Dear Future Doctor

For the Next Generation of Doctors

How To Place a Simple Interrupted Stitch

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If you’re new to suturing, it’s important to start with the basics. The simple interrupted suture is a great place to begin. Once you’ve mastered this technique, you can move on to more advanced methods.

Required Materials

You will need a set of instruments to perform the simple interrupted suture. This includes:

  • Needle Holder
  • Training Scissors
  • Adson Toothed Forceps
  • Thread and needle
  • Suture pad

Step 1: Properly Hold The Needle Holder

There are specific ways to hold the needle holder. The way I hold it is called the tripod grip. It is characterized by:

  • Inserting the thumb and ring finger of your dominant hand into the rings of the needle holder. (Should only be the distal phalanges inside the ring)
  • Placing the index finger over the joint to stabilize the needle holder. 

Step 2: Grasping the Needle

To properly grasp the needle with the needle holder, grasp the needle approximately 2/3 along the length of the needle, perpendicular to the needle holder.

Once you’ve done that, press the ratchet lock on the handle to securely hold the needle in place. This will ensure that you can work with precision and accuracy while performing your task.

Step 3: Pull The Skin back and take the first Bite

Taking a bite is the process of inserting the needle into the tissue and withdrawing it. What you must keep in mind is that each bite must be equidistant. That means that if you’re inserting the needle 5 mm away from the edge of the wound, you must do the same for the second bite.

Step 4: Go in for the Second Bite

Taking the bite separately improves accuracy so once you have the first bite through, you can proceed to the next bite.

Step 5: Create a Knot

There exists a multitude of knots, however, the simplest and most effective knot can be created following these steps:

  1. Loop the long end of the material over the needle holder twice, in a clockwise direction.
  2. Using the needle holder, grasp the other end of the material and pull it tight, moving the shorter end towards you and the longer end away from you.
  3. Loop the longer end of the material again over the needle holder once, and grasp this time in a counter-clockwise direction.
  4. Grasp the shorter end with the needle holder and pull it right, moving it away from you, with the long end moving towards you.
  5. Repeat steps 3 and 4.

Step 6: Cut the Suture

Cut the stitch leaving about 5-6 mm of suture material.

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