Chapter 4: Table of Contents
- 4.8 Cruciate Pattern
- 4.9 Cushing Pattern
- 4.10 Ford Interlocking Pattern
- 4.11 Intradermal Pattern
- 4.12 Lembert Pattern
- 4.13 Mattress Suture Patterns
- 4.14 Modified Transfixing Ligature
- 4.15 Purse-String and finger trap
- 4.16 Simple Continuous Pattern
- 4.17 Simple Interrupted Pattern
- 4.18 Skin Staples
- 4.19 Subcutaneous closure & How to bury a knot
- 4.20 Suture Material and Patterns Quiz
Suture Size
Choosing appropriate suture size is imperative to prevent wound dehiscence (use of too small a suture material) and promote proper wound healing (increased tissue reaction with larger suture materials causes more inflammation and slower healing). Use of the smallest suture that approximates the tissue’s own tensile strength is ideal. Furthermore, larger suture is more difficult to handle and tie. Suture sizes are described most commonly using the USP (United States Pharmacopeia) denotation. Using this system, sutures diameter is described from 11-0 (smallest) to 7 (largest). The numerical USP system worked well when there was only a few larger suture materials (size 1, 2, 3, etc..), but as technology allowed for smaller and stronger suture mature, the number system became confusing. The suture material smaller than the USP size 1, is 1-0 which is pronounced as ‘ought’ and smaller yet is 2-0, meaning 00 (pronounced ‘two ought’ or ‘two zero’). The more zeros, the smaller the material, so 6-0 is actually size 000000, and is pronounced ‘six ought’ or ‘six zero’. It is important to note that the USP dimensions for catgut are different to those of other sutures. For example, 2-0 Catgut is larger than 2-0 PDS. Stainless steel is typically described by the metric scale or in gauges.
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