Simple Interrupted
Properties
- interrupted
- appositional
- appropriate for normal tension on the incision's edges
- local tension is managed by adjusting tension on individual sutures
- not recommended if significant tension
- minimal impact on the local blood supply to the incision's edges unless overtightened
Horizontal mattress
Properties
- interrupted
- appositional
- appropriate for normal tension on the incision's edges
- local tension is managed by adjusting tension on individual sutures
- not recommended if significant tension
- impact on the local blood supply to the incision’s edges is major if overtightened
General recommendations
- the bite on each side of the incision is roughly equal to the thickness of the tissue (ie. 3-5mm)
- sutures are spaced approximately twice this distance apart (ie. 6-10mm)
- these guidelines are adjusted depending on
- the tendency of the tissue to open (if opening take bigger bites and move them closer)
Cruciate
Properties
- interrupted
- appositional pattern
- a tension suture
- less effect on blood supply than the horizontal mattress but more than a simple interrupted
General recommendations
- place each bite a distance from the wound edge equal to the thickness of the tissue (ie. 3-5mm)
- space sutures approximately twice this distance apart (ie. 6-8mm)
- leave loop loose enough to accommodate postoperative swelling
Vertical mattress
Properties
- interrupted
- everting pattern
- a tension suture
- less effect on blood supply than the horizontal mattress, but more than simple interrupted
General recommendations
- inner bite on each side of the incision is roughly equal to the thickness of the skin (ie. 3-5mm)
- outer bite is approximately twice the thickness of the skin (ie. 8-10mm)
- spacing reflects amount of opening tension but is usually about twice the skin thickness
Near and far patterns
Properties
- interrupted
- appositional pattern
- a tension suture
- "far" component protects against tension while the "near" component apposes the wound edges
- less effect on blood supply than the horizontal mattress, but more than simple interrupted
General recommendations
- width of "near" bite approximates thickness of skin (ie. 3-5mm)
- width of "far" bite is approximately double (ie. 6-10mm)
- name of pattern describes order of bites