Terminology: Single vs Multiple Sutures in Running (Continuous) Technique
A running or continuous suture is considered a single suture, regardless of how many passes or "bites" are made through the tissue. This is the standard terminology used in surgical practice and medical literature.
Clinical Context and Evidence
The terminology is consistently applied across surgical guidelines and research literature. When surgeons describe suture techniques, they distinguish between:
- Single running suture: One continuous strand of suture material that runs the entire length of the wound 1
- Double running suture: Two separate continuous strands running parallel or in opposite directions 2, 3, 4, 5
- Interrupted sutures: Multiple individual sutures, each tied separately 6, 7
Key Distinctions in Practice
The 2023 World Society of Emergency Surgery guidelines consistently refer to "a continuous running suture" (singular) when describing closure techniques for laparotomy 1. This terminology is maintained even when discussing:
- The suture-to-wound length ratio of 4:1 (where a single continuous suture is 4 times the length of the wound) 1
- Small bite technique with approximately 5mm spacing between stitches 1
- Mass closure including all layers in "a single bite" 1
The distinction matters clinically: When comparing "single running" versus "double running" suture techniques in keratoplasty, researchers explicitly differentiate between using one continuous suture versus two continuous sutures 2, 3, 4, 5. This demonstrates that "single" refers to the number of continuous strands, not the number of passes through tissue.
Practical Implications
- One continuous strand = one (single) suture
- Two continuous strands = double running sutures
- Multiple separate tied knots = multiple (interrupted) sutures
This nomenclature is universal across surgical specialties, from abdominal wall closure 1 to corneal transplantation 2, 3, 4, 5 to general wound closure 7.