The above link (if it goes down just search the article on www.jfponline.com) has some nice, classic tips on proper sewing for not just good, but great, outcomes. A few highlights, but again the article is encouraged:
- NEVER underestimate the importance of a well documented flushing of the wound. Again, avoid alcohol or anything that could harm the new, regenerating tissue. A solid rule is the old maxim, "don't put anything in a wound to clean it that you would not put in your eye!"
- Note the table on suggested suture removal times. In the real world, I have long railed against the "usual 7 days" for MOST wounds (ie- those from the neck down excluding the fast healing well vascularized face and scalp). I totally concur with the table in that the majority of our express care lacs need 10-14 days.
- The # 1 tip to go from good to great in sewing is this: EVERT the edges so dermis matches dermis. Many subtle tricks, ranging from deep, tension relieving mattress sutures to undermining the wound edges exist. The key is to aggressively utilize these tips consistently!
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