1. What are the types of wounds and suture techniques used for each?

- Clean: primary closure/repair; essential suturing techniques includes simple

interrupted suture, continuous simple, vertical mattress, horizontal mattress,
intradermal
- Clean-contaminated: primary closure/repair; essential suturing techniques includes
simple interrupted suture, continuous simple, vertical mattress, horizontal mattress,
intradermal
- Contaminated: heal by secondary intention; perform wound toilet and surgical
debridement
- Dirty: heal by secondary intention; perform wound toilet and surgical debridement
- In treating clean contaminated wounds and clean wounds that are more than six
hours old, manage with surgical toilet, leave open and then close 48 hours later.
This is delayed primary closure.
- If suturing is needed with contaminated and dirty wound, do simple interrupted
suture to allow the wound to breathe; however, each suture is a foreign body which
increases the chance of infection (use least number of sutures possible to bring
wound together without tension]
2. What are the types of sutures and in what instances are they used?
- Simple interrupted suture: most commonly used to repair lacerations of the skin
- Continuous or running suture: if the tissue is of good quality; decreases amount of
foreign material in the wound and tension are distributed more evenly
- Vertical mattress technique: best for allowing eversion of wound edges and perfect
apposition and to relieve tension from skin edges
- Horizontal mattress technique: reinforce the subcutaneous tissue and provide more
strength and support along length of the wound keeping tension off the scar
- Continuous subcuticular suture: used to eliminated dead space and to relieve
tension on the skin sutures
- Purse string suture: used to close visceral stumps and to secure percutaneous tubes
into viscus such as may be seen in gastrostomy and cystostomy procedures
- Retention suture: used in high tension wound closures to support primary wound
closure