injuries poisoning
How To Repair a Laceration With Vertical Mattress Sutures
Step by Step Description of Vertical Mattress Sutures
(See How To Cleanse, Irrigate, Debride, and Dress Wounds for step-by-step descriptions of wound preparation, anesthesia, and dressing; see Cleanse, anesthetize, irrigate, and debride the wound as necessary. Place a sterile fenestrated drape over the wound. Place additional drapes nearby as needed to provide a large-enough sterile work area. In general, place the first suture in the middle of the wound. Place all subsequent sutures in the middle of each open section, until there are no gaps. 1 cm) and deeper than the bite of a How To Repair a Laceration With Simple Interrupted Sutures . Push the needle through both wound edges if this can be done with little resistance. If resistance is significant, or if you are placing a suture across a relatively wide space (as may occur with the first few sutures), pull the needle out through the center of the laceration after it passes through the first wound edge; then reattach it to the needle driver and continue the suture with a second bite, passing it into the opposite side of the wound. Reverse the direction of the needle in the needle driver. The second pass(narrow-shallow bite) is placed closer to the wound edge and begins on the same side of the laceration as the exit site of the first pass. Use forceps as needed to maintain edge eversion. In this pass, unlike with simple interrupted sutures, the width of the bite need not be greater at the deepest part of the wound than at the surface. Tie the suture closed. The first pass of the needle is the same as a large simple suture, but instead of tying off, another smaller bite is taken back across the wound to end on the starting side. Both ends are pulled up to closely align (approximate) the wound edges. Points A and B must be at the same depth, as must points C and D; this placement results in correct vertical alignment. 