Healthcare and Medicine Reference
Figure 21.5 Step-by-step guide: suturing. (a) Initial insertion of needle
(with eversion of distal wound edge). (b) Insertion of needle through
proximal wound edge. (c) Position of suture - length of 3-5 cm on distal
edge. (d) Two clockwise turns of suture over needle holder. (e) Grasping the
short end of suture with needle holder. (f) Forming the fi rst knot.
(g) Securing knot with anticlockwise turn of suture over needle holder.
(h) Securing the knot.
Joint aspiration (arthrocentesis) is a procedure of therapeutic and
diagnostic importance for joint swellings. It must be performed in
a competent, safe manner as it can potentially introduce infection
into a previously sterile joint space.
Inversion/overlapping of wound edges.
'Dog-earing' - this is where there is a unilateral excess of wound
edge left over, caused by poorly placed sutures. If this occurs take
your sutures out and start again.
Indications for joint aspiration
Drainage of a tense haemarthrosis <24 hours old.
Bleeding (secondary haemorrhage).
Drainage of a tense joint effusion for pain relief.
Evaluation of an unexplained arthritis with associated effusion.
Clinical suspicion of a septic joint/crystal arthropathy.
Loss of function.
Evaluation of antibiotic sensitivities to a suspected septic joint.