Too many foreign bodies in the epitendinous repair. I think the Kessler’s or modified Kessler’s for me, is still the gold standard. Thanks for the excellent demonstration.
Thank you, the epitendinous suture is actually an adjunct to the core suture which could be a Kessler, they are not used independent of each other. The epitendinous suture adds around 30% to the strength of your repair, and only really needs to be used in flexors distal to zone V.
@@sharpnsurgery Oh great. Thanks for this reply. For epitendinous sutures I have hitherto used simple or continuous 5/0 or 6/0 prolene sutures, but will try this technique next time.
@@kendaddi5857 yes we would usually use a 5-0, maybe 6-0 in a little finger flexor or child. The continuous epitendinous is just as good and actually like you say has less suture foreign material reaction and might be better than the silferskiold according to more recent studies, so it's fine to stick to a continuous epitendinous suture.
Hi, the sutures are being demonstrated on pig fat, it is the rind/fat of a piece of pork chop which has been cut in half. The hollow plastic tube is just the protective tube that comes with disposable forceps/scissors to protect the tip.
My 5 year child diagnosis with tendon injury she had a glass cut on her ankle of foot in emergency they stitch the injured area and now after 10 days of trauma the doctors diagnose the tender injured n suggested to reopen the wound n surgery .is it safe to undergrow surgical process for 5 year child
Hi and thank you. We are unable to give medical advice on TH-cam regarding your child unfortunately, but in general the main question in the ankle you have to ask your doctor is which specific tendon has been injured, what function is lost and do the risks of surgery and anesthesia outweigh the benefits of repair.
Thank you so much . they did not mentioned anything just said this need a surgery to fix and did not had any mri of her foot just done an xray and examine her foot her foot n finger can move downward but she has to struggle to lift her thumb
Thank you for your question. The short answer is yes, they heal and "re seal" themselves through intrinsic and extrinsic means. The sutures provide strength while they heal so that the ends are approximated and rehabilitation and moving the tendon is possible to prevent adhesions and stiffness. The tendon is fully healed to around 80% of the original strength at 12 weeks and the patient can return to all previous activity. At this point if you were to (hypothetically) do an operation to cut and remove the sutures, it would make no difference to the integrity of the tendon.
Hello, I would be very happy if you could help me. I had stitches on my arm 13 years ago. My wrist tendon was stitched. Do you think the stitches on my wrist tendon are the type of stitches that dissolve? The other day I felt a pain in my arm and something appeared inside. I did some research. And there were 2 pieces of sewing thread left that had not melted. I removed one of them myself because it was just under the skin, but I couldn't even touch a piece of it and couldn't remove it any further. If I go to the surgeon now, can they remove this? So this rope is not connected to the tendon or anything, right? Do you think it will be a problem? The aid I used was a blue colored rope. Thanks for
Hi, the suture that was used to repair your tendon was likely the blue suture you see, which is usually non-dissolvable. The tendon is fully healed in 3 months, so 13 years down the line if you remove the suture it shouldn't cause any problems, but yes a surgeon would be able to remove your suture for you if it is extruding/showing now.
@@sharpnsurgery Thank you for your answer, but I don't remember getting stitches on my tendon. I feel a bulge when I touch the tendon. Does that mean there's a seam there? So the glass was on my arm. The tendon in my arm remained as it was, that is, the glass did not cut the tendon, but in such a case, does the tendon still need to be stitched again?
Please tell me how long it takes for the tendon to return to normal or as it was before because I had my right knee tendon cut and then surgically reattached. Please tell me how long it will take to recover
Hi, the tendons in the hand are different to the knee tendons. A repaired flexor tendon will only get back to being about 80% as strong as it was structurally, although this will not be obvious clinically and one should be able to regain full power. The recovery is slow the tendon is weakest from 1-2 weeks after repair, then gets stronger up to 8 weeks when splints are usually discontinued and only applied at night and full recovery is complete at 12 weeks, where return to full activity, heavy lifting and contact sports can be resumed. The knee tendon, will be different and might have a longer rehabilitation period depending on which tendon is cut.
@@sharpnsurgery Thank you very much. My tendon below my knee was cut a lot with ceramic cutter glander, the day after the cut I had surgery to attach it then put 42 pins in the upper part now how long will it take to heal and after how long can I join heavy work please Please let me know if I do any heavy work before the scheduled time, is there a risk of tearing the tendons that have been reattached?
@@sharpnsurgery If I ask the person who is doing the surgery or to meet him, it takes 30 thousand in Bangladeshi taka because I am in Saudi Arabia and at the moment I don't have any money to ask him. So I asked you if I could know anything, it would be helpful. I am 24 years old. And now I am unemployed after the operation, all the money I had was spent on the operation, so I can no longer go to the doctor
The biological material is rind/fat of a pork chop that’s been boiled to soften it. The hollow clear tube is the sleeve that comes on the top of a pair of suture or tenotomy scissors.
Hi, it’s simply skipped moving the needle from the left to the right and pulling the suture, as it was the same bites repeating to save time in the video.
Too many foreign bodies in the epitendinous repair. I think the Kessler’s or modified Kessler’s for me, is still the gold standard. Thanks for the excellent demonstration.
Thank you, the epitendinous suture is actually an adjunct to the core suture which could be a Kessler, they are not used independent of each other. The epitendinous suture adds around 30% to the strength of your repair, and only really needs to be used in flexors distal to zone V.
@@sharpnsurgery Oh great. Thanks for this reply. For epitendinous sutures I have hitherto used simple or continuous 5/0 or 6/0 prolene sutures, but will try this technique next time.
