The running percutaneous suturing technique is a nice technique to help you speed up lengthy wound closures. Simple interrupted suturing is still a preferred technique when you want the most meticulous repair, but when dealing with less cosmetic areas, I like this technique as it is involves less knot tying and gets the job done a lot faster without sacrificing much in terms of wound appearance.
Advantages of the running percutaneous suturing technique include more equal distribution of tension across the entire wound, allowing for tissue expansion due to edema and great tissue eversion.
A variation of the running percutaneous suturing technique involves “locking” each loop of suture as you go. This is accomplished by passing the needle through the loop of sutures. This added step will allow each loop of suture to act more independently in holding tension (almost like, but not quite as good as, a simple interrupted suture). This is most useful for a long laceration that is mostly linear but may have a little curve to it. Be advised, with locking the equal tension distribution which was an advantage of the basic running technique is lost, so you have a higher risk of tissue strangulation.
Could you also just end these sutures with a simple surgeons knot correct or using the needle driver similar to interrupted sutures, just treating the loop as string #2?
Yes, those techniques would also work.
Curious as to the best way to remove the continuous per cutaneous suture.
Great question. So as not to traumatize the tissue, I like to cut at each individual loop and then remove small pieces of thread as you would simple interrupted sutures. This is preferable to cutting at intervals and pulling The suture through, which has the potential to injure tissue as you pull. You do need to keep track of each thread loop, so as not to leave any foreign bodies, a big risk factor for infection.
Any preference regarding the direction or side with respect to the curvature of the wound in the locking of a running percutaneous suturing technique? Great videos! Greetings!
Francisco: thank you for your comments! I’m not sure if there’s an official answer to this. I would say that personally I tend to place the needle on the inner curvature of the wound first, which results in the locking affect appearing on the outer curvature of the wound. Although I suppose the converse approach would still work.
I welcome others comments here!