(b) Hold the needle holder in the palm of your hand, using the index
finger for fine control. (This gives you better control than if your fingers were in the
needle holder fingerholes.)
(c) Suture towards yourself, entering at the far side of the wound and
exiting on the near side.
(d) Using forceps such as adson forceps, control the edges of the
Remember to treat the tissue as gently as possible. When forceps are
employed, be sure not to crush the tissue.
(e) Enter the skin with the needle at approximately a 90-degree angle
(f) Be sure the suture lies at the same depth on both sides of the
wound (figure 2-7). The level at which the needle exits the tissue on one side of the
wound must be the same as the level in which the needle reenters on the other side of
Tying the knot: general principles. Follow these general principles:
(a) Adhere to the proper knot tying procedure strictly.
(b) The strands of suture material need to intertwine in alternate
directions with each throw in order for the knot to square. Squaring is essential for the
knot to remain tied securely.
For nylon or prolene, use a total of four or five throws per knot.
(d) For silk or cotton, use a total of three throws per knot.