EM · Procedural & diagnostic ED skills

Wound closure and suturing techniques

Also known as Suturing · Suture techniques · Wound closure · Tissue adhesive · Dermabond · Steri-strips · Subcuticular suture · Mattress suture

Wound closure and suturing techniques in the ED — the suture material choice (absorbable: catgut, Vicryl polyglactin, Monocryl poliglecaprone; versus non-absorbable: nylon Ethilon, polypropylene Prolene), the gauge-by-site rule (5-0 for the face, 4-0 for the body, 3-0 for the scalp and extremity), the five core techniques (simple interrupted, continuous running, vertical mattress, horizontal mattress, subcuticular intradermal) with the indication and the pitfall of each, the tissue adhesive (2-octyl cyanoacrylate, Dermabond) and adhesive strips (Steri-Strips) for the low-tension low-risk wound, the suture removal schedule (face 5 days, scalp 7 to 10, body 7 to 10, joints 14), the local anaesthetic doses for painless closure, and the recognition of the wound that must heal by secondary intention (bites, punctures, infected and heavily contaminated wounds). ACEM-primary, globally tagged.