CONTINUOUS SUTURE TECHNIQUE
It is a suture technique that provides to close the wound with a single suture. It is similar to the simple interrupted suture technique, but unlike simple interrupted sutures, knots are not tied at every stitch. Only the first and last stitches are fixed by knotting. It is easy to apply, frequently preferred suturing technique that provides eversion.
Initially, a simple interrupted stitch is placed at one end of the wound. This suture is knotted but not cut. Simple continuous sutures are placed over the length of the wound, re-penetrated the epidermis, and passed dermally or subcutaneously. It is important to place each stitch on equal distance in the simple continuous suture technique. The application is terminated by a single knot at the end of the suture line. If a wound is longer than can be easily closed by simple interrupted or interrupted horizontal mattress suture, a continuous suture technique can be used to perform the closure efficiently.
The most frequently used continuous suture technique is the non-locked suture technique. In this technique, the distance between the stitches is about 1 to 1.5 cm. When placing a non-locked continuous suture; it is useful to provide a slight tension on the placed suture loop while the next tissue transition is performed. This prevents the suture from loosening in the tissue when performing any additional sutures. The tension may be provided by the surgeon’s hand or by the assistant, not by the needle holder.
A continuous suture can also be locked. Continuous suture locking is accomplished by placing friction points along the length of the wound to reduce the tendency of the suture to loosen when placing the rest of the suture. Suturing is continued by passing through the previous stitch. Thus, the locked stitches help to hold the previously placed portions of the continuous suture tight as the operation is completed. Locking involves passing the suture through the previous suturing cycle.
The primary advantage of this technique is its simplicity and speed of stitch placement over other techniques. The suture length used is less. It ensures that the tension is evenly distributed along the suture line. It is useful for long wounds where wound tension is minimized with properly placed deep sutures. It is also useful for fixing a full or split-thickness skin graft. There is less scarring compared to the simple interrupted suture technique. Closing the tissue using a simple continuous suture technique is an advantageous technique because of its hemostatic properties and reduced the tissue deterioration. When using this technique, there is not a requirement to knot each stitch; this makes suturing a long wound faster and leaves fewer knots to collect debris.
The possibility of tissue dehiscence may be higher in tissues closed by this technique, because only two ends of the suture line are knotted. If one of the knots is damaged or opened, the entire suture line will be damaged. One of the disadvantages is that continuous suturing allows for the transmission of infection along the suture line. If continuous suture technique is used in infected tissues, the risk of infection transmission can be reduced by choosing a monofilament material as a suture type. Monofilament sutures are not capable of accommodating microorganisms like multifilament sutures. A disadvantage of a continuous suture is that if a suture enters or breaks through the tissue, the entire suture has to be loosened or removed.