Pulley Stitch

Last updated 02.01.14

 

Definition

-  Stitch used in wound repair with tension in tissues due to size or shape of wound

 

Features

-  Allows for reduction in a large tissue gap in a wound

-  May be required for scalp or leg wounds

- May be left in place or removed once other tissue closed

 

Indication

-  Wound repair for tissues under tension

 

Equipment

- Suture material

- Needle holder

- Scissors

- Tissue forceps

 

Procedure

-  Modified Vertical Mattress Suture

-  Far-near Near-far method

-  Performed similar to a vertical mattress suture

- First bite enters far from wound edge & exits on contralateral side of wound near to edge

- Second bite enters at near edge of initial side of wound & exits on contralateral side of wound far to wound edge

- Knot is then tied with pulley effect

 

Far-Near

 

- Vertical Mattress pulley suture

-   Performed similar to a vertical mattress suture

- Before tying not running end passes through loop of suture on contralateral side of wound

- Not is then tied with pulley effect

 

Vertical

 

- Modified Horizontal Mattress Suture

-  Performed similar to a horizontal mattress suture

- Before tying not running end passes through loop of suture on contralateral side of wound

- Not is then tied with pulley effect

 

 

 

References

 

eMedicine: Suturing techniques

  YouTube: Horizontal Pulley Stitch