The needle should not go through the cloth, but drag the hair in the layer of matter, coming out 2-3 mm from another cut. The needle is injected back into the same place where it came out, then they give it a slightly oblique direction so as not to pull out the already threaded hair. It is not necessary to stretch the hair too much, it is better if it lies freely.

After finishing the seam, it is smoothed on a bare, hard wooden board, through a wet towel from the inside out. If the darning is done well, the keenest eye will not notice it. ”

So, let’s see:

On my own I will add:

Point-to-point stitch is our modern back stitch.

With one difference that the stitching itself on the front side is equal to the needle puncture of only one or two (depending on the density of the fabric) threads of the fabric (the size is exactly the same as the point with a pencil on paper), and not two to five mm. And it does not reach the previous puncture, but leaves a distance of 2-4 mm empty.

The fluff is a completely different seam.
And its purpose is different: for the internal connection of parts of products with air stitches, which lie down without tightening too much.

For example: attaching the center hem to the front, collar, etc.
A point-to-point seam replaced the main modern machine seam in the old days.

Now this seam can be used for sewing lines on the lapels of coats, jackets, etc. mostly for beauty.

…………………………………….

————————————————– –

Stitches: to the point, over the edge, hidden, overcast in my works:

>

The hem and folds on my shirt by hand.

Material – medium linen:

————————————————– ————————————————– –

QUESTION to me:

Svetlana, I have a question about the seam to the point. How does it differ from the “beaded seam”? I already understood about the stitch length, maybe there are still some nuances?

My ANSWER:
Before answering this question, let’s try together to deal with all these pop-up names of the same seam here and there.
For example:

This seam (as in the picture above) is also called the “seam for a needle”.

And if you pierce just one thread back (by the needle), then you get a seam “to the point” (the name until the middle of the 19th century).
Other type of seam:

It was also called in the 19th century: “line”, and already in the 20th century – “hand stitch seam”, because. replaced the machine.
This seam should be very correct (even). What is achieved when sewing products from light fabrics – by counting threads, thick ones – by the skill of a dressmaker and a good eye.

What is a point-to-point seam and how does it look in the products of its time?
This seam was used most often, mainly until the middle of the 19th century, until the seam was invented. sacking.

This stitch not only fixed the layers of fabric, but also made the finishing line and quilted the product.

A seam is made much faster and easier than a stitch seam.
Another advantage of such a seam is the seamy side, namely its neatness. The threads from the seam on the wrong side do not intertwine as clearly with each other as with the seam “back to the needle”, but lie in an even stitch.

Moreover, with good dexterity, you can achieve that either the dots from the threads or neat stitches of small width will remain on the wrong side. That is very valuable when sewing a product by hand, because. make both the outer and the back look more beautiful, and at the same time the seam itself is strong and invisible (if necessary).
Here are some examples of the appearance from the originals of that time (18-19 centuries)

Now about beaded stitch.

This seam is made on the basis of a needle back seam.Those. its task (of the seam itself) is to fix the bead (beads) so that the thread is invisible.

And therefore, the seamy side is not so essential with this kind of needlework.
Precisely handicrafts, not making products (sewing).

———————————————–

LINES:

Edging with a cord single, double edging with a cord from the book “Guide to dressmaking” 1876 p. 28-31 https://archive.org/stream/guidetodressmaki…age/28/mode/2up

source club Season.

—————————————-

Read the same:

Types of decorative seams

The simplest seams

The simplest seams are the basis for all types of embroidery. They are used when embroidering towel seams, satin stitch, and rococo winding, are the main ones when embroidering with ribbons and beads. And also of them you can make up compositions that are used to decorate clothes. Patchwork finishing seams are widely used to mask and decorate seams.The simplest seams also include finishing and edge seams.

Seam “Forward needle”

This seam is a series of stitches and gaps of the same length. It is convenient to embroider it on the canvas by counting the cells. For example, one cage per needle and one under. By changing the size and position of the stitches of this seam, you can create a wide variety of embroidery for finishing napkins, towels and clothes. The stitches can be arranged in two or more rows – it all depends on the pattern. One of the options for the forward needle seam is the Millet seam.

