There are four frequently used suture techniques:
1. Interrupted sutures:
Interrupted sutures require the needle to be inserted at right angles to the incision and then to pass through both aspects of the suture line and exit again at right angles. It is important for the needle to be rotated through the tissues rather than to be dragged through for fear of unnecessarily enlarging the needle hole.
2. Continuous sutures:
For a continuous suture, the first suture is inserted in an identical manner to an interrupted suture, but the rest of the sutures are inserted in a continuous manner until the far end of the wound is reached. Each throw of the continuous suture should be inserted at right angles to the wound and this will mean that the externally observed suture material will usually lie diagonal to the axis of the wound. It is important to have an assistant who will follow the suture, keeping it at the same tension in order to avoid either purse stringing the wound by too much tension, or leaving the suture material too slack.
3. Mattress sutures:
Mattress sutures may be either vertical or horizontal and tend to be used to produce either eversion or inversion of a wound edge. The initial suture is inserted as for an interrupted suture, but then the needle either moves horizontally or vertically and traverses both edges of the wound once again.
4. Subcuticular suture:
This technique is used in skin where a cosmetic appearance is important and where the skin edges may be approximated easily. The suture material used may be either absorbable or non-absorbable.