How to close intraoral wounds and incisions - DVM
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How to close intraoral wounds and incisions
Best practices for choosing dental sutures, needles and suturing methods


The knot

Photo 7: A simple interrupted suture pattern.
In most cases, simple interrupted suture patterns are used to close oral surgical wounds. The needle should penetrate 3 mm to 4 mm from the wound edges or at the base of the interdental papilla (Photo 7).

Photo 8: A simple continuous suture pattern.
Simple continuous suture patterns can be used when there's a large area to close, such as in feline full-mouth extractions (Photo 8).

Photo 9: A deep wide grab to approximate

Photo 10: Vicryl Rapide suture being used to close an incisor extraction site. Note that suture needles should only be grasped with needle holders.

Photo 11: The proper needle position on a Castroviejo needle holder.

General guidelines for placing oral sutures
Mattress sutures are best used in areas where tension-free flap closure can't be accomplished. Usually a ⅜-in. reverse cutting needle is used with a thicker (3-0 or 4-0) thread diameter. The needle penetration through the surgical flap should be 8 mm to 10 mm away from the flap edge or just above the mucogingival junction in keratinized tissue.


By choosing the right suture material and needle and then using the most appropriate closure methodology, you can have your patients back to good health in short order.

Jan Bellows DVM, Dipl. AVDC, Dipl. ABVP

Dr. Bellows owns All Pets Dental Clinic in Weston, Fla. He is a diplomate of the American Veterinary Dental College and the American Board of Veterinary Practitioners. He can be reached at (954) 349-5800; e-mail:

For a complete list of articles by Dr. Bellows, visit


Source: DVM360 MAGAZINE,
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