Stitch “Forward needle”

Stitch “Millet”

Back needle stitch

Behind the Needle, Needle Back, or Stitching Stitch is a continuous row of stitches. We fasten the thread, make the first stitch from right to left and skip one length, for example, equal to one cell on the canvas. For the second stitch, lay the thread from left to right. We insert the needle at the same point where the first stitch ends, and bring it to the front side 1 cell to the left of the second stitch. This will make the purl stitch twice as long as the front stitch.The seam stitches must be the same length.

Seam “Back needle”

Stalk seam

The seam forms a continuous row of oblique stitches that fit tightly together. Having made the first stitch on the fabric from ourselves, we bring the needle and thread to the middle of the left side of the stitch, put it to us and press it against the fabric. On the second stitch, make a puncture in the fabric above the first stitch, and bring the needle out in the middle of the second stitch on the left side. The seam is performed by moving the needle towards us. Each new stitch comes out half of the previous one.When sewing a stalk seam, the working thread should always be on one side – to the right or to the left. It is impossible to change the direction of the thread, as this violates the structure of the seam. All stitches must be of the same size.

Stalk seam

Tambour seam

A tambour stitch is a continuous row of loops coming out of one another. We sew the seam from right to left. First, we fix the thread, bring it to the front side, throw it in a loop, make a small stitch 3-4 mm long and take out the needle.The thread is tightened with a loop. We again throw the thread in a loop, stick the needle into the point from where we output it in the previous stitch. This seam can be made in a zigzag strip. Then the loops on the front side will be located alternately, now to the left, then to the right of the middle line of the seam.

Tambour seam

Seam “Worm”

Perform from right to left in two thread colors. A zigzag line is sewn in one color. To do this, fix the working thread diagonally from right to left with a loop, and get the first stitch.A needle is inserted from above into the first stitch and brought out to the lower left corner of the next square. Then we repeat the first stitch and so on until the end of the row. After completing the desired length, from left to right we embroider the skipped stitch. We fasten the thread of a contrasting color with a loop from the seamy side and wrap the stitches.
Worm stitch

Cross stitch

Cross stitch consists of two crossed stitches. When doing it, you need to make sure that the top stitch is directed in one direction.Having secured the thread, folded in half, we bring it to the front side and make a stitch from the lower left corner to the upper right one (Fig. 1). We carry out the required number of half-cross stitches. Then close the half-crosses with a stitch from the upper left to the lower right corner. Horizontal stripes are obtained from the inside out.

Cross stitch

Stitch “Goat”

Place the stitches from left to right, making punctures in the fabric alternately along one and the other edge of the strip. The distance between the punctures should be the same.In the middle of the strip, the stitches cross. Each new stitch overlaps the previous one. This seam is used to embroider small leaves, flower cores. Smooth seam stripes are used to complement large, intricate embroidery, and to mask seams when joining fabric pieces.

Seam “Goat”

French knot

The “French knot” stitch is used as a decorative element when a cross of this color is very large. And the French knot is just right.

French knot

Buttonhole seam

Buttonhole seam refers to edge seams. It can be used in decoration, both embroidery and knitted products. Here are the main types of buttonhole stitches that will help you decorate your work. Before proceeding with the stitching seam, carefully tuck and mark the edge with a needle-forward seam. We fix the working thread in the middle of the hem and bring it to the front side under the hem. Then we direct the needle up and from right to left we wind it under the working thread, we get the first loop.We also carry out the following stitches, place them at the same distance from each other.

Buttonhole seam

What are the seams

For the manufacture of products from decorative fabrics, it is especially important to use various specific machine or manual operations, which will ensure good quality, attractive appearance and durability. The choice of a suitable seam for joining fabric parts is of great importance. The most common seams are double (French), stitching, overhead sewing.Consider in advance which seam is best for the look and purpose of your garment.

Basic stitching techniques

A seam is the simplest and most versatile way to join basic fabric parts. Always chop and sweep parts before sewing on the machine. To clean convex and concave cuts and corners, trim and trim them. Cut the triangle of the fabric at the corners, and make cuts or denticles along the curved cut.

Elbow stitch

Pin and sweep the parts, place them on the machine under the needle, press down with the foot.Secure the thread at the beginning of the seam by stitching back and forth about 1 cm several times. Sew along the edge next to the basting line; at the end, fasten the thread in the same way as at the beginning of the seam. Remove the basting, iron the seam. When using a new material, first check on small patches how the seam is going and adjust, if necessary, the stitch length, presser foot pressure, thread tension, and the appropriate needle and thread for the fabric.

