Complications - Suturing and knot tying technique

  1. Complications and how to avoid them

    • Tissue trauma → smooth-surface suture, atraumatic needle-suture assembly
    • Bacterial influx → if possible, suture material without capillary effect
    • Tissue ischemia with subsequent necrosis and thus increased risk of infection
    • → layered fascial closure excluding muscle tissue ("small bites" technique), no subcutaneous sutures (ongoing controversy)
    • Wound dehiscence → Suture technique adapted to wound tension, suture material with adequate tensile strength
    • Knot loosening → stiff suture material with a smooth surface decreases knot security, which must be compensated by a higher number of throws (approx. 6 to 8).