ENGLISH TASK

THE USEFUL SUTURES IN VETERINARY SURGERY

By:
Eko Diki Danafi 135130100111050
Katrina Rahmadewi Hendarto 135130101111046
Cindy Oktati Kasari 135130101111058
Cholid Mawardi 135130101111060

FACULTY OF VETERINARY MEDICINE

BRAWIJAYA UNIVERSITY
MALANG
2016
 The Useful Sutures in
Veterinary Surgery
Eko Diki Danafi, Katrina R. Hendarto, Cindy Kasari, and Cholid Mawardi
Faculty of Veterinary Medicine, Brawijaya University, Malang

Sutures role in wound repair process is to provide hemostasis and support

for healing tissue. Different tissues have differing requirements for suture support
because they heal at different rates. Some tissues need support for only a few days
(e.g. muscle, subcutaneous tissue, skin), whereas others require weeks (fascia) or
even months (tendon) to heal. Patient variations further affect suture choice.
Infection, obesity, malnutrition, neoplasia, steroids and disorders of collagen may
delay wound healing. An ideal suture material would be one that will lose its tensile
strength at about the same rate as the tissue gains strength and it will be finally
absorbed by the tissue so that no foreign material remains in the wound.
Endosurgery and minimally invasive surgical techniques in general, put additional
demands on suture performance. Good knot security must be maintained, tissue
drag should be minimal and the surface lubricant must ensure ease of manipulation.
Furthermore biocompatibility with minimal inflammatory response is mandatory.
Surgeon’s preferences also need to be taken under consideration. Some years ago,
a typical general veterinary practice would have stocked only catgut, silk, nylon and
perhaps stainless steel, but we now routinely use a wide range of synthetic
absorbable and non-absorbable sutures. These are some useful suture methods that
can be used in veterinary surgery.

Simple interrupted suture is the most fundamental technique of wound

closure used in cutaneous surgery. To place a simple interrupted suture, the needle
enters one side of the wound and penetrates well into the dermis or subcutaneous
tissue. By altering the depth or angle of the needle, one can use this technique for
wound edges of uneven thickness. The needle is then passed through the
subcutaneous tissue to the opposing side of the wound and exists closer to the
wound edge so that the final configuration of the suture is flask-shaped. The major
disadvantage of this technique is that they tend to leave a series of crosshatched
linear scars resembling railroad tracks. Interrupted sutures tend to cause wound
inversion if they are not placed correctly which can prevented by placing the suture
in the flask-like configuration. Interrupted sutures are easy to place, possess greater
tensile strength and have less potential to cause wound edema and impaired
circulation.

Another name for a simple continuous suture is furrier suture, and sutura
pellionum. This can be applied to suture tissues without tension, the wall of inner
organs, the stomach, the intestines and the mucosa. It can be performed quickly,
since a knot should be tied only at the beginning and the end of the suture (here,
only a part of the thread is pulled through and the strands of the opposite sides are
knotted). The tension is distributed equally along the length of the suture. During
suturing, the assistant should continuously hold and guide the thread (with hands or
forceps) to prevent it from becoming loose. The continuous suture is not as accurate
as the interrupted suture, and it cannot be adjusted as easily. Another disadvantage
is that it cuts off more of the blood supply to the healing wound edge. The blanket
suture does not bunch up the wound as does the continuous simple suture but it too
can cause wound ischemia. And if the suture knot open then all the stitches will
open.

Lembert suture pattern is a variation of a vertical mattress pattern applied in

a continuous pattern. It is an inverting pattern. The needle penetrates the serosa and
muscularis approximately 8 to 10 mm from the incision edge and exits near the
wound margin on the same side. After passing over the incision, the needle
penetrates approximately 3 to 4 mm from the wound margin and exits 8 to 10 mm
away from the incision. This pattern is repeated along the length of the incision.
This pattern is very useful to close viscera like intestine, vesica urinaria, and uterus
but it is not suitable for cutaneous suture.
 Simple interrupted, simple continuos, and Lembert sutures are the three
most used sutures in veterinary medicine. It is because of their simple and fast
procedures for the tissue to be sutured.