Corner connection

At the corner, cut a triangle from the cut edge of the fabric after joining the pieces with the seam seam.Leave a distance of about 6 mm between the seam and the cut, otherwise the parts may part when turned to the right side.

Connection of rounded cuts

Cut teeth along the convex edge of the parts to be joined – this will make the fabric lighter and will not deform. Make cuts along the seam allowance on the concave edge so that the fabric does not wrinkle. Be careful not to cut the fabric too close to the seam.

Processing cut edges

Cut edges of parts should be sealed to protect them from shedding.This process is called overcasting. It is especially important to process the edges of durable or heavy-duty items. Overcasting the edges of the fabric can be done in different ways: overcasting (overcasting), sewing, buttonhole seams, hemming “zigzag”, bias tape or just scissors with serrated blades.

The simplest way to overcast cut edges is zigzag sewing. A good way to do this is to use a bias tape that hides the cut edges. Double French or false seam seams can also hide raw edges, but the latter requires extra fabric for the hem.When the reverse side of the product and the seams are visible, a double French seam should be used.

Machine zigzag

Place the zigzag tool on the machine and place the raw edge under the needle. Secure the thread, sew in a zigzag as close to the edge as possible; secure the end of the thread.

Hand overcasting

Sew straight stitches from wrong side to right side of fabric. Do not pull the thread together to avoid wrinkling the edge.

Processing with bias tape

Fold the edge of the bias tape over the edge of the fabric being sewn.Machine pin, sweep and sew. Fold the tape over the edge of the fabric and sew through all layers.

Hemming

Seam allowances should be 2.5-3 cm wide. Cut one edge after joining with a seam seam to 0.5 cm, overlap and fold a wide edge under it. Pin, baste, and sew along the folded edge.

Pruning with special scissors

Special scissors with serrated blades cut fabric, leaving teeth.With their help, you can quickly and easily process the edge, but such processing is not very reliable, so it should only be used for internal seams.

Double French stitch (seamed, or turned out, stitch)

This is a strong, neat stitch that does not require additional basting on the right side of the fabric. However, it can only be used to grind straight edges of parts; The seam allowance should be at least 1.5 cm. This is an ideal seam for garments and light, transparent fabrics where both sides are visible.

1. First seam. Fold the parts to be joined with the wrong sides inward, pinch and sweep. Sew the parts with a simple seam 5 mm from the edge. Remove the fabric from the machine, pull out the basting.
2. Pruning. Using sharp scissors, carefully trim the edge to a distance of 3 mm from the machine stitch. Fold the stitched parts right side in, round and iron along the edge.
3. Second seam. Sweep right-side-folded parts close to the edge. Sew 1 cm from the first (now inner) seam; trimmed edges will remain inside.
4. Final operation. Remove the basting and fold the stitched parts face up. The result is a neat seam with inconspicuous stitches. Smooth out the allowance to one side.

Embossed seam

This is a very simple technique used to accentuate the seam line. This requires a contrasting thread or a long stitching seam. Pin the parts with pins, sweep, connect with machine stitch, remove the basting, straighten and iron the seam.From the right side, run a finishing stitch along the right or left side of the seam.

False seam

False seam is used where a strong flat joint is needed, for example, for upholstery and curtain material. The seam is visible on the right side of the fabric.

1. Staple. Fold the two parts right side in, align the cuts and sew with a machine stitch, stepping back from the edge 1.5 cm.Cut one edge to 0.5 cm.
2. Seam hem.Unfold the stitched fabric, fold the wide edge under the narrow one, press both edges to one side and sweep.
3. Second seam. Sew along the basting from the right side, iron the seam. From above, one seam will be visible.

Quilting

The stitch gives not only bulk to the spacer, but also a decorative look to the entire product. The gasket is placed between the layers of fabric, as in the figure, quilted, the edges are sewn up. Alternatively, baste the spacer to the wrong side of one piece and fold both pieces right side together.Sew them on three sides, turn them out and sew on the fourth side with a blind stitch.

1. Drawing markup. Select a pattern for the stitch. The simplest is a diagonal pattern, but you can take any other. Mark sewing lines on the fabric using a suitable stencil.
2. Assembling product layers. Cut out the same details: gasket, lining and front side; fold them together by placing a spacer between the fabric pieces.