All procedures
GMC #21/Therapeutic procedures taught Y4 (exposure from Y3)
Wound care & basic wound closure
Provide basic care of surgical or traumatic wounds and apply dressings appropriately (includes basic suturing).
Target · Perform under supervision0% ready
Do it on a patient with a supervisor observing you (GMC “direct supervision”).
Overview
Assess, clean, close appropriately, dress. Suturing must be demonstrable by either a hand-held tie or an instrument tie in the exam.
Key numbers
- Technique: needle 90° to skin, ~4 mm bite from the edge, equal depth either side, edges evertedRCS / surgical practice
- Suture removal: face ~5 days · scalp 7–10 · limbs/trunk 10–14 · over joints ~14CKS / surgical practice
- Suture choice: non-absorbable monofilament (nylon/polypropylene) for skin; absorbable (e.g. Vicryl) for deep/buried layersRCS
- Do not primarily close: mammalian bites, grossly contaminated, or wounds >6–12 h oldCKS lacerations
Indications
- Simple lacerations, surgical wound closure/dressing
Contraindications & cautions
- Do not primarily close: bites, heavily contaminated wounds, or wounds >6–12 h old (infection risk)
- Assess neurovascular status & for tendon/foreign body; consider tetanus status
Equipment
Suture pack (needle holder, toothed forceps, scissors)Suture material (appropriate gauge)Local anaestheticCleaning/irrigation solution, dressing
Step by step
Assess & prepare
- 1Examine depth, contamination, neurovascular and tendon status; check tetanus
- 2Clean and irrigate the wound thoroughly
- 3Infiltrate local anaesthetic and test
Close
- 1Choose the method: sutures, adhesive strips (Steri-Strips), tissue glue, or staples
- 2Load the needle ~⅔ from tip to thread in the needle holder
- 3Pierce perpendicular (90°) ~4 mm from the wound edge, with equal bites and depth either side
- 4Evert the edges, instrument-tie the knot (~3 throws), and space sutures evenly
- 5Aim for good apposition without tension
After
- 1Apply a dressing; give wound-care and red-flag advice (infection)
- 2Advise suture-removal timing: face ~5 days, scalp 7–10, limbs/trunk 10–14
Complications
- Infection, wound dehiscence, scarring, retained foreign body
OSCE tips
- Be ready to suture by hand-held or instrument tie.
- Don’t primarily close bites/contaminated wounds; consider tetanus.
- Quote suture-removal times by body site.
Read
Sources & credits
Authored to UK finals standard and verified against UK guidance (RCS · CKS · CKS lacerations) and Geeky Medics OSCE guides . Southampton teaching materials © University of Southampton. Always follow current local policy.