What are the disadvantages of sutures?
Disadvantages include possible crosshatching, the risk of dehiscence if the suture material ruptures, difficulty in making fine adjustments along the suture line, and puckering of the suture line when the stitches are placed in thin skin.
What is a continuous suture used for?
Continuous sutures are one with a series of stitches but they are not individually knotted. They are typically used when the wound is in the visible region of the body and thus the stitches will not be readily apparent.
What is a continuous suture?
It is a suture technique that provides to close the wound with a single suture. It is similar to the simple interrupted suture technique, but unlike simple interrupted sutures, knots are not tied at every stitch. Only the first and last stitches are fixed by knotting.
How many sutures are in keratoplasty?
Typically 16 sutures are placed, although in large corneal grafts or corneoscleral grafts, additional sutures may be necessary. Suture placement is usually performed to minimize the development of astigmatism, with every other suture being placed 180 degrees away from the previous suture.
When do you use continuous and interrupted sutures?
Continuous sutures are usually inserted underneath the skin surface using absorbable or non-absorbable suture material. Interrupted sutures involve the full thickness of the skin and are usually non-absorbable (but not always). Impaired wound healing increases costs of health care and leads to poor cosmetic results.
When is continuous suture technique used?
A simple continuous stitch can be a useful technique for skin closure when speed is important, e.g. closing a scalp laceration on a screaming child. The simple running, or continuous suture, is begun in the same way as a simple interrupted suture.
What are the indications of penetrating keratoplasty?
Indications for total penetrating keratoplasty were infectious keratitis, autoimmune disease, injury of the eyeball (mainly chemical burns), and other combined disorders. The main goal of the surgical treatment was the total removal of the infected or destroyed cornea and restoration of ocular integrity.
What is continuous interlocking suture?
Continuous locking suture begins with an interrupted suture at one end of the flap. The short tag end of the suture is cut leaving the long end to form a loop that the assistant controls. The surgeon then begins another pass from flap to adjacent tissue.
How many sutures do you need for a cornea graft?
The cornea is then sutured in place with either interrupted or continuous sutures. Interrupted sutures are preferred in vascularized, inflammed, or thinned corneas as well as in pediatric cases. Typically 16 sutures are placed, although in large corneal grafts or corneoscleral grafts, additional sutures may be necessary.
Can a keratoplasty graft be performed beyond the limbus?
Sometimes in the case of microbial keratitis, the infection extends beyond the limbus. In these cases, the surgeon may choose to perform a larger corneoscleral graft. In other extensive cases, such as with corneal dystrophies, corneal trephination may not include the entirety of the pathology.
Where are the first four cardinal sutures placed in the keratoplasty?
The first four cardinal sutures are placed at the 12:00, 3:00, 6:00, and 9:00 positions. Care must be taken so that each suture has equal tension compared to the other sutures.
Which is the first step in penetrating keratoplasty?
The initial step in penetrating keratoplasty should be the preparation and punch of the donor tissue. The epithelial side of the donor may be marked as well to guide suture placement. It is critical to prepare the donor tissue prior to entering the patient’s eye, to be prepared for any need for urgent closure.