The basic principles of suturing.

01. Ensure good alignment of the sutured wound or wound: sutures should be performed in layers, according to the anatomical level of the tissue, so that the tissue level is tight, do not involve or sew into other tissues, do not leave residual cavity, and prevent fluid accumulation, blood accumulation and infection. The margin distance and needle spacing of the suture must be uniform and consistent.

02. Pay attention to the tension of the suture: the tightness of the ligature suture should be such that the edges of the incision are closely connected, and should not be too tight.

03. The selection of sutures and suture needles should be appropriate.

Surgical suture is a special thread used for wound ligation, suture hemostasis and tissue suturing in surgical procedures. According to its biodegradability, it can be divided into: non-absorbable thread and absorbable thread. In orthopedic surgical incisions, except for the repair of tendons and ligaments where inert non-absorbable materials should be selected, absorbable sutures containing antimicrobial agents are basically recommended to reduce the infection caused by implants (sutures) and foreign body reactions caused by silk threads.

Types of suture needles.

1. according to the cross-sectional shape of the needle tip: round needles; angled needles (sharp, mostly used for suturing skin); round body angled needles; spade needles (mainly used for ophthalmic surgery); blunt needles.

2. According to the curvature of the needle: 12 arc; 318 arc (mostly used for suturing skin); 5/8 arc; straight needle; 14 arc (mostly used for ophthalmic surgery)

3. The diameter of the body of the suture: the curvature of the body is generally 2/8 round, 3/8 round, 4/8 round, 58 round or corresponding to the diameter of the needle body: 0.25, 0.375, 0.5, 0.625 inch (Note: 1 inch = 2.54 cm) diameter. The needle with a body curvature of 3/8 circle (0.375 inch) is most commonly used for skin suturing, and the needle body curvature of 48 circle (0.5 inch) is designed for suturing in tight spaces to accommodate the operator's larger wrist manipulation movements.

The orthopedic surgical incision suture approach follows the principles of asepsis, minimal invasiveness and restoration of the patient's anatomy as well as ensuring a good blood supply. Incisional sutures are divided into two main categories: continuous sutures and interrupted sutures, on the basis of which sutures such as encapsulated sutures, purse-string sutures, reduced-tension sutures and knot-free sutures have evolved.

Simple interrupted sutures, simple continuous sutures, continuous horizontal mattress sutures (intradermal sutures) and knot-free sutures are most commonly used in orthopedic surgery; sometimes "8" sutures, vertical mattress sutures (external sutures) and reduced tension sutures are also used.