A medical student posted the above photo to Figure 1 and asked the following question: “What are some tips and tricks (or materials) for quality suturing?” Many healthcare professionals shared their advice. From that discussion and other surgery cases, here are five pieces of advice for medical students and others learning how to suture.
1. Head to the grocery store.
When you’re learning how to suture, start at the produce aisle and get a few different fruits:
- Peaches: An interventional radiographer recommended practicing on this fruit because they “are great to mimic pediatric skin.”
- Green bananas: It’s important to use bananas before they ripen. A dermatologist said, “If it’s ripe, the suture will tear through.”
- Grapes: An emergency medicine resident shared, “I saw a video of someone peel[ing] a strip of skin from a grape and practic[ing] delicately suturing it back to the grape. Certainly would help skills for suturing thinner skin, especially in the elderly!”
2. Consult a butcher.
Students can often get free or discounted animal parts from a butcher. Healthcare professionals suggested practicing on pigs’ feet (trotters), chicken trachea, beef tongue, or chicken breast for a texture more like human tissue.
The meat can even vary based on your location. One medical student shared, “We use goat meat in Egypt 😀 “. Another replied: “We use ox tongue here in Brazil”.
3. Wear gloves, always.
A pediatrician shared, “Practice with gloves on. It’s a lot harder but you’re going to be wearing gloves whenever you suture, so get used to it now.”
4. Don’t use a sewing needle.
An EMT said: “The biggest thing is to use real made-for-purpose suturing materials – much easier to suture with curved needle and hemostat than with sewing supplies.” A suturing kit can be obtained from your school or purchased online.
5. Learn from the best.
Before you practice, examine successful suture repairs done by others. Here are a few examples:
Repair of a lip laceration. ”First irrigate, irrigate, irrigate. Mark your white roll and Vermillion BEFORE injecting. Then clean up the frankly necrotic tissue and the edges with a scalpel or littler scissors. Approximate your orbicularis oris with Vicryl or Monocryl, line up white roll and vermillion with Monocryl deep dermals. Skin closure with Plain Gut, mucosa grows back quick so +/- depending on the patient/situation.”
Repair of a deep thumb laceration through the nail bed. ”Deep laceration, down to the periosteum. No tendon or (surprisingly) nerve injury. I have a couple of questions for those more experienced. Would you use antibiotic prophylaxis or such an injury? Also, how would you handle the small piece of nail (that I simply sutured in place)?”
Repair of a laceration in a young child. ”I worked medial to lateral. The middle wound was the hardest to repair. I couldn’t close as much as I wanted for fear that small wound flap would die off if I put one more suture through it.”