Six tips to improve apposition of the buried horizontal continuous intradermal suture pattern for skin closure in dogs and cats.

Abstract

OBJECTIVE: To provide a video tutorial describing and demonstrating techniques to improve apposition of the continuous intradermal suture pattern. ANIMALS: With owner approval, a female cat undergoing ovariohysterectomy was used for demonstration. METHODS: To perform the buried continuous intradermal suture pattern, absorbable suture, needle drivers, and forceps are required. During intradermal bites, dermal apposition may be improved by needle positioning that promotes complete engagement of the dermis, backtracking to avoid skipping lengths of dermal tissue, and maintaining tension of the suture line. Exposed or unburied knots may impede incisional healing. Appropriate knot burial is promoted by ensuring correct orientation of knot-forming components and utilizing incisional dead space. RESULTS: Implementation of proper technique may result in improved dermal-to-dermal apposition, which may promote primary-intention healing and improve patient outcomes. CLINICAL RELEVANCE: The continuous intradermal suture pattern is a common method for surgical skin closure, particularly for elective procedures including ovariohysterectomies and neuters. However, it is a challenging and time-consuming pattern compared to alternative methods for skin closure. Avoiding common mistakes may improve dermal apposition for incisional healing.