Suture is to rearrange the tissues separated by surgical anatomy or the remaining tissues after lesion resection to promote the primary healing of the wound. Under the condition of normal healing ability, whether the healing is perfect and the size of the scar after healing often depends on whether the suture method and operation technology are correct, which is particularly important in plastic surgery. Except for some special cases, such as exposed surfaces and infected wounds after oral surgery, all wounds should be preliminarily sutured.

1. Principles and basic requirements of stitching

Principle (1): On the basis of thorough hemostasis, strict and correct contraposition suture should be performed layer by layer from deep to shallow to achieve the purpose of primary healing.

(2) Basic requirements

1) The tissues on both sides of the incision should be in good contact, and the tissues on both sides of the suture should be symmetrical, so as to avoid leaving dead corners, otherwise there will be hematocele or effusion, which will not only delay the healing process, but also easily lead to infection.

2) Suture should be carried out under no tension or minimum tension to avoid postoperative dehiscence and excessive scar after healing. According to the nature, location and intraoperative situation of the operation, it is highly required in plastic surgery to determine the appropriate needle distance and cutting edge.

3) The suture sequence should be free side first, then fixed side, otherwise the tissue will be easily torn.

4) When sewing the skin of the face and neck, besides cutting along the sunken wrinkles, we should also prevent the edge of the wound from closing and excessive eversion, so as to avoid leaving obvious scars after the infection heals. Therefore, the suture should include the whole skin layer, the needle tip should be perpendicular to the skin when the needle is inserted, and the needle insertion distance on both sides of the skin incision should be equal to or slightly less than the subcutaneous distance, so as to achieve a complete effect. The needle distance between the inlet and outlet on both sides of the incision is greater than the subcutaneous distance; This causes the edge of the skin wound to roll inward. On the contrary, if the distance between the needle distance of the inlet and outlet is smaller than the subcutaneous space, the edge of the skin wound will be excessively everted.