Seevana Karma: Sushruta's Ancient Art of Suturing - A Critical Review with Contemporary Surgical Correlation

Abstract

Ayurveda, one of the oldest documented systems of healing, accords a distinct place to Shalya Tantra (surgical science) as the foremost of its eight branches. Acharya Sushruta, regarded as the father of surgery, systematised eight fundamental surgical procedures the Ashtavidha Shastra Karma of which Seevana Karma (suturing) is the culminating step. Described chiefly in the twenty-fifth chapter of Sutrasthana of the Sushruta Samhita, Seevana Karma is elaborated with remarkable precision: its indications, contraindications, suturing materials (Seevana Sutra), needles (Seevana Suchi), the pre-, during and post-suturing protocol, and four distinct suturing patterns, Vellitaka, Gophanika, Tunnasevani and Rujugranthi. This review revisits the original Sanskrit verses relating to Seevana Karma, translates and interprets them, and correlates each classical concept with its corresponding technique in contemporary surgery, such as continuous, blanket (lock-stitch), subcuticular and interrupted sutures. The striking congruence between a description composed over two millennia ago and present-day suturing principles underscores the empirical rigour of ancient Indian surgical thought and its continuing relevance to modern surgical education and research.