Suturing & Wound Care

Introduces self	0	1
Confirms name & date of birth of patient (against wristband if present)	0	1
Explains & gains consent	0	1
Checks if patient has any allergies e.g. local anaesthetic	0	1
Washes hands and puts on non-sterile gloves to examine wound	0	1
Checks wound is not contaminated with infection or foreign body	0	1
Assesses neurovascular status of surrounding area	0	1
Checks location of wound and that wound is not more than 24 hours old	0	1
Prepares equipment (sterile drape and suture pack, cleaning solution, local anaesthetic, syringe, 21G and 25G needles, suitable size and type of suture, sterile  gloves)	0	1
Selects appropriate suture size (5-0 or 6-0 for facial laceration, 4-0 for scalp, chest, limbs or abdomen)	0	1	2
Checks type, expiry and concentration of local anaesthetic. Confirms whether it contains or doesn’t contain adrenaline. Confirms this with another staff member	0	1	2
Prepares sterile field and places sterile drape	0	1
Cleans the wound area with cleaning solution	0	1
Draws up a safe volume of local anaesthetic with 21G needle. This may require someone to hold anaesthetic vial to prevent contaminating sterile field	0	1	2
Infiltrates area with a 25G needle ensuring that you are avoiding any blood vessels	0	1	2
Warns patient to tell you about any perioral tingling or numbness or other symptoms	0	1
Places suture needle in needle holder around two thirds of its length from the tip	0	1
Raises skin with forceps and inserts needle around 5mm from the wound edge	0	1
Pulls needle through with needle holder	0	1
Raises opposite skin edge and inserts needle through wound to dermis, emerging 5mm away from the wound edge	0	1
Ties knot by wrapping suture twice round the needle holder one way, pulling the other edge, then wrapping once around the other way and pulling the other edge and finally twice again the first way and once again pulling the other edge	0	1	2
Pulls knot to one side of the wound and cuts leaving around 8-10mm	0	1
Ensures wound edges oppose each other but do not overlie each other and are not in tension	0	1
Continues in a similar fashion to close wound	0	1
Discards needle in sharps bin	0	1
Applies appropriate dressing	0	1
Disposes of waste appropriately in clinical waste bin	0	1
Checks tetanus status of the patient	0	1
Washes hands and answers any questions	0	1
Alerts other staff members that a cannula been placed	0	1
Examiner global score: confidence, methodical and proficient	0	1	2

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