The Art of Dental Suturing. A. Burak Çankaya

       Typical characteristics of oral mucosal wound healing

       Wound healing and systemic factors

       Age

       Nutrition

       Dehydration

       Diabetes

       Nicotine intake

       Diseases and/or therapies affecting the host defense mechanism

       Drugs and wound healing

       Antithrombotic therapy

       Antiangiogenic agents

       Antiresorptive agents

       Corticosteroids

       Local factors affecting wound healing

       Direction and length of incision

       Surface angle of incision

       Hemostasis

       Tissue moisture control

       Removal of necrotic tissue and foreign bodies

       Prevention of dead space in wounds

       Tissue tension

       Infection

       Wound and clot stabilization

       Blood supply to the wound site

       Enhanced visualization

       Recommended reading

       Chapter 2: Suture materials and suturing instruments

       Suture threads and needles

       Physical properties of suture threads

       Gauge

       Physical structure

       Capillarity

       Tensile strength

       Tissue passage

       Knot-holding security

       Elasticity

       Shape memory

       Absorption characteristics of suture threads

       Absorbable suture threads

       Absorbable natural suture threads

       Absorbable synthetic suture threads

       Non-absorbable suture threads

       Non-absorbable natural suture threads

       Non-absorbable synthetic suture threads

       Suture needles

       Needle anatomy

       Hand instruments

       Needle holders

       Scissors

       Tissue forceps

       Tissue adhesives

       Fibrin adhesives

       Collagen and protein-based adhesives

       Cyanoacrylates

       Polyurethane adhesives

       Recommended reading

       Chapter 3: Suturing techniques

       General principles of suturing

       Suture characteristics

       Suturing techniques

       Operational safety

       Function-based classification of suturing techniques

       Wound closure sutures

       Interrupted sutures

       Simple and locking continuous sutures

       Corner sutures

       Displacement sutures for approximating wound margins

       Sling sutures

       View-enhancing (tissue retraction) sutures

       Fixation sutures for biomaterials or grafts

       Membrane fixation sutures

       Sutures for adapting autogenous soft tissue grafts to the recipient site

       Sutures for securing surgical dressings or packings

       Hemostatic sutures

       Positioning sutures

       Sutures to prevent foreign material from traveling into deep tissue

       Abscess drainage sutures

       Recommended reading

TYPES OF WOUND HEALING

      Diverse biologic events such as hemostasis, coagulation, inflammation, granulation, connective tissue formation, and reepithelization occur during wound healing and continue upon remodeling of the wound site, even after wound closure. The healing model where the wound edges are well approximated is known as primary healing or primary intention, and that where a gap is left between the wound edges is called secondary healing or secondary intention. However, in case of injuries with significant tissue loss and in which the wound is contaminated with bacteria through contact with a foreign body, the wound is often left open for a couple of days to avoid the risk of infection, and then closed once this risk is eliminated. This is known as tertiary healing. In such cases, the wound should be irrigated with saline while it is left open.

      In primary healing, the wound remodels rapidly with a very small amount of granulation tissue formation, whereas in secondary healing, a void exists between the wound edges, resulting in more granulation tissue formation. In these types of injuries, the epithelium needs to extend further to cover the wound surface by filling the gap between the wound edges due to tissue loss. This indicates prolonged epithelization compared with primary healing. In addition, healing becomes more complicated in contaminated wounds with the additional process of eliminating the infection.

      Wound healing takes place through either regeneration or repair of damaged tissue. Healing through regeneration involves the recovery of lost tissue with