Clinical Skills
The Duke Suture Skills Course video presented by Dr. Michael Zenn as a demonstration of the technical aspects required for the cosmetic closure of open wounds is very informative. I have learned much about the various suture techniques, their variations, and how to perform them correctly. Firstly, I have learned that although there are different suture techniques, they all use the same instrument tie (Zenn, n.d.). It takes at least three or four suture throws for a firm surgeon’s knot; however, the number of throws depends on the type of suture material used. Based on how the different types of sutures are done to close a wound, I have learned that the choice of the suture technique also depends on the characteristics of the wound, such as wound depth, location, and reasons for suturing. For instance, the simple buried suture technique is used when the wound is deep and requires deeper sutures before skin sutures are applied to close the skin. In contrast, the vertical mattress suture technique is selected when swollen wounds or swelling is expected (Zenn, n.d.).
Other suture techniques, such as the horizontal and half-buried suture techniques, are used to avoid suture marks on one side of the incision. The subcuticular running suture technique is the most complicated cosmetic wound closure technique. It runs within the dermis and leaves no visible suture tracking on the skin, making it the most suitable cosmetic surgery. During suturing, the distance between the sutures is critical to avoid inverting the skin around the wound. Inversion delays and compromises the wound’s healing process and risks scarification and site infection (Sureshkumar et al., 2018). Avoid inverting the skin; I have learned to maintain a small and equal spacing between the sutures. This spacing can be supported by exaggerating a 90° for each suture.
References
Sureshkumar, S., Jubel, K., Ali, M. S., Vijayakumar, C., Amaranathan, A., Sundaramoorthy, S., & Palanivel, C. (2018). Comparing Surgical Site Infection and Scar Cosmesis Between Conventional Linear Skin Closure Versus Purse-string Skin Closure in Stoma Reversal – A Randomized Controlled Trial. Cureus, 10(2). https://doi.org/10.7759/CUREUS.2181
Zenn, M. (n.d.). Learn How To Suture – Best Suture Techniques and Training [Video]. Retrieved 21 September 2022, from https://www.youtube.com/watch?v=TFwFMav_cpE.
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Question 
Clinical Skills
Discussion Prompt
This week’s content addresses common techniques and testing that the Nurse Practitioner can prescribe. Please review ONE of the following videos and post what you have learned this week for the class after reviewing.
Watch the following video on suturing or appropriate ordering of imaging:
Suture Skills Course – Learn Best Suture Techniques https://www.youtube.com/watch?v=TFwFMav_cpE
OR
Ordering the most appropriate imaging test- Appropriateness criteria https://acsearch.acr.org/list
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years