This page features 'how-to' videos on basic and advanced suturing techniques commonly used for acute traumatic lacerations treated in an emergency department, urgent care or general practice clinic.
Basic suturing
Simple interrupted suturing
"Simple interrupted suturing is the most basic and most important of the suturing techniques. Here is a short demo video, meant for the beginning/infrequent practitioner to review prior to suturing a laceration."
(Laceration Repair, 2014)
Advanced suturing
Undermining
"Undermining is one of the most underutilized, but superbly useful techniques in high tension laceration repair. Undermining refers to the technique of using sterile scissors to bluntly dissect the dermal layer away from the underlying connective tissue. Through the use of this technique, you can take away some of the connective tissue adhesions which anchor the skin in place and remove static tension on the wound."
(Laceration Repair, 2014)
Alternative wound closure
There are times when suturing is not feasible or the best option for closing a wound. Sutures are a foreign body and this can cause tissue inflammation and can sometimes lead to infection. Unsightly 'train tracking' marks can appear on certain skin types. Suturing wounds for children is much more difficult and often requires a general anaesthetic.
Hair apposition technique
"Scalp lacerations over hair-bearing areas have traditionally been closed with staples. An alternative technique is the Hair Apposition Technique, also known as the HAT trick. This technique provides a more cost-effective, faster, and less painful approach to scalp laceration repair. This is not a new thing. It’s been discussed in the literature since 2002, but it astounds me how many experienced practitioners have not adopted this simple and time-saving technique."
(Laceration Repair, 2014)
Special situations
"Discussion of special situations in wound care. These may include repair considerations in specific anatomic regions, or other more complex repair techniques." See more here
Wound blog
"A archives of descriptions of tips & tricks in laceration repair." See more here
Anatomic regions
"Certain areas of the body warrant specific considerations and specialized discussion, even if some of the techniques discussed in basic and advanced wound closure are employed. You’ll find some of these discussions here on management of:
- extensor tendon lacerations of the hand
- lip lacerations
- tongue lacerations
- ear lacerations
- nail bed injuries."
Blocks
"Many laceration repair and procedural techniques require use of regional anaesthesia techniques. This section is a guide to performing some of these injection techniques." See more here
Burns
"A series of posts focusing on a different kind of wound–one that doesn't require suturing."
Topics discussed include:
- Burn injury depth grading
- Total body surface area assessment, the use of smartphone applications to this end, and fluid resuscitation
- Initial management and first aid for minor burn injury
- A discussion of dressings used in the care of the outpatient burn wound
- How and when to perform escharotomy
Soft tissue
"Tips and tricks on management of soft tissue injuries, specific wound situations, and other related topics in the ED." See more here
Multimedia
"Links to videos and audio files for presentations on wound care related topics." See more here
Patient resources
"Resources specifically oriented towards patients treated for traumatic lacerations." Laceration aftercare instructions
"A video demonstrating suture removal (either for patients to review prior to a scheduled visit, or, for certain qualified patients, for self-removal at home)." See more here