What does the word suture mean?

  • A kind of immovable articulation, in which the bones unite by means of serrated edges, which are, as it were, dove-tailed into each other. The articulations of the greater part of the bones of the skull are of this kind. A dentated suture- Sutura dentata- is one in which the processes are long and dentiform, as in the interparietal suture. In a serrated sutura- sutura seu syntaxes serrata- the indentations and processes are small and fine, like the teeth of a saw, as in the suture between the two portions of the frontal bone. In the sutura limbosa there is along with the dentated margins a degree of bevelling of one, so that one bone rests on the other, as in the occipito-parietal suture. Suture, in Surgery, Rhaphe, means an operation which consists in stitching the lips of a wound to procure their union. The suture was, at one time, largely employed; but, in modern times, its use has been wisely restricted. There are few wounds in which the edges may not be brought together by adhesive plaster appropriately applied. This kind of union, by adhesive plaster simply, has been absurdly termed Sutura sicca or dry suture, in opposition to the Sutura cruenta or suture properly so called. The suture is generally performed with waxed thread and straight or curved needles, according to the arrangement of parts. The chief sutures are the interrupted suture, the quilled suture, the glover's suture, and the twisted suture. 1. The INTERRUPTED SUTURE, is performed by passing a needle, armed with a ligature, through the lips of the wound prevously brought into contact; and then tying the extremities of the thread. The other stitches are made in the same manner. They are separate or interrupted. It is the suture most commonly used. 2. The QUILLED SUTURE, Sutara clavata, is merely the interrupted suture, with this difference, that the ligatures are not tied over the face of the wound, but over two quills or rolls of plaster, or bougies, which are laid along the sides of the wound. It is used by some surgeons, on account of there being less danger of the stitches tearing out. It is not much employed. The CLAMP SUTURE, used by Dr. Sims, of New York, in the treatment of vesico-vaginal fistulae, is a modification of this. It is formed by two cylinders of silver or lead, perforated at several points for the passage of small pieces of fine silver wire, which are to supply the places of thread, and are prevented from slipping by perforated shot carried down upon them, pressed against the cylinders, and kept in situ by being firmly pinched with pliers. 3. The GLOVER'S SUTURE, is executed by introducing the needle first into one lip of the wound from within outwards, then into the other in the same way; and, in this manner, sewing up the whole extent of the wound. It has been chiefly used in wounds of the intestinal canal. It is now rarely employed except for stitching up dead bodies. 4. The ROYAL STITCH or SUTURE is the name of an old operation for the cure of bubonocele. It consisted in putting a ligature under the hernial sac, close to the abdominal ring, and then tying that part of the sac, so as to render it impervious by the adhesive inflammation thus excited. 5. The TWISTED SUTURE, is employed, chiefly, to unite wounds of the cheeks and of the free edges of the lips. To perform it, a pin or needle is passed through the edges of the wound, so as to keep them accurately in contact. A piece of thread is then wound accurately around the pin, from one side of the division to the other, in the form of the figure 'infinity'. The number of pins and sutures must, of course, correspond with the extent of the wound. This is the suture used in cases of harelip. The BUTTON SUTURE, of Dr. Bozeman, of Alabama, employed in vesico-vaginal fistula, is a modification of this. 6. The SUTURE A ANSE, of Le Dran, has only been employed in cases of wounds of the intestines. For this purpose, the edges of the wound are brought together, and as many needles, with unwaxed threads, used as there are to he stitches. Each stitch is then made by passing a needle through the edges; and all the ligatures which belong to one side of the wound are tied together, and twisted so as to form a thread, which is fixed externally. 7. The IMPLANTED SUTURE, is formed by pins arranged parallel to the edges of the wound, and implanted in their substance. By means of threads, the needles are approximated so as to bring the edges of the wound together. 8. The PLASTIC SUTURE, so called by Prof. Pancoast, of Philadelphia, its proposer, is a suture by tongue and groove. The groove is made by an incision in the part, which is to receive the flap. The tongue is made on the flap by bevelling off the two surfaces, cuticular and adipose. The suture is made by passing a loop of thread, by two punctures, deep through the inner lip of the groove. The two needles are passed through the base of the tongue, and again through the outer dip of the groove. The two ends of the thread are then tied over a small roll of adhesive plaster, by which the tongue is, of necessity, forced deep into the groove. Four raw surfaces are thus firmly held in connection, making the union of parts, by this suture, a very certain process.

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