Sutures and Suturing

Popliteal Artery Suture Direction

Begin the suture at the inferior (or distal) portion of the incision and suture superiorly.

Anterior and Posterior Tibial Arteries Suture Direction

Begin the sutures distally and suture superiorly.

Baseball Suture

Considered most secure and common. Airtight. Used for autopsy, long surgical, and long-bone donor incisions. Pass suture needle and thread from beneath incision up through integument and cross the needle from side to side with each stitch.

Interlocking (Lock) Suture

Creates a tight, leakproof closure. Begin suture at one end and direct needle through tissue so that is passes through both sides of the incision from the outside. Keep thread tight, then, lock the stich by looping the needle through the thread. Repeat process until incision is closed.

Inversion (worm) Suture

Excellent for closing carotid incision or closing scalp on cranial autopsy. Used to gather in and turn under excess tissues. Stitches are made parallel to the incision edges and do not pierce margins of incision. Made as close to margins as possible in uniform length.

Continuous (Whip) Suture

Generally used to close long incisions by autopsy technician. Prevents leakage of fluids during transfer. Anchor suture thread, pass needle through both sides of the incision, starting on the outside on one side and passing directly through and out the tissues of the opposite side. Pass thread over top of incision and begin next stitch half inch to inch beyond previous stitch.

Individual (Bridge) Suture

Individual sutures are used to align tissues into position prior to, during, or after embalming. They are temporary and are replaced.

Single Intradermal (Hidden) Suture

Made with one needle and single thread. Used on exposed areas of the body and is directed through subcutaneous tissue only. Insert needle deep into tissues at one end of incision, make a knot in thread a short distance from the end. Pull knot to the position of the needle puncture. Keeping needle directed through dermal tissues only, develop a back-and-forth pattern from one side of the incision to the other.

Radial and Ulnar Arteries Suture Direction

Suture from the distal portion of the incision medially

Femoral Artery Suture Direction

Suture from the inferior portion of the incision superiorly.

Axillary Artery Suture Direction

Suture from the medial area of the incision laterally (with the arm abducted).

Brachial Artery Suture Direction

Suture from the medial portion of the incision laterally with the arm abducted.

Autopsies (Trunk Standard "Y" Incision) Suture Direction

Use bridge sutures to align the skin into position. Begin the trunk suturing at the pubic symphysis and suture superiorly.

Common Carotid Artery Suture Direction

if using the parallel incision, suture from the inferior portion of the incision superiorly. Suture from the medial portion of the incision laterally if using supraclavicular incision.

Double Intradermal Suture

made with two needles threaded with opposite ends of the same thread. Pass each needle through dermis at opposite margins so both stitches are parallel. Continue process until incision is completely sutured. Draw margins tight, knot two ends together within the incision. To end suture, insert both threads onto one needle and insert it under skin from end of incision to a point 1/2 in. away.