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Nurse practitioners have a high rank in the health care sector owing to their skills, experience, and expertise. Moreover, a successful transition of the nurse practitioners into practice requires autonomous practice, competence and confidence, and mastery of clinical skills (Barnes, 2015). They can prescribe various techniques and testing to deliver quality and safe care that leads to better patient outcomes. Dr. Michael Zenn presents the Duke Suture Skills Course in the suturing video that teaches viewers the approaches for suturing wounds (Zenn, 2013). Through this week’s video, I have learned the basic suturing techniques and some of the variations when managing wounds. My interest in suturing emanates from the prevalence of injuries and accidents that leads to abundance of trauma patients in various care settings. Therefore, nurse practitioners should acquaint themselves with suturing techniques to give the trauma patients a proper wound care.
My first learning point was the significance of an instrument tie that is the basic preliminary activity of any suturing technique. The Duke Suture Skills Course gives nurse practitioners an opportunity to become the best surgical residents because it begins with skills for squaring a knot during suturing. Once the mastery of the instrument tie is intact, a nurse practitioner can now alter the style of suturing according to the type of the wound. The suture instrument tie comprises of long loop end, short end, and the needle drive that lies at the midpoint (Zenn, 2013). The surgeon’s knot forms upon wrapping the longer end twice around the resting needle drive and grabbing the shorter end and pulling it towards the opposite side. The square knots should be tight with at least three loops to avoid untying that can look cosmetically cumbersome.
Secondly, I learned the various suturing techniques after covering the basic instrument tie. Suturing promotes wound healing by flap stabilization and adhesion of fibrin clots (Burkhardt & Lang, 2015). The simple interrupted suture is the commonest suture. The surgical residents holds the needle driver at the tip and enters the skin at 90° while taking thin bites from the skin. Repetition of the same procedure on the opposite side leads to skin eversion. On the other hand, a simple buried suture is suitable for deeper tissues before putting a skin suture. The surgeon starts at deep tissues before becoming superficial and ending up in the dermis. Even though wounds can swell and become difficult to suture, the surgeon can use a vertical mattress suture that begins from afar and moves under the skin to relieve the superficial tension (Zenn, 2013). In case staying close to the skin edge is desirable, the nurse practitioner can opt to use the horizontal mattress suture.
Suturing is one of the basic but the most important technique for nurse practitioners who often encounter injured patients. The Duke Suture Skills Course provides all the vital information and demonstrations for achieving better suture outcomes. Mr. Michael Zenn have used his demonstration and teaching skills to point out the important aspects of suturing and its variations. In conclusion, I have learned that for any suturing activity to begin, the surgical resident should begin with formation of an instrument tie. The instrument tie consists of the shorter end, long end, and the needle drive place exactly at the middle. However, the surgeon should decide on the technique to use based on the nature of the wound. For example, the simple interrupted suture is the commonest suturing technique suitable for most wounds. However, the mattress suture prevents tension in swollen wounds.
Barnes, H. (2015). Exploring the factors that influence nurse practitioner role transition. The Journal for Nurse Practitioners, 11(2), 178-183. doi: 10.1016/j.nurpra.2014.11.004.
Burkhardt, R., & Lang, N. P. (2015). Influence of suturing on wound healing. Periodontology 2000, 68(1), 270-281. doi: 10.1111/prd.12078.
Zenn, M, R. (2013, November 19). Suture skills course - learn the best suture techniques [Video File]. Retrieved from