Fig. 69
Fig. 70
Clove hitch.
Fig. 71
Staffordshire knot.
When an absorbable suture will serve the purpose it is desirable to use it, since the necessity of subsequent removal is thereby avoided. Inasmuch as every point through which a suture is passed will show its own minute scar, it is desirable for cosmetic purposes to use a subcutaneous suture, which may be made of chromic gut, silk, or fine wire. If of catgut it may be left to disappear spontaneously; but a silk or wire suture should be left with ends protruding from the wound so that after a few days it may be withdrawn by steady traction in the proper direction.
Secondary sutures are those which are placed at the time of the operation, but either not drawn so as to unite the wound edges, or are tied with a bow-knot, so that they may be untied and utilized later. They are useful when either hemorrhage or suppuration is anticipated, and when it is compulsory to pack a cavity with gauze.