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The horizontal mattress stitch is a suture technique used to close wounds.It everts skin well and spreads tension along the wound edge. [1] [2] [3] This makes it ideal for holding together fragile skin [4] as well as skin under high tension such as the distant edges of a large laceration or as the initial holding suture in complicated repairs.
A surgical suture, also known as a stitch or stitches, is a medical device used to hold body tissues together and approximate wound edges after an injury or surgery. Application generally involves using a needle with an attached length of thread. There are numerous types of suture which differ by needle shape and size as well as thread material ...
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At the end of the running suture line, clips can be placed across the suture tail. Barbed suture is a knotless surgical suture that has a pattern of barbs on its surface. These barbs lock the suture into the tissue, eliminating the tying of knots. Barbed sutures are typically used in cosmetic and reconstructive surgery.
Monocryl is a synthetic, absorbable suture manufactured in Cornelia, Georgia, USA, and trademarked by Ethicon. It is composed of poliglecaprone 25, which is a copolymer of glycolide and epsilon-caprolactone. [1] It comes both dyed (violet) and undyed (clear) and is an absorbable monofilament suture.
Catgut suture has excellent handling features, high knot-pull tensile strength, and good knot security. It is used for all surgical procedures including general closure, ophthalmic, orthopedics, obstetrics/gynecology and gastrointestinal surgery. It is absorbed faster in patients with cancer, anemia, and malnutrition.
The vertical mattress stitch is most commonly used in anatomic locations which tend to invert, such as the posterior aspect of the neck, and sites of greater skin laxity such as the closure of lax skin after removing a dermoid cyst or reduced subcutaneous tissue (e.g., the shin) that do not provide adequate subcutaneous tissue for dermal closure. [6]
In some types of fistulae, a seton may be tied with more tension and tightened periodically. In this case, the seton loop will slowly cut through tissue inside the loop while scarring behind the loop, essentially "pulling out" the fistula without surgery. This is the Kshar-Sutra method mentioned by Sushruta in ancient Indian surgical practice.