The running suture is a medical procedure used to close wounds or surgical openings. Generally, the technique is similar to the fabric sewing stitch of the same name. The doctor or practitioner uses a continuous piece of suture material and works on alternating sides of the opening to pull the edges together to promote healing. The advantages of the running suture are that it is easy and fast, but the stitch has several disadvantages, including the tendency to let the tissues shift or ripple.
The running suture is easy to learn. The person pulls the wound edges together with forceps and then stitches from one edge to the other edge, using a length of suture. The stitch is similar to the sewing stitch, where the sewer uses a continuous piece of thread and enters the first piece of fabric from the top to the bottom and then places the needle across to the second piece. The stitch into the second piece travels from the bottom to the top. These alternating stitches are repeated the length of the opening.
In surgical stitching, generally the wound or opening edges are deeper than cloth. The person must determine how deep to penetrate the tissue before stitching into the other side. Many factors determine this, including the wound's location, cosmetic concerns, and the thickness of the tissue or skin. Generally, when using the running suture, a person uses a small curved needle, which helps to achieve the correct depth.
There are several types of running stitches. The running locked suture is similar to the simple running stitch, but the person passes the needle through the previous suture's loop to lock the suture in place. Another locking running stitch is the interrupted stitch, which is the running stitch with the thread knotted after each suture. A person stitches the running subcuticular suture horizontally into only the dermis layer of skin, not the epidermis. Often a doctor back-stitches into the previous suture to create a tighter bond.
Typically, a person needs to take special care to ensure proper suturing. Suture tension is one of the main concerns, because too little or too much tension on the sutures can inhibit the healing process. If the sutures are not placed properly, the opening may ripple or pucker. In a running suture, the top of the stitch should be straight across and the underside of the stitch should be angled to advance the suture line.
People such as medical students and nurses practice running sutures on artificial skin or pigs' feet. Some companies specialize in making practice models and often supply suture tutorial videos with their products. The simple running stitch has the disadvantage of letting the edges shift, and by practicing on the artificial tissue, a person can minimize the chances of inadequately stitching a person or animal.