|Principles of stitchcraft in oculoplastic surgery
|In oculoplastic surgery, the aim
is to achieve a fine line of scar tissue which is minimally visible. The
following tips are
useful in achieving the aim.
1. Avoid inversion of the wound
This can result from:
To avoid dead space close a wound in
layers. The deep layer is closed in as many layers as necessary using
To ensure sufficient depth of the bites.
Turn the needle perpendicularly and preferably turning it slightly laterally
Unequal bites produce an unsightly two-level scar. Ensure that both bites are of the same depth.
A final note here, after the suture
is tied, move the knot to one side to avoid depressing the scar.
2. Suture from the loose to the
3. When suturing a thin edge to
a thick edge , take a deeper bite on the thin side and a more superficial
4. When the wound edges are of unequal
height. Start on the high side superficially and then pick up the
5. When closure demands tension requiring longer suture
retention and in a position where stich marks are