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Stay sutures are temporary stitches placed during a surgery to hold or manipulate an anatomical structure. They are typically removed at the end of the surgery before an incision is closed, although they may be left in place if the surgeon feels they pose no risk for the patient. In addition to helping the surgeon work, they can sometimes be useful in the management of surgical emergencies. Decisions about whether to use such sutures and where to place them depend on the preference and experience of the individual surgeon.
One reason to use stay sutures is to temporarily align a structure to hold it in place. If a clamp slips or another problem develops, it will remain stabilized instead of moving out of position. This can allow a surgeon to work more safely around the area. Stay sutures can also be useful for exposing the surgical field or limiting bleeding if there are concerns about significant bleeds from key vessels in the area.
In some cases they act as anchors that can be used to gently manipulate structures inside the patient’s body. Stay sutures along the trachea, for example, can help with surgical positioning. They are also useful for emergency airway management, where they can be used to assist with intubation to secure the patient’s airway during a crisis. The best positioning and application can depend on the structure and the procedure.
Once the procedure is finished, the surgeon may need to remove the stay sutures to prevent complications in some cases. The surgeon carefully pulls out the sutures and confirms that they are entirely removed before closing the incision. In other situations, it may make sense to leave them in place if they pose no particular harm. Staples, surgical glue, and stitches can be used to close the site, depending on the type and location of the incision.
With some procedures, there are worries that stay sutures might expose the patient to a higher risk of complications, as for example in heart surgery where they can cause problems with the coronary arteries. Studies on the use of stay sutures provide more insight for surgeons with questions about their applications and safe use. The latest findings and recommendations are typically published in trade journals dedicated to discussing advances in surgery. Surgeons can review these to determine if they need to make adjustments to their practices in the operating room.
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