There are 14 steps in the cross-linked suture technique:

  1. The needle is passed through the skin on the far side of the incision and suturing is started at the end of the incision closest to the hand (with the right hand it is the right end, with the left hand it is the left end).
  2. The needle is passed through the tissue near the incision; To minimize tissue damage, the needle should follow the folds across the tissue and the surgical staff should continue by rotating the wrist. The suture is drawn in such a way that the short tip remains approximately 3-4 cm long.
  3. An important point in this step is not to tie a knot or cut the suture. The needle is passed through the tissue again, adjusts a distance of about 1 cm from the first part of the suture.
  4. The needle and suture material should always be passed through the tissue at right angles to the incision.
  5. The suture is pulled in the diagonal direction until the suture material fits flat on the top of the incision.
  6. The knot here is tied in the same way as a simple interrupted suture. That is, the needle holders are placed over the incision and the long end of the suture material is wrapped around the needle holder twice.
  7. The short end of the suture material (free end) is held close and the needle is pulled through the loop around the needle holders.
  8. The tension must be equal; Therefore, care should be taken to pull with equal strength with both hands. The suture should be tight enough to form the wound edges. But it should not be too tight. If the suture is too tight or loose, it may cause discomfort and skin infection may occur.
  9. For a second ‘throw’: The needle holder is placed over the incision site.
  10. The long end of the suture is wrapped around the needle holders.
  11. The short end of the suture is held near the free end with the help of a needle holder.
  12. The short end is pulled from the ring.
  13. Continue with 2 “throws” and continue until the number of throws in total is 4.
  14. The ends are cut enough to remain approximately 1 cm long. The length of the suture tip should be long enough to grip and hold when removing the sutures.

Some important points to control your suture technique:

  • For a long cut or wound and to ensure that the wound edges are well placed, you should prefer cross cruciate technique instead of a simple suture technique.
  • The jagged edge of the needle holders, that is, the inside of them, is rough and should not be used to grip or loosen the sewing material (except when gripping a short end when tying a knot). The suture is damaged by the serrated edge and can be torn in a short time.
  • When the procedure is finished, the two sides of the wound should be:
  • It should be suitable for the entire length of the incision
  • There should be no gap at either end or between the sutures.
  • The sutures will be in the correct tension:
  • Not too tight: otherwise swelling, redness and discomfort may occur around the incision site and inflammation may develop.
  • Not too loose: contamination gets into the tissue spaces and infection occurs.
  • Sutures should not be too close to the incision: Each suture should be approximately 5 mm from the edge of the incision.
  • The sutures should be placed at equal intervals and the suture ends should be enough in length.

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