Suturing

Plastic surgeons use sutures for other purposes than the approximation of tissue. They are used to tie over a bolus to close a dead space or maintain a tissue graft in a desired place until it becomes adherent. A bolus of Vaseline gauze over a cotton dental roll is useful (Fig. 7). Sutures may be used to maintain certain tissue relationships until firm scarring will retain this position. Purposeful suturing in contrast to automatic closure of the wound involves the knowledge of wound healing, careful selection of appropriate needle and suture, and the infliction of minimal trauma. Adequate postoperative support of the wound is desirable. Careful critical observation of wounds over long periods of time is instructive.