INSERTING SUTURES. 



^37 



The greater number of special sutures described from time to time 

 have only an historical interest. 



Skix Sutures. — The most important and the most commonl\- used 

 is the plain interrupted suture shown in Fig. 159, which can be employed 

 in almost all cases. It is made by passing a thread through the opposing 

 lips of the wound, drawing the free ends together, and tying them firmly 

 towards one side of the wound. The needle carrying the suture is 



r 



Fi. 



Fig. 160. — Insertino; the suture. 



grasped in the right hand, the thumb on the concave, the index and 

 middle fingers on the convex side (Fig. 160), or a needle-holder may be 

 used (Fig. 156). The edges of the wound are successively raised with 

 the fingers of the left hand or with forceps, and the needle passed 

 through them first from without inwards, then through the opposite 

 lip from within outwards (Fig. 160). A better method, however, is to 

 raise both lips together, producing a somewhat deep fold, through 

 the upper part of which the needle 

 is passed with a single thrust (Fig. 

 161). This secures a larger surface 

 for union ; when only the extreme 

 edges of the skin are brought into 



contact, rapid union is much less Fig. 161. — Methods of suturing to secure 



, • T-1 ,• , largest possibb surface for adhesion. 



Certam. The comparative poverty a: Interrupted suture, a Z?. Suture 



of blood-vessels in the skin of of rela.xation. 



animals as compared with that of man explains the difficulty with 

 which skin surfaces alone unite, or when united hold together 

 under tension. The appearance of a wound sutured in the above- 

 described manner is certainly somewhat unsatisfactory, but there 

 need be no fear of the fold remaining. As soon as the threads are 

 absorbed or removed the fold disappears, leaving only a narrow 

 cicatrix. To relieve tension in wounds so united it is generally 

 desirable to insert one or more " relaxation " sutures. 



