How to Suture a wound

Suturing, at first glance, can be pretty scary. But with the right tools and enough practice, suturing a wound shut can be a breeze. This guide will simplify the suturing process. But before we get to the HOW, we need to understand the WHEN and WHY.

Suturing a wound is ideal when dealing with large gaping wounds that cannot be patched up by gauze or bandages. Your tissues need to be bound together before they can start healing but that’s not the more immediate and alarming threat. What’s concerning is that open wounds are breeding grounds for infectious organisms. Even if the outside is sealed with a well-applied bandage, the tissues inside are still separated and open for infection. A suture is also used to reconnect severed circulatory systems like reconnecting an artery or patching up a vein. In some cases, you can even suture a cut off finger back on. Anyone who has experienced that surely has a wild story to tell you, but that’s beside the point. In short wherever, basic first aid isn’t enough, suturing is recommended. Now that we’ve covered that, let’s get to the HOW.

While performing this operation, you need some basic tools to get started. Get your hands on a needle driver, scissors, tissue forceps and a sterilized needle and thread. Do ensure everything is sterilized before you begin. Most suture kits include sterilizing alcohol. Also, you may want to avoid your first operation being on a live organism. So, grab yourself a practice suture pad. They are available quite cheaply and unlike other modes of practice such as using chickens or pig bellies, you can reuse suture pads multiple times. Additionally, most of them even come with pre-cut wounds.

There is a plethora of different suturing techniques, each having its own uses and complexities. But let’s start off nice and easy with simple interrupted sutures.

Follow the step-by-step procedure below:

Wash your hands. Similar to the raving adverts on television telling you to wash your hands, you really need to do it this time. Be slow and thorough. Put on latex gloves afterwards. 

Prep the wound. You need a clean wound as much as you need clean hands. Rinse off any debris and as much as blood as you can with it. The clearer you can see the wound, the better you can patch it up. This step wouldn’t be necessary if you’re practicing on a suture pad. 

Get ready to drive that needle. Grab your needle with the driver and double-check to see the clamp is tightly locked. Pull enough thread out of the kit for smoother sewing.

suture pad

Line it up. This is where your tissue forceps come in. Use them to line up the part you’re going to inject the needle in. Try to be as precise as possible so you don’t have to redo your stitch.

suture practice kit

Push the needle in. This needs to be a right angle and about a centimeter to the right of the wound. Take care to not pierce the fat. Stay above that layer. Some suture pads have a sort of mesh that tells you when you’re entering the fat layer. Anyway, once deep enough, tilt your hand slightly until your needle comes out the other side of the wound exactly in line with where you made the hole on the initial side.

suture kit for medical students

Reposition your needle driver. Let go of the needle and grab it again by the tip from the other side. Pull up until you have about 2 inches of thread left on the other side. Hold the thread and wrap it in a clockwise motion two times around the needle driver.

suture practice kit

Completing the first knot. Slightly loosen the driver and grab that 2 inches of thread you left on the starting side. Proceed to pull the long part of the thread. Your wrapped thread will unfurl and you will have created a regular knot. This is popularly called “The first throw". Tighten it just enough in order for both sides to gently connect.

suture practice kit by Artagia med suture kit by Artagia med

suture kit by Artagia med suture practice kit by Artagia med

The Second throw. Repeat the process, going in a clockwise motion, but make only one rotation around your driver. Tie off your second throw. 

The final throw. To be on the safe side, make one final throw, but this time go anti-clockwise around the driver. Tie off your final throw. This may not be a good idea if you’re short on thread, but generally this isn’t the case.

Cut off the excess thread. Nothing special to it. Just cut off the extra part dangling around.

medical student suture kit medical student suture kit

suture training kit suture training kit

Move a quarter inch along the wound and repeat the steps above. Do it until the wound is good and shut.

Remember to get adequate practice before you operate on a living being. I cannot emphasize enough, the need for practice. Any mishap could result in a horrible infection or at best a really ugly scar. Suture practice kits are available quite easily all around. Happy suturing.