Walking sutures: Step 3A (large photo)

Walking sutures: Step 3A (large photo)

source-image
Apr 19, 2010
By dvm360.com staff
Using 2-0 or 3-0 absorbable suture material with a swaged needle, place the first walking suture near the junction of the undermined skin and the underlying tissue. Pass the first suture bite through the deep portion of the dermis but not through the full-thickness of the skin (A in photo above and schematic in Step 3B). Pass the needle perpendicular to the wound edge to help conserve blood supply to the skin. By carefully observing the deep portion of the dermis in areas without a panniculus muscle, you can avoid incorporating large vessels into the suture, thus ensuring adequate blood supply to the skin. You should feel some resistance to the needle passage; this resistance indicates proper placement in the dermis. Before completely passing the needle through the partial thickness of the dermis, place some tension on the needle. A dimple should form on the epidermis, further indicating that the needle is properly placed. Then complete the needle passage.

Take the second suture bite toward the center of the wound (B in photo above and schematic in Step 3B). To ascertain precisely where to take the second bite, pinch the area of the first bite between your thumb and forefinger, with your thumb on the dermal skin surface and your forefinger on the epidermal surface. Stretch the skin toward the center of the wound as far as possible, and place the first suture bite down against the underlying tissue. Take the second suture bite at this point, incorporating the dense muscle fascia. If the bite is being placed in granulation tissue with secondary wound closure, place it deeply so it can pass through the dense collagenous base of this tissue.

Step by Step Article

ADVERTISEMENT

Photo galleries

Cats and dogs explain football penalties

FIRSTLINE - Jan 29, 2015

By dvm360.com staff

All of those fancy football phrases can make you dizzier than a quarterback after he's been sacked. Before you tune into the Super Bowl, check out this quick rule refresher—brought to you by canine and feline fans.

If cats and dogs refereed the Super Bowl

FIRSTLINE - Jan 27, 2015

By dvm360.com staff

Check out the short list of penalties pooches and kitties might call if they had zebra stripes and a whistle at the big game.

Photo gallery: Puppy Bowl XI

FIRSTLINE - Jan 23, 2015

By dvm360.com staff

Check out the loveable, squeezable, puppy-tastic pooches that make up the starting lineup of Puppy Bowl XI.