Vertical Mattress Suture

A vertical mattress suture is a variation of a simple interrupted suture. It consists of a simple interrupted stitch placed wide and deep into the wound edge and a second more superficial interrupted stitch placed closer to the wound edge and in the opposite direction (see the image below).

What is vertical mattress suture used for?

Vertical mattress sutures are particularly useful in wounds under tension. They also help to evert wound edges in situations where the skin is prone to naturally inverting into the wound. The vertical mattress stitch has one deep throw and one superficial throw (directly above and parallel) to evert the skin edges.

What is the difference between vertical and horizontal mattress sutures?

The horizontal mattress is also comprised of two bites across the wound margin, but unlike the vertical mattress, these bites are spaced apart along the horizontal plane, are at the same distance from the wound margin, and reach the same depth.

When should the tied mattress suture be removed?

Because of the risk of scarring from horizontal mattress sutures, some authorities recommend that they be removed as early as three to five days after placement.

What is Connell stitch?

The Connell stitch is achieved by passing the suture from the outside in, then inside out, on one end. The same step is repeated on the other end in the form of a continuous U-shape. The suture is tied so that the knot is outside.

When should you run with sutures?

Simple running sutures may be placed with the goal of (1) accomplishing epidermal approximation in a wound under mild to moderate tension, such as a laceration, or, more frequently, (2) fine-tuning the epidermal approximation of a wound where the tension has already been shifted deep utilizing a deeper dermal or

When do you use Everting sutures?

Inverting suture patterns are indicated to close hollow viscera or, in the form of the Lembert pattern, for fascial imbrication. Everting sutures eliminate dead space and counteract the tendency of wound edges to invert during healing. Most tension sutures have everting characteristics.

What are the different types of suture materials?

These types of sutures can all be used generally for soft tissue repair, including for both cardiovascular and neurological procedures.
Nylon. A natural monofilament suture.Polypropylene (Prolene). A synthetic monofilament suture.Silk. A braided natural suture.Polyester (Ethibond). A braided synthetic suture.

How deep should a wound be for a suture?

Your wound likely requires stitches if: it’s deeper or longer than half an inch. it’s deep enough that fatty tissue, muscle, or bone is exposed. it’s wide or gaping.

What is an absorbable suture?

‌Absorbable sutures, also known as dissolvable stitches, are sutures that can naturally dissolve and be absorbed by the body as a wound heals. Not all wounds are sealed with absorbable sutures. Doctors generally evaluate your wound to decide on the best types of sutures to use.

What happens if a doctor leaves a stitch in?

If left in too long, your skin may grow around and over the stitches. Then a doctor would need to dig out the stitches, which sounds horrible. That can lead to infections, which, again, not good.

What happens if you remove stitches too late?

When stitches are left in for too long, it can result in marks on the skin and in some cases, result in scarring. Delay the removal of stitches can also make it more challenging to remove the stitches. In the event the stitches or staples come out earlier than expected, there is a possibility that wound may reopen.