@@kendaddi5857 yes we would usually use a 5-0, maybe 6-0 in a little finger flexor or child. The continuous epitendinous is just as good and actually like you say has less suture foreign material reaction and might be better than the silferskiold according to more recent studies, so it's fine to stick to a continuous epitendinous suture.
It's great to show inside of the tube. Easy to understand!!
Glad it was helpful!
Could you please upload more videos???Thank you for this video.It is really helpful.
Yes I will
Excellent video. Would you be able to demonstrate the Tajima suture technique?
Great suggestion! We will probably re-do this video with other techniques as well.
thank you. this is high quality and rare resource
Thank you for your support
In fact, the best tendon suture is the one has been made a thousand times
There would be no tendon left at that point unfortunately.
Which material you are showing this technique
,where can we arrange that material for practice
Hi, the sutures are being demonstrated on pig fat, it is the rind/fat of a piece of pork chop which has been cut in half. The hollow plastic tube is just the protective tube that comes with disposable forceps/scissors to protect the tip.
My 5 year child diagnosis with tendon injury she had a glass cut on her ankle of foot in emergency they stitch the injured area and now after 10 days of trauma the doctors diagnose the tender injured n suggested to reopen the wound n surgery .is it safe to undergrow surgical process for 5 year child
Hi and thank you. We are unable to give medical advice on TH-cam regarding your child unfortunately, but in general the main question in the ankle you have to ask your doctor is which specific tendon has been injured, what function is lost and do the risks of surgery and anesthesia outweigh the benefits of repair.
Thank you so much . they did not mentioned anything just said this need a surgery to fix and did not had any mri of her foot just done an xray and examine her foot her foot n finger can move downward but she has to struggle to lift her thumb
@@sharpnsurgery tendon can recover without surgery ?is it important to go for surgery
Can you have tendon repair surgery years after an injury?
Usually after that long you would need a 2-stage reconstruction or a tendon transfer.
@@sharpnsurgery aghh.. I will look into this! Thank you so much!
can you please tell me this? in the modified kessler technique, are the transverse bites supposed to go under the longitudinal fibres?
Essentially yes, under the sutures of the longitudinal bites, watch the hollow tube part under common errors to see how it looks like from the side.
Do tendons re seal themselves? Or are they permanently only held together by sutchers?
Thank you for your question. The short answer is yes, they heal and "re seal" themselves through intrinsic and extrinsic means. The sutures provide strength while they heal so that the ends are approximated and rehabilitation and moving the tendon is possible to prevent adhesions and stiffness. The tendon is fully healed to around 80% of the original strength at 12 weeks and the patient can return to all previous activity. At this point if you were to (hypothetically) do an operation to cut and remove the sutures, it would make no difference to the integrity of the tendon.
Thank you
Hello, I would be very happy if you could help me. I had stitches on my arm 13 years ago. My wrist tendon was stitched. Do you think the stitches on my wrist tendon are the type of stitches that dissolve? The other day I felt a pain in my arm and something appeared inside. I did some research. And there were 2 pieces of sewing thread left that had not melted. I removed one of them myself because it was just under the skin, but I couldn't even touch a piece of it and couldn't remove it any further. If I go to the surgeon now, can they remove this? So this rope is not connected to the tendon or anything, right? Do you think it will be a problem? The aid I used was a blue colored rope. Thanks for
Hi, the suture that was used to repair your tendon was likely the blue suture you see, which is usually non-dissolvable. The tendon is fully healed in 3 months, so 13 years down the line if you remove the suture it shouldn't cause any problems, but yes a surgeon would be able to remove your suture for you if it is extruding/showing now.
@@sharpnsurgery Thank you for your answer, but I don't remember getting stitches on my tendon. I feel a bulge when I touch the tendon. Does that mean there's a seam there? So the glass was on my arm. The tendon in my arm remained as it was, that is, the glass did not cut the tendon, but in such a case, does the tendon still need to be stitched again?
Please tell me how long it takes for the tendon to return to normal or as it was before because I had my right knee tendon cut and then surgically reattached. Please tell me how long it will take to recover
Hi, the tendons in the hand are different to the knee tendons. A repaired flexor tendon will only get back to being about 80% as strong as it was structurally, although this will not be obvious clinically and one should be able to regain full power. The recovery is slow the tendon is weakest from 1-2 weeks after repair, then gets stronger up to 8 weeks when splints are usually discontinued and only applied at night and full recovery is complete at 12 weeks, where return to full activity, heavy lifting and contact sports can be resumed. The knee tendon, will be different and might have a longer rehabilitation period depending on which tendon is cut.
@@sharpnsurgery Thank you very much. My tendon below my knee was cut a lot with ceramic cutter glander, the day after the cut I had surgery to attach it then put 42 pins in the upper part now how long will it take to heal and after how long can I join heavy work please Please let me know if I do any heavy work before the scheduled time, is there a risk of tearing the tendons that have been reattached?
Hi, you will have to ask your treating surgeon for that advice, as said before knee tendons are very different to hand tendons.
@@sharpnsurgery If I ask the person who is doing the surgery or to meet him, it takes 30 thousand in Bangladeshi taka because I am in Saudi Arabia and at the moment I don't have any money to ask him. So I asked you if I could know anything, it would be helpful. I am 24 years old. And now I am unemployed after the operation, all the money I had was spent on the operation, so I can no longer go to the doctor
What material are you using to simulator the tendon?
The biological material is rind/fat of a pork chop that’s been boiled to soften it. The hollow clear tube is the sleeve that comes on the top of a pair of suture or tenotomy scissors.
excelente video, muy explicito y visual. Gracias=)!😀
You're welcome!
Excellent. Kindