How to Document a Running Suture in the Operative Note
Document running sutures by specifying the suture material (including manufacturer and size), technique used (continuous/running), anatomical layers closed, and whether it was locked or unlocked. 1
Essential Documentation Elements
According to the SCARE 2018 guidelines for surgical documentation, your operative note must include specific intervention details 1:
Required Suture Documentation Components:
Suture specifications:
- Material type (e.g., absorbable vs. non-absorbable: Vicryl, Monocryl, Prolene, etc.)
- Size (e.g., 3-0,4-0)
- Manufacturer name and model - this is explicitly required by guidelines 1
Technique details:
- State "running" or "continuous" suture technique
- Specify if locked or unlocked
- Document the direction (e.g., proximal to distal, medial to lateral)
Anatomical specificity:
- Which layer(s) were closed (e.g., fascia, subcutaneous tissue, skin)
- Starting and ending points
- Whether buried or superficial
Additional context:
- Any knots placed (typically at beginning and end)
- Whether reinforced at specific points
- Any modifications to standard technique
Example Documentation Format
A properly documented running suture might read:
"The fascia was closed with a running 0 Vicryl suture (Ethicon) in a locked fashion from caudal to cephalad. The subcutaneous layer was approximated with running 3-0 Monocryl (Ethicon) in an unlocked continuous pattern. Skin was closed with running 4-0 Prolene (Ethicon) subcuticular suture."
Common Pitfalls to Avoid
- Never use abbreviations - spell out suture types and techniques 2
- Don't simply write "closed in layers" - specify each layer and technique 1
- Avoid vague terms like "standard closure" - be explicit about what was done 1
- Don't omit manufacturer information for suture materials 1
Why This Level of Detail Matters
This documentation standard exists for medico-legal protection, quality assurance, and to allow other surgeons to understand exactly what was done if reoperation is needed 2. Implementation of structured electronic proformas has been shown to improve compliance with documentation standards from 80% to >95% 2, suggesting that using templates with these required fields can help ensure complete documentation.