Chapter 4: Table of Contents
The continuous Cushing pattern is often used for closing incisions in hollow viscera such as the stomach, urinary bladder and uterus. It penetrates the submucosa but does not penetrate the organ’s lumen. It runs parallel to the incision line by taking tissue bites on either side of the incision. It is begun by first creating a partial thickness simple throw across the incision. Next, the needle crosses the incision line and is driven down into the tissue to the muscular and submucosal layers and directed parallel to the incision line approximately 5-8 mm. Then the needle is exited on the same side of the incision, crossed to the other side and again penetrated down to the muscular and submucosal areas and driven parallel to the incision. It is surfaced on the same side, and crossed over, continuing this pattern to the end of the incision line and then knotted. This pattern inverts the tissues. If done correctly, this pattern should invert the tissues enough to cover the first layer leaving only the knots of the inverting pattern visible.