Suture Techniques

1.Simple interrupted sutures

This can be either:

  • Simple Interrupted
    • Used on majority of wounds
    • Each stitch is independent

2. Vertical vs Horizontal Mattress sutures

Vertical Mattress – Useful for everting skin edges “Far-far-near-near”

Horizontal Mattress – Useful for single-layer closure of lacerations under tension

3. V-shaped wound closure

How do you Hand tie?


Dressings/ Surveillance for complications

  • Consider splinting digits, joint surfaces
  • Check tetanus status
  • Pre-printed wound care instructions
  • Pt must understand signs of infection

Once the scab has fallen off, massage and moisturize to reduce the risk of keloids and hypertrophic scar formation, this includes avoiding sun exposure, sunblock.

The district nurse or GP can follow simple, uncomplicated wounds for further wound care and suture removal.

Higher risk wounds must be reviewed earlier (24-48hrs), either at the ED clinic or respective speciality. Examples of high-risk injuries: hand wounds, Bites, heavily contaminated or wounds requiring antibiotics.


Anatomic Area Days until Removal External suture size Buried Absorbable suture size
Face 4-5 5-0 or 6-0 5-0
Scalp 10-14 4-0, staples 3-0
Upper body 7-10 4-0 4-0
Hand 7-10 4-0 or 5-0 4-0
Lower body 10-14 4-0 3-0
Over joint (splint recommended) 14-21 4-0 3-0

Adapted from Face and scalp lacerations: timing for suture removal.10

  • Physiotherapy and rehabilitation
    • Injuries with associated fracture
    • Injuries affecting joints
    • Injuries to special areas.