Sadiq M, Neerudi SR, Kasam RR, Koribilli SP, Naik VRS, Naik BD, Singh PK, Manne A, Kothalanka UK, Mettu AK, Nunnabatla K, Ale SK, Mallepogu KK, Bebartta SP. Comparative study between combined oblique and vertical everting running stitch and the conventional suturing technique. World J Orthop 2025; 16(12): 112435 [DOI: 10.5312/wjo.v16.i12.112435]
Corresponding Author of This Article
Sharon Rose Neerudi, Senior Postdoctoral Fellow, Department of Orthopaedics, ESIC Medical College and Hospital, National Highway 65, Sanatnagar, Hyderabad 500038, Telangāna, India. rosesharon832@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Randomized Controlled Trial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Dec 18, 2025; 16(12): 112435 Published online Dec 18, 2025. doi: 10.5312/wjo.v16.i12.112435
Comparative study between combined oblique and vertical everting running stitch and the conventional suturing technique
Mohammed Sadiq, Sharon Rose Neerudi, Rohith Reddy Kasam, Sai Pradeep Koribilli, V Ratan Singh Naik, B Devandra Naik, Praveen Kumar Singh, Anudeep Manne, Uday Kumar Kothalanka, Anil Kumar Mettu, Keerthi Nunnabatla, Shiva Kumar Ale, Kiran Kumar Mallepogu, Shyam Prasad Bebartta
Mohammed Sadiq, Sharon Rose Neerudi, Rohith Reddy Kasam, Sai Pradeep Koribilli, V Ratan Singh Naik, B Devandra Naik, Praveen Kumar Singh, Anudeep Manne, Uday Kumar Kothalanka, Anil Kumar Mettu, Keerthi Nunnabatla, Shiva Kumar Ale, Kiran Kumar Mallepogu, Shyam Prasad Bebartta, Department of Orthopaedics, ESIC Medical College and Hospital, Hyderabad 500038, Telangāna, India
Author contributions: Sadiq M conceptualized and validated; Sadiq M and Neerudi SR wrote draft, reviewed and edited the manuscript; Kasam RR, Koribilli SP, Mettu AK, and Ale SK validated the research; Naik VRS, Naik BD, Kothalanka UK, and Nunnabatla K analysed the results; Singh PK, Manne A, Mallepogu KK, and Bebartta SP curated the data. All authors have read and approved the final manuscript.
Institutional review board statement: The article is accepted by the Institutional Ethical Committee ESIC Medical College and Hospital [approval No. ESICMC/GLB/IEC(2)/24/2021].
Clinical trial registration statement: The article has been sent for the clinical trials registry of India (REF/2025/08/112552).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Available from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sharon Rose Neerudi, Senior Postdoctoral Fellow, Department of Orthopaedics, ESIC Medical College and Hospital, National Highway 65, Sanatnagar, Hyderabad 500038, Telangāna, India. rosesharon832@gmail.com
Received: July 28, 2025 Revised: August 22, 2025 Accepted: October 30, 2025 Published online: December 18, 2025 Processing time: 143 Days and 13.6 Hours
Abstract
BACKGROUND
Wound management is an essential part of emergency medicine practice. A good suture technique should deal a complex irregular traumatic wound without any complications of dehiscence/gaping, infection, delayed wound healing, frequent dressings and further stay in hospital. There is no ideal technique of suturing for any wound. In pursuit of the new techniques, we have introduced a new suturing technique called combined oblique and vertical everting running (COVER) stitch which has showed good healing with less complications.
AIM
To compare the outcomes between the COVER stitch and conventional suturing group.
METHODS
In this study, we included 40 cases which were divided into two groups. Group 1 patients were managed by COVER stitch, and group 2 patients underwent conventional suturing for their wounds. The outcomes were measured in terms of scar quality, suturing duration and length of suture material used, suturing related complications and suture removal time which were compared by t-test using χ2 test.
RESULTS
Better results were seen in COVER stitch than the conventional suturing. COVER group had significantly better results in terms of time taken for suture, amount suture material used and time taken for suture removal compared to the conventional group. No wound related complications were seen in this group. Moreover, scar formed was also better in COVER group.
CONCLUSION
COVER stitch is another new technique which can be used to deal simple to complex wounds and it is an emerging idea with good healthy scars with less complications.
Core Tip: The combined oblique and vertical everting running stitch technique provides superior wound edge eversion, tension distribution, and cosmetic outcomes compared to the conventional vertical mattress suture. This hybrid approach minimizes tissue strangulation, promotes faster healing, and reduces scar prominence, making it a more effective and aesthetic alternative for skin closure in surgical and traumatic wound repair.
