SUTURING 99 



Suturing. 



DEFINITION. — The word suturing in surgery refers 

 to the temporary repair of lost continuity in tissues by means 

 of the needle and thread. They are referred to as "tempor- 

 ary" in their action because they only serve to hold separated 

 parts in contact while the tissues themselves construct 

 the permanent uniting object, the cicatrix. Thus sutures 

 perform the function of the scar while the latter is forming 

 into a substantial structure. 



INDICATIONS. — Except in cordiform structures, such 

 as nerves and tendons, and in tubular organs, such as bowels 

 and blood vessels, sutures are not absolutely indispensable, 

 as the most serious breach of continuity will be restored 

 without them. Any ordinary gap in tissues will be repaired 

 without their transient assistance by filling up with granula- 

 tions which soon transform into a firm connective tissue, but 

 when the edges or walls of a breach are brought into closer 

 apposition with them the amount of tissue required to fill 

 the traumatic cavity is reduced to the minimum, to the end 

 that the process will be shortened and the amount of con- 

 structive tissue (granulations) lessened. Hence the chief 

 object of sutures in veterinary surgery is to limit the size of 

 the scars, that supervene all wounds. A scar may be small, 

 almost imperceptible, or it may be large and unsightly, ac- 

 cording to the amount of formative tissue that was required 

 Vo fill the gap. To make the gap small, which in turn dimin- 

 ishes the volume of the granulations and finally the size of 

 the scar, restores the surface to a condition as nearly ap- 

 proaching the normal as possible. 



When soft tissues are divided their natural elasticity, 

 their tension, and also the swelling that usually follows in- 

 juries, all acting together or separately, always produce a 

 gap the width of which will vary according as these influ- 

 ences chance to operate. Thus an incision of the abdomen, 

 if compared with one of similar constitution in the forehead, 

 will be found to be more widely separated, although both of 

 them will gap to a certain degree, as will all wounds which 

 destroy continuity in soft tissues. It is to bring such gaping 

 parts into apposition, or at least to approximate them as near 

 as possible, that sutures are used in veterinary surgery. 

 They are indicated to prevent avoidable blemishes and also 

 to promote a more rapid repair in all of the innumerable sur- 

 face wounds, surgical and accidental. Mucous membranes, 



