Sutures placed in an interrupted fashion as opposed to continuous or "running" sutures are preferred because they reapproximate
tissues with less tissue necrosis and less chance for luminal narrowing.
Care must be taken to retrieve and reapproximate
the torn ends of the bulbocavernosus muscles, which are also often retracted laterally and superiorly.
The insertion site of the sternal head is located just posterior and slightly superior to the clavicular head insertion, in all of our cases both the clavicular and sternal heads were ruptured and in these situations care should be taken to reapproximate
their anatomy and orientation.
The mucosal flaps were then reapproximated; a 4-0 Vicryl rapid suture is used to reapproximate
the flaps in a quilting fashion.
A series of 4-0 chromic sutures were used in interrupted fashion to reapproximate
the skin and close the circumferential defect (Figure 3).
Deal with the contamination, reapproximate
the midline, and then reinforce that closure with an absorbable piece of mesh.
Place full-thickness, interrupted delayed absorbable sutures to reapproximate
the cuff edges.
these margins with absorbable suture (2-0 polyglactin 910 [Vicryl]) in an interrupted or running fashion, in 2 layers (9) (FIGURE 9).
Kho: I use a similar laparoscopic approach for myomectomy, using laparoscopy to assess the uterus and fibroids, enucleate the fibroid and remove it from the uterus, and then creating a mini-laparotomy incision 3 cm to 4 cm in length to manually remove or morcellate the fibroid and reapproximate
Not only does the presence of these fibroids leave some concern about the functional ability of the remaining myometrium in pregnancy, but it may be technically difficult to adequately resect all of the critical fibroids and reapproximate
the myometrial defects.
The skin is closed with three to five sutures--one that reattaches the center of the umbilicus to the fascial plate and one or two inverted sutures on either side that reapproximate
the lower and upper poles of the umbilicus.