1. Presented by Angel Sheridan FNP
Basic Suturing
Presented by
Angel Sheridan FNP

2. Objectives
Identify important components in evaluating lacerations and wound healing.
Identify and demonstrate proper selection and use of instruments used in suturing.
Discuss types of anesthetics and methods of administration.
Discuss various types and sizes of suture material and their indications.
Discuss and practice basic wound closure techniques.
Discuss safe handling techniques for sharps.
Identify common complications associated with wound closure.
Discuss and practice alternative skin closure methods.
Discuss appropriate wound care and followup.

3. Wound Evaluation Location Size Depth Shape MOA Time elapsed
Foreign body/contamination
Circulatory/Motor/Sensory
Patient dependent factors
Tetanus

4. Risk Factors Delayed presentation Foreign bodies Contaminated wounds
Bites
Puncture wounds
Crush wounds
Open fracture
Tendons

5. Selecting/Handling Equipment
Face shield
Syringe/needle
Anesthetic
Suture
Forceps
Scissors
Needle Holder

6. Anesthesia Lidocaine 1% Lidocaine 2% Lidocaine with epi Topical
Buffering

7. AnesthesiaTips Avoid letting them watch injection
Always aspirate before injection
Start with topical dripping of anesthetic
Inject within wound

8. Suture Material Absorbable Non-absorbable Braided/Non-braided
Types of needles
Curved/Straight
Cutting/Tapered
Size

9. Suture Size Face: 6-0 Scalp: 4-0 (blue) Back/torso: 3-0, 4-0
Extremities: 4-0, 5-0

10. Wound Preparation
Cleaning
Irrigating
Debridement
Foreign Body
Hair

11. Basic Wound Closure Simple interrupted Continuous (running stitch)
Vertical Mattress
Horizontal Mattress

12. Tips Comfort Lighting Wound eversion Rule of halves Equal distance
Corners
Landmarks

13. SHARPS!!!

14. Complications
Swelling
Pain
Fever
Infection
Wound dehiscence
Scarring

15. Alternative Skin Closure Methods
Steri-strips
Adhesive Glue
Staples

16. Followup Care Cleaning Dressing Splinting Antibiotics Clean and dry
Recheck
Suture removal

17. Suture Removal Face 3-5 days Neck 4-6 days Scalp 7-10 days
Trunk 7-10 days
Arms/Legs 7-14 days
Joints 14 days

18. Bibliography Wound care manual- Johnson& Johnson
Wounds and lacerations-emergency care and closure. Mosby 2005
Basic laceration repair. New England Journal of medicine. Oct 355:17
Essentials of skin laceration repair.
Basic suturing workshop for Family Practitioner students.