Suture Course

Lesson 1 • Wound Classification Systems

Introduces clean, contaminated, and complex wound categories used clinically. Guides students in matching closure method to wound type.

Lesson 2 • Phases of Wound Healing

Explains haemostasis, inflammation, proliferation, and remodelling phases. Links each phase to suture selection and timing decisions.

Lesson 3 • Skin Anatomy and Wound Layers

Covers epidermis, dermis, subcutaneous tissue, and fascia relevant to suturing. Provides the anatomical map students reference throughout all closure techniques.

Lesson 4 • Principles of Tension-Free Closure

Defines tissue tension, dead space, and eversion as core closure goals. Students apply these principles when planning every suture technique.

Lesson 1 • Absorbable Suture Materials

Covers natural and synthetic absorbable sutures, absorption timelines, and tensile strength retention. Students match material to tissue healing rate.

Lesson 2 • Non-Absorbable Suture Materials

Examines nylon, polypropylene, silk, and polyester for permanent or long-term closure. Connects material properties to scar outcome and removal timing.

Lesson 3 • Needle Anatomy and Geometry

Details needle body shape, point type, and chord length relevant to tissue penetration. Students choose needle geometry based on tissue depth and access.

Lesson 4 • Suture Sizing and Packaging

Explains the USP sizing scale, metric equivalents, and sterile packaging conventions. Students read labels accurately and select correct gauge for each tissue layer.

Lesson 1 • Pharmacology of Local Anaesthetics

Covers lidocaine, bupivacaine, and epinephrine adjuncts including onset, duration, and maximum doses. Provides the pharmacological basis for safe anaesthetic selection.

Lesson 2 • Field and Regional Nerve Blocks

Introduces ring blocks, digital blocks, and facial nerve blocks for larger wound areas. Reduces total anaesthetic volume and preserves tissue architecture.

Lesson 3 • Recognising Anaesthetic Complications

Identifies systemic toxicity signs, intravascular injection, and vasovagal responses. Students respond promptly to adverse events during wound preparation.

Lesson 1 • Suture Spacing and Wound Assessment

Develops the ability to evaluate spacing, tension balance, and edge alignment after placement. Students identify and correct poorly placed sutures before completion.

Lesson 2 • Instrument Tie and Square Knot

Covers the two-hand and instrument tie methods to form a secure square knot. Knot security directly determines wound dehiscence risk.

Lesson 3 • Simple Interrupted Suture

Teaches bite depth, spacing, and perpendicular needle entry for the simple interrupted stitch. This is the primary technique students refine before advancing.

Lesson 4 • Instrument Handling and Needle Loading

Establishes correct needle driver grip, needle loading position, and tissue forceps use. Proper instrument control is prerequisite to all suture placement.

Lesson 1 • Simple Running Suture

Teaches the continuous over-and-over pattern anchored by knots at each end. Students achieve uniform tension distribution across the wound length.

Lesson 2 • Subcuticular Intradermal Suture

Covers the buried horizontal running technique for cosmetically sensitive closures. Students place sutures entirely within the dermis to minimise surface scarring.

Lesson 3 • Locking Running Suture

Adds the locking loop modification to prevent suture slippage in high-tension wounds. Students distinguish when locking is advantageous over simple running.

Lesson 4 • Buried Interrupted Dermal Suture

Teaches the inverted knot technique to close deep dermal layers without surface exposure. Reduces dead space and supports the overlying skin closure.

Lesson 1 • Hand and Finger Laceration Repair

Teaches tendon sheath awareness, digital nerve proximity, and fine closure on the hand. Students avoid iatrogenic injury while achieving functional closure.

Lesson 2 • Oral and Mucosal Wound Closure

Introduces absorbable suture selection, knot security in wet tissue, and mucosal bite technique. Students close intraoral lacerations with appropriate material and pattern.

Lesson 3 • Trunk and Extremity Wound Closure

Addresses layered closure of deep trunk wounds and high-tension extremity lacerations. Students apply mattress techniques and layered repair to complex body wounds.

Lesson 4 • Facial Laceration Repair

Addresses cosmetic alignment, vermilion border landmarks, and fine suture selection for facial wounds. Precision placement minimises visible scarring on high-visibility anatomy.

Lesson 1 • Wound Dehiscence Assessment

Identifies partial and complete dehiscence causes including tension, infection, and poor technique. Students determine whether re-closure or secondary healing is appropriate.

Lesson 2 • Wound Infection Recognition and Treatment

Covers erythema, purulence, cellulitis, and abscess formation as post-suture infection signs. Students initiate appropriate wound care and antibiotic decision-making.

Lesson 3 • Suture Removal Timing and Technique

Establishes region-specific removal timelines and the correct technique to avoid track scarring. Students remove sutures cleanly without disrupting the healing wound.

Lesson 4 • Haematoma and Seroma Management

Explains fluid accumulation in dead space and its impact on healing and infection risk. Students drain collections and revise closure to eliminate dead space.

Lesson 1 • Negative Pressure Wound Therapy Basics

Introduces NPWT principles, foam dressing application, and indications for complex wounds. Students recognise when NPWT bridges the gap before definitive closure.

Lesson 2 • Relaxing Incisions and Undermining

Introduces undermining technique to mobilise tissue and reduce closure tension. Students perform controlled undermining to achieve tension-free primary closure.

Lesson 3 • Simple Advancement Flap Closure

Covers V-Y and single-pedicle advancement flap design for tissue defect coverage. Students plan flap geometry and execute closure without vascular compromise.

Lesson 4 • Tissue Adhesives and Wound Closure Strips

Covers cyanoacrylate adhesive application, wound strip placement, and their appropriate indications. Students combine adhesives with sutures for layered or paediatric closures.