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Suturing Techniques in Oral Surgery

Dr. Roser is Professor and Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, 1365B Clifton Road, Atlanta, GA 30322; 404-778-5883 phone; 404-778-5879 fax; sroser{at}emory.edu.

The purpose of this book, according to the author, is to provide the reader with precise knowledge of the variables involved in the successful management of soft tissues. Its goal is to provide useful indications for the most appropriate choices for suturing technique in the oral cavity. The author, with the help of the illustrator, certainly accomplishes this goal. Virtually all of the suturing techniques useful in the oral cavity are well described, with step-by-step illustrations and color photographs that are very easy to look at and understand. Also dealt with in detail are the different types of suture materials, needles, and instruments for suturing. The sections on suture material and needles, similar to the sections on suturing technique, are dealt with in detail.

In addition to its detail, a strength of this book is its organization. Following the chapters on wound healing, classification of wounds, and tissue reaction to sutures, the author divides the remainder of the book into the technical aspects of sutures, instrumentation, and clinical application. He uses cases with high-quality clinical photos to illustrate the clinical setting in which each type of suturing technique could be used. The combination of text and illustrations should provide the first-time user with enough information to have the confidence to employ the technique. To the author’s credit, the cases he chose to include all deal with implants and/or bone grafting. However, he includes illustrations of the implant or grafting technique and prosthetic restorations that are not really relevant to the suturing technique and could have been left out.

The early chapter on wound healing is well done and gives the reader a current understanding of the protein and cellular aspects involved in wound healing and the timing of events that occur during the different phases of wound healing. However, the author chose not to reference the book and only to include a bibliography. For the sections describing suturing techniques, this is acceptable, but this is not a good choice for the chapters on wound healing and tissue response to sutures. In this age of evidence-based medicine and rapid progress being made in the understanding of wound healing, providing the reader with references is mandatory.

The section on needle types and suture materials is comprehensive, but I would like to have seen a more comprehensive section on instrumentation. I missed seeing comments on the uses and advantages of the different types and sizes of needle holders. Curious to me is that the author chose to leave out what is happening in the left hand (or right hand in left-handed surgeons). The management of other side of the wound with tissue forceps or skin hooks can be as critical to the success of wound healing as the suture technique itself and, in my opinion, should have been described.

The author could have enhanced the value of this book to the reader by including a chapter on suture techniques useful for the various areas of the oral cavity, including the lips, tongue, and palate. Also a chapter on knot tying and flap design, although not required, would have been useful and could have been used as a vehicle for illustrating the various suture techniques.

In summary, this is a nicely done book on oral suturing technique that presents useful and accessible information on the techniques it covers and only fails in a few places with coverage. I think the book would be particularly useful for dental students beginning the surgical journey. For residents in surgical training programs and practitioners performing surgery on daily basis, having the book available in the library for a one-time review and read of selected areas could also be useful.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Roser, S. M. Search for Related Content PubMed Articles by Roser, S. M.