Arrange the steps in the correct order for performing a running suture on long, straight wounds.

MP NHM CHO-2024 (Shift-1)

Medical Surgical Nursing

Medium

Appeared in: MP NHM CHO-2024 (Shift-1)

Explanation

The correct sequence for a running suture is DBEAFC, which follows the logical progression of wound closure.
The procedure must start by placing and securing the first stitch with a knot at one end of the wound (Steps D and B).
This is followed by taking continuous bites along the wound's length (Step E).
To finish, a loop is left at the final bite (Step A) to facilitate the tying of the terminal knot (Step F).
The final action is to cut the excess suture material (Step C).

Option B: This sequence (ABCDEF) is illogical. It starts by leaving a loop (A) before any stitches are placed and cuts the suture (C) before the final knot is tied.
Option C: This sequence (DEDFAC) is incorrect because it repeats step D and places the final knot (F) before taking continuous bites (E) or leaving a final loop (A).
Option D: This sequence (DABCEF) incorrectly places leaving a loop (A) immediately after the first stitch, before the continuous bites (E) are taken.

Visual 1: Diagram - A step-by-step illustration showing the six stages of placing a running suture, from the initial knot to the final cut.
Visual 2: Infographic - A comparison table showing the visual differences between running, interrupted, and mattress sutures on a skin model.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The procedural steps for applying a continuous (running) suture for wound closure as background academic context rather than a clinical decision trigger.
Understanding the correct suturing technique is a fundamental skill in surgery and wound management, ensuring proper tissue approximation and optimal healing.
A running suture is advantageous for its speed and even distribution of tension, but its disadvantage is that if the single strand breaks, the entire wound may dehisce. Nurses must monitor the integrity of the suture line.
Nurses are responsible for post-operative wound assessment, including checking for signs of infection, hematoma, or suture failure. Knowing the type of suture used helps in this assessment.

How to Approach the Question

First, identify the core task: arranging procedural steps in the correct order.
Analyze the procedure in question: a running suture. Recall or deduce the logical flow of any surgical closure: start, secure the start, perform the main action, prepare to end, secure the end, and finish.
Apply this logic to the given steps: You must first place a stitch (D) and then tie a knot to secure it (B). This establishes the beginning of the sequence as 'DB'.
Next, the 'running' part involves taking multiple stitches (E).
To end the suture line, you need to tie a final knot. The standard technique is to leave a loop (A) to tie this knot (F).
The very last step is always cutting the excess material (C).

Concept Tested & Keywords

Concept Tested: The procedural steps for applying a continuous (running) suture for wound closure.
Stem keywords: Arrange the steps, correct order, performing, running suture, long, straight wounds
Lead-in keywords: Arrange

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