Points cutanéo-dermiques séparés simples

Appelés points séparés simples, ils chargent le derme et l'épiderme de façon symétrique sur chaque berge. Il faut toujours penser à la rétraction cicatricielle qui entraine une invagination de la cicatrice, donc les points doivent être absolument éversants. C'est la technique de réalisation de chaque point qui reste déterminante:

- si l'aiguille est insérée parallèlement aux berges de la plaie, la suture est parfaite initialement mais l'évolution entrainera une invagination.

- lorsque l'aiguille charge plus large en superficie qu'en profondeur, la suture est invaginée dès le départ et le sera encore plus ultérieurement .

- lorsque l'aiguille charge plus large en profondeur qu'en superficie, le point est éversant. C'est l'idéal et la cicatrice finale sera à niveau.

Les noeuds ne doivent pas être placés sur la tranche de section mais sur le côté.

Ce sont les points les plus simples et ils sont réalisables pratiquement dans toutes les situations. Leur inconvénient est la séquelle esthétique qu'ils laissent, à type d'"échelle de perroquet". Pour limiter cette conséquence, il faut penser à ne pas trop serrer les noeuds et ne pas laisser les fils en place trop lontemps.

- si l'aiguille est insérée parallèlement aux berges de la plaie, la suture est parfaite initialement mais l'évolution entrainera une invagination.





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