Veterinary Suture Patterns

Did you know there are hundreds of different veterinary suture patterns? Veterinarians have their own specific way of stitching up an animal’s injury, and some patterns are particularly effective at preventing infection. Understanding the intricacies of each technique can be difficult without looking into a textbook,

Which Are the Most Used Suture Patterns?

Cushing Suture Pattern

The Cushing Pattern is an inverting pattern that can be used to create a watertight seal and is often used when closing the intestines or the bladder.

When a patient has excision of the tumor within the sella, a Cushing suture pattern is used to close the wound.

Cushing Pattern Process Explained

1. Place one-half of forceps on each side of the external ear opening and proceed postero-laterally (outside and back) until reaching the zygomatic arch.
2. Place the forceps on the mastoid process and proceed laterally.
3. Place the forceps over the tragus and proceed medially, to close the ear opening.
4. Pull down on the mastoid to fix it to the skull and proceed cranially, to close the ear opening.
5. Use the other half of the forceps to close the opposite ear opening.

The second step is usually performed with a combination of large and small forceps since there is a considerable amount of tissue that needs to be held.

Simple Continuous Suture Pattern

A continuous pattern is used for deep wounds that are not too wide (four to six cm). This type of pattern can be fixed with a single row of sutures. The continuous pattern may also be used on “superficial” wounds, which are found on the face or in areas where the skin is thin and there is little fat to protect.

The most common knot for this type of suture would be one called the “solid knot” or “surgical knot”. The surgeon uses this knot for the continuous suture pattern.
The suture is threaded through the first hole, then brought back up through the last hole and tied with a half knot. The suture is then put through the first hole again, and this sequence is repeated until closed. By going in a circular motion, each stitch is tied the same way.  

This pattern of suturing can also be used in an open cavity (for example, a surgical wound).

Simple Interrupted Suture Pattern

Just over 100 years ago, doctors in Vienna started using interrupted suture patterns during surgeries. It was not until a few decades later that the technique was used on all types of patients. The slowed-down time and cooling of incisions allowed for quicker healing and more predictable results. Nowadays, this simple but profound surgical technique is still in use around the world with a lot of success.

This particular pattern, as found in the image above, is called a closed interrupted suture. In order to achieve this, surgeons use a single thread that is threaded through two stitches. A variety of needle sizes can be used for this pattern from very large needles to smaller ones and even spray needles. The suture will be removed in four – 12 weeks after the operation making it an ideal choice in some cases where sight or a feeling of pain may prevent your patient from applying pressure on their incision.

Cruciate Suture Pattern

When your pet has had surgery to repair a serious knee injury, your veterinarian will likely apply a type of suture pattern referred to as Cross-Kill. This is the gold standard for repairing the cruciate ligament because it’s adjustable and can be tied in different ways in order to still maintain secure healing. The most common cross-kill suture pattern is as follows: left oblique muscle over iliopsoas tendon, left lateral acetabular notch, anterior, superior, and posterior lacings.

Horizontal Mattress Suture Pattern

A horizontal mattress suture pattern is a re-sewing of the fascia from one side to the other over the muscle. This procedure may be used when there is a need to close off an area of necrosis after skin grafting.

The veterinarian will initiate the process by making small incisions at the margins of a lesion, most often on or under an existing scar, which has been surgically prepared for grafting.

Vertical Mattress Suture Pattern

The image is an illustration of a vertical mattress suture pattern.

To put it simply, this pattern uses the same stitches you might see in a mattress to repair your four-legged friend’s laceration or another wound on a pet’s body.

It’s an easy quick fix if you have some surgical knowledge and are brave enough to attempt it yourself.

These infographics are from Veterinary facts, a page created to share interesting and useful information about pets and how to look after them.