Suturing and stapling in elective procedures - DVM
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Suturing and stapling in elective procedures


DVM Best Practices


In cases with possible abdominal sepsis, delayed healing or the presence of significant amounts of abdominal transudate or exudate, we use a non-absorbable suture. Using a simple continuous suture pattern for abdominal wall closure has been shown to be as safe and efficient as using simple interrupted sutures. In either case appropriate suture size, proper knot technique and security is important. In most routine cases using an absorbable monofilament for abdominal closure is satisfactory. In general, this type of suture material maintains +75 percent of its strength during the critical time for abdominal wound healing.

Dewclaws There are several different methods of skin closure, including the use of surgical adhesives, use of absorbable monofilament or simply bandaging the site. In general, we recommend using an appropriate size absorbable monofilament suture. In mature animals, it is important to ligate the digital blood supply and accurately appose the skin edges. In neonates, one may use either a small hemostat or scissors to clamp and remove the dewclaw and then appose the skin edges with suture.


Photo 1: During the last decade, skin staples have offered veterinarians an easier and more pratical procedure for closing wounds and surgical sites.
Skin closure The options for skin closure include skin staples, intradermal sutures and skin sutures. Skin staplers have enjoyed more widespread use in veterinary surgery over the last decade (Photo 1). Staplers have become more affordable, and their ease and speed of application are primarily responsible for their popularity (Table 1, p. 11).

There are several important points to remember for skin closure.

  • Skin sutures or staples are placed 3-5 mm apart and at least 5 mm from the skin edge.
  • It is important to place sutures or staples to accurately approximate the skin edges. Sutures tied too tightly may cause tissue strangulation and cause tissue necrosis. Sutures tied too loosely fail to accurately appose the skin edges.
  • In general using a series of simple square knots is recommended.
  • Use a reverse cutting needle so that the flat edge of the needle hole faces the incision.
  • Remember the role of skin suture is to appose skin edges, not "hold everything in."


Suggested Reading.
Conclusion There are several acceptable methods for tissue apposition, closure and ligation. Automated stapling or ligation devices offer the advantage of speed, simplicity and versatility. Regardless of the method chosen for wound closure and ligation, basic principles of knot security, tissue apposition and proper technique are important factors to remember.

Dr. Taylor is the owner of Alameda East Veterinary Hospital in Denver. He received his veterinary degree from Texas A & M College of Veterinary Medicine. Dr. Taylor has a master's degree in veterinary surgery from the University of Colorado College of Veterinary Medicine (CSU). He is a diplomate of the American College of Veterinary Surgeons. Dr. Taylor serves as a clinical affiliate to CSU's veterinary teaching hospital.


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Source: DVM Best Practices,
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