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- เผยแพร่เมื่อ 1 ก.ค. 2011
- Advanced Suture techniques are explained in this lesson.
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The Sim*Suture Module will help the learner practice skills of simple interrupted and running suture, instrument tying, vertical mattress sutures, and running subcuticular sutures. As with all our modules, practice outside the simulation lab is encouraged with the availability of all necessary supplies: suture pad (with printed lines to guide placement of sutures), surgical instruments, and suture material. The exercise book provides the opportunity for the learner to practice in any convenient locale. Enough suture material is provided to place over 250 single needle passes. The time required for this module is about 4-6 hours. Curriculum offers opportunity for formal objective skills assessment (OSATS) when the module is completed. - วิทยาศาสตร์และเทคโนโลยี
I wish I had this system when I started surgery. Purchased it at the end of my MS3 year, and I have to say it's great. I will say this, though: the running sub-Q suture is more difficult to perform correctly on this model than it is in real life...If you can do it right here, you're golden in the OR.
Nice demonstration of technique. Aberdeen's knot at the end may be favored, the suture should be absorbable. However excellent technique for budding surgeons.
We don't remove intradermal sutures. We use absorbable material and close the surface of the skin with dermal glue. This causes less irritation because the sutures don't catch on things. Of course, different wounds require different suture patterns.
@OsakaUE The advantages are not having to schedule a post-op or follow up visit for suture removal, no scarring from suture holes and not having to worry about non-compliant patients. These sutures are absorbed by the body through controlled breakdown occurring at a predictable rate.
I'd love to see a MS do this in front of my attending!
At it again with another classic stitch up
The normal technique is a continuous subcuticular suture, using 3-0 / 4-0 prolene / nylon. The ends of the suture are left out in a knot on the surface of the skin. After the wound heals (approx. 10 days), one can carefully remove the suture material by pulling it out slowly using the needle holders.
Is this method more for cosmetic purposes and or deep tissue wounds, rather than shallow lacerations?
Terrific manual for the leyman. Thanks !
+Prepper * layman or layperson.
hmm... one thing I would comment on is that you should avoid gripping the needle by the tip, since it's so delicate and easy to blunt/snap off.
Beautiful Teaching.Unbeavle
I like it
I was only a C.M.A. so we were never taught a sub q suture but I really like it
For a running subcuticular suture, you would use an absorbable suture like a Chromic or a Vicryl. Your body will just degrade and absorb it over time as the incision heals so there's no need to get it out. This closure technique is simply done for cosmetic reasons.
you are thinking of the epidermis, the very top layer. skin also includes the next layer, the dermis, which is thicker, and is where this suturing is taking place.
Excelent video, but how you remove the suture?? Thanks!!
@Oxidized181 no need to take out the sutures b/c they absorb
Interesting pad!
GREAT VIDEO
wouldnt that depend on what you are suturing? thanks
isnt this intradermal I am confused
I’ve watched multiple ER pediatrician’s perform these procedures.
I appreciate when they pay attention to details.
I also noticed everyone had their specific techniques.
I also appreciated when they would wet the sutures before the procedure for a smoother pass.
I miss my days working in the ER. I loved my patients and my job.
I miss working with my friends. I😊🫶🏾
Extremely helpful
very good video continue ...
Cool channel!
How will you remove the nylon after healing?
what if i have a laceration and got my stotches off but it didnt really heal and my doctor just put a steri stripe
whats the material called that you are using to suture?
how do you get it out after it heals? o.O do you get out?
I'm sure Rudiger will be fine with this technique 💪🏿
Interesting. Thanks :)
I don't know what any of this is but I feel like I learned something.
+whitem0use same
Wow thanks!
Ok how you take that suture off after a week if the nods a buried deep?
You use an absorbable suture for this kind of technique.
maybe you have to use absorbable thread
watching so many surgical videos Incase I need them.
they might be using dissolvable stitches
А где у нас такую кожу купить?
Nice
Hi, is he using nylon?? and if thats going under the skin it wont be absorbe by the body?? could some one explain this please...
+olvin ortez they pull it out usually its self absorbing ones
This is what I wanna ask. Nylon is non absorbable suture. So I wonder how to remove the end of suture if you bury it in the subcutaneous. If it remains underneath skin, it would irritate and form the granulation I guess
Use an absorbable suture for subcuticular sutures.
O_o Looks too painful! [Fingers crossed] I hope I or all of us never attempt to have real surgery!
@Oxidized181 that's what I was thinking.
Excellent....Thank you
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you use dissolvible sutures so you dont have to remove them
Follow rules of sterlization
"YoUUuuu do nottTT touch needle!" --- grouchy Chinese guy.
Make me music video by Britney spears brought me to this LOL
Watching this makes me ooooh oooh oooh oooh.....
the video was a bit confusing at times...also, there's gotta be a way to do this without grabbing the needle with your hands, though I"ve met an attending who tells me to use my fingers if I feel it's easier...
seeing how you grab the tip of the needle, even with the needle driver makes me cringe!
Shut up
The other reason you don't grip the needle with your fingers should be the risk of needle poke injury and body fluid precautions should you poke a hole in your glove and put yourself at risk for contracting HIV/HEP.
Holy fuck OKAY GUYS WE GET IT don't touch the needle. how many times is the same comment going to be made
My 5 year wants to be a surgeon.so here we are watching this.🤔
Fantastic! Love to see that interest from the little ones.
It's absorbable suture, monocryl is the best for this, ( I don´t like this type of suturing thought)
What material is that?
i think it is 4 0 silk as it is black , proline is blue and vicryl is violet
And what about the rubber sheet? Is it silicone or anything else?
ahmed tarek how to remove it?
It kind of looks like Nylon?
and how would you remove the suture?
Who says you get a clean cut like that?
The needle should never be touched with the fingers! When the tip of the needle comes out through the skin, it should be grasped with the Adsons, not the needle driver, and immediately reloaded properly on the needle driver using instruments only. It's faster and a lot safer!
Not necessarily true.
0ł
your hand is clean
I just use qlue.
How many stitches apply in c section can u olz tell me
Which layer?
You just pull it out...
I got my stitch removed that way.
If you watch this video, have the patience to watch completely, otherwise totally misleading. Any way done by some novice rather than someone with real hands on experience...
Avoid handling the needle with your fingers! Use instruments to handle the needle.
why the Fuck am I watching this lol
you leave it...it gets absorbed
Don't touch the needle with your hands
NEVER load the needle with your fingers - it's a great way to get stuck!
Wow dude comon, dont touch the needle. Thats like the first thing you learn.
+SnorkFlirt i was teached to never touch it. If you know your way around with the tweezer (is that the word?) you are faster. And it looks so much better ;)
"Since you're just learning surgery... Do as I say, not as I do... Don't touch the needle even though everyone you'll ever work with does..." - All of my attendings thus far (ortho, cardiothoracic, plastics, gen surg, trauma, neurosurg).
Be like water my friend (Bruce Lee)..
Make a number 8
Hey bop
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It is not good... You should not ever touch the needle. We v'done that with a corps skin, and never forget the rule).
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Я НЕ ХИРУРГ НО ЗНАЮ НЕЛЬЗЯ КАСАТЬСЯ ИГЛЫ РУКАМИ.ТОЛЬКО ПИНЦЕТОМ
Good info thx
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