Vertical Mattress Suture | BMJ Learning

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3D Animation of the vertical mattress suture technique

In the emergency department vertical mattress sutures are used for simple closure of wounds, including contaminated wounds following trauma. They are particularly useful when the wound requires more tension to bring together the skin edges, or for thin skin where this technique helps evert the skin edge effectively. In the operating theatre they may also be used for hand sewn bowel anastomoses.

00:02 Hold the needle holder correctly
00:15 Always use the instruments to pick up the needle
00:20 Use the forceps to position the needle
00:25 ⅔’s along from the point of the needle
00:30 Small wounds
00:40 Take a slightly larger bite than normal
00:44 Start vertical mattress suture
00:50 Rotate the needle smoothly
01:10 Prepare for the backhand part of the mattress suture
01:27 Backhand technique
01:41 Standard knot
01:45 Double forward throw
02:01 Single backwards throw
02:17 Squared knot
02:26 Equally spaced vertical mattress sutures
02:30 Dispose of all sharps safely

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EXCELLENT representation, very clear, no details missed . Thank you.

bigboss-tlxr

Loved the animation that showed the knot so clearly.

dougtaylor

Consider throwing the first knot at the midpoint of the laceration to facilitate skin approximation and reduce risk of dog ear formation.

chrisoltorik

I have seen a few different videos showing different ways to do sutures, but none describe which suture to use for different wound types or areas of the body and why. I'm only looking to learn the basics in case of a SHTF situation.

technoir