Wound closure is something which we do all the time in the ED and you may never have had to do before. Some of the best teachers and sources of wound care advice are ENP’s and senior nurses. Our seniors are more than happy to review wounds and advise on closure. As well as closure it is useful to watch how others clean and dress wounds as this is also a specialist skill.
By watching the following presentations and by using training suture blocks (just ask at lunchtime handover) you will become comfortable and competent with the key skills.
2 Key points to remember
There are many different closure techniques, tailor the technique to the wound and the patient.
Think about Tetanus risk with any wound – follow intranet guidelines
Wound laceration.com is a great resource with videos of basic wound closure techniques. Please note that some of the equipment and techniques do vary slightly in the UK. For example we use a different tissue glue and application technique.
- Simple interrupted suture
- Vertical mattress suture
- Deep dermal suture
- Horizontal mattress suture
- The corner stitch
There are also some links on the site to more advanced techniques and special circumstances.
CEM FOAMed – Paediatric wound closure is a nice review of how to approach children’s wounds. Remember you have to win over the patient before you close the wound. Really consider the use of LAT gel or other atraumatic analgesia techniques. A smartphone with children’s songs/games (with a smash-proof case) can be invaluable.