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To Suture Or Not To Suture

The opinions and views of this blog is for information and entertainment only and should not be used as a substitute for seeking advice from your veterinarian about your horse and your situation. Specific advice may only be given after a valid veterinary - client - patient relationship is made.Why is skin sutured?  Among the many jobs that the skin does, one of the most important things it does is to keep what is underneath it from coming out and to keep what is outside the body from coming in.  Now, before you all say “Duh!” give me a moment to answer the question. 

When the skin is separated (torn, sliced, ripped, blown apart, etc) the body’s first response is to close the wound.  This is a slow process.  First, the wound needs to clean itself and remove all damaged tissue.  Then it needs to create a base layer to close the wound.  Finally, the wound edges need to close so the skin covers the wound.  The end result may take several days, maybe weeks, and sometimes, may never occur. 

When suturing a wound, all these steps occur within hours.  Cleaning is the most important aspect and often takes two thirds of the total time in suturing a wound.  Damaged skin and tissue as well as hair and dirt must be removed with scissors and forceps and then scrubbed clean with soap.  The infrastructure is set up using absorbing suture material to bring together the many layers such as muscle and subcutaneous tissue.  This also removes the tension on the skin allowing the edges to remain together.  Finally, a layer of non-absorbable suture is used to keep the edges of the skin together.  The wound is solid in 10 to 14 days.

This is the simple overview and many wounds offer complications.   But how do you know if a wound needs suturing?  Here are a few points.  1) If the wound involves the full thickness of skin – in other words, the skin edges completely come apart – then suturing is helpful.  Scrapes and abrasions do not require suturing.  2) If the cut is below the knee or hock, then suturing greatly reduces formation of granulation tissue (“proud flesh”).  This proud flesh requires a lot of attention and often prevents wound healing for months to years.  Remember, below the knee or hock, suture.
Equine Dentistry Without Drama™ Articles by Geoff Tucker, DVM is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 United States License.
Based on a work at www.theequinepractice.com.
Blog by Geoff Tucker, DVM is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.