Basically, it is the broader question for this problem.

Stitching is, simply put, just joining body tissues together after an injury or surgery. As any wound has wound margin, isn't it possible to join any two tissue edges together?

  • 1
    Are you asking if there are some wounds that can not or should not be sutured? – Graham Chiu Feb 5 '18 at 20:56
  • @GrahamChiu Can not. I‘m interested whether some wounds are impossible to suture because of the nature of the wound. – Narusan Feb 5 '18 at 22:34

Not necessarily.

Here are some examples that aren't good candidates for closing with sutures:

  • A wound that is much wider than it is deep-- a bad road rash abrasion, for example.
  • A wound with extremely fragile or messy margins (I treated a patient a few weeks ago whose food processor turned on while her hand was in there scooping food out).

  • A wound that has lots of dead tissue (such as when there is a flap of skin with poor blood supply)

  • A very dirty or contaminated wound (for example a cat bite, which is deep and filled with bacteria).

These wounds are not amenable to suturing, aka closing via primary intention. Instead, they are allowed to close via secondary intention, which essentially means heal on its own.

For wounds that should be sutured, there are many techniques that allow you to closely appose irregular wound margins.

  • 3
    Even in a clean incision I'd be wary about suturing a distal based flap on the anterior shin. – Graham Chiu Feb 5 '18 at 22:10
  • Yup, I mentioned a skin flap in my answer-- anything with necrotic or soon-to-be necrotic tissue is not a good candidate for suturing. – Nate Feb 6 '18 at 1:41
  • I should answer with my 25 cm leg laceration images – Graham Chiu Feb 6 '18 at 1:43
  • Your #2 example made me wish I hadn't read your answer. – Phylyp Feb 6 '18 at 5:14
  • Haha sorry-- she was actually OK if that's any consolation. Just not a good candidate for sutures. – Nate Feb 6 '18 at 16:09

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