A stay suture is a specialized, temporary surgical aid used during an operation to help the surgeon better access the surgical site. Unlike the stitches used for final wound closure, this technique is designed specifically for the manipulation and stabilization of internal tissues. This method ensures a safer and more efficient surgical environment during complex procedures.
Defining the Role of Stay Sutures
The primary function of a stay suture is to provide temporary mechanical control over tissues that are difficult to hold or that obstruct the surgical field. These sutures establish traction or counter-traction, helping retract tissue edges or stabilizing an organ for delicate work. By anchoring to underlying structures, they allow the surgeon to apply tension without causing trauma to delicate surface layers. This controlled manipulation minimizes the need for bulky metal retractors, which can sometimes damage surrounding tissues. Stay sutures are also effective at maintaining the patency of hollow structures or lumens, such as holding open the edges of an incision in a vessel or duct.
Specific Surgical Uses
Stay sutures are frequently employed in procedures involving hollow organs where temporary control over the incision is necessary. In surgeries on the bladder or stomach, they are placed along the cut edges of the organ wall to lift the organ and prevent spillage of internal contents, maintaining a sterile operating area. They are also routinely used in vascular surgery to secure and align fragile vessel walls. This stabilization is necessary for precise procedures like anastomosis, the surgical connection of two separate tubular structures. Another common application is in a tracheostomy, where the sutures are placed in the tracheal wall to maintain the opening during tube insertion.
Suture Materials and Placement
The materials chosen for stay sutures are selected for their strength and durability, given their role in maintaining high tension. Non-absorbable materials, such as braided silk or monofilament polymers like polypropylene, are preferred because they maintain integrity throughout the procedure. The placement technique involves taking a deep bite of the tissue, securing the suture in a strong structural layer. The ends of the suture material are intentionally left long, a practice often referred to as “tagging.” These long ends are then secured with a surgical clamp or hemostat, allowing the surgeon to easily grasp and manipulate the tissue for the required traction or adjustment.
Post-Procedure Care and Removal
Since stay sutures are placed for temporary manipulation, they are almost always removed before the final closure of the surgical site. In most cases, they are cut and withdrawn while the patient is still under anesthesia in the operating room. In specific instances, such as after a tracheostomy, stay sutures may be left in place for a short post-operative period. These external sutures act as a safety measure to help reinsert the breathing tube quickly if it becomes dislodged during recovery. Because the material is non-absorbable, removal is a simple process, contrasting with internal dissolvable sutures that break down naturally.