Thursday, September 6, 2012

TO SEW OR NOT TO SEW

There are areas of the body that do not need suturing when they sustain lacerations. And there are areas of the body where a laceration no matter how small need suturing.
We have a standing protocol in surgery (foremost do no harm - Hippocrates) that if the wound does not gape in motion or in stand still, we do not suture for suturing leaves ugly marks than the natural wound healing.
Lacerations on the face usually do not need suturing if they do not gape. Boxers when they sustain lacerations during a fight may not have any surgery except when the wound persist to bleed. Thus, the main purpose of suturing is to contain bleeding and not for aesthetic reason.
Sutured wounds is called in medical parlance: HEALING OF SECONDARY INTENTION, for the reason that we force nature to heal fast and to lessen the natural tendency of wounds to form ugly scars. Sutured wounds if well approximated ( perfectly aligned skin) will result to a linear scar. But if they are not well aligned, one side of the skin overlaps the other, the scar result will be ugly. Suture marks will add to the railroad tract scar.
Surgery and surgical techniques have gone a long way over the years. We had absorbable sutures that do not lose their tensile strength up to 15 days in the 60's. Today we have absorbable sutures that last for 120 days without being disrupted by the body.
On development today is a kind of ointment or cream that could be applied to the skin that bonds two sides of the wound similar to  MIGHTY BOND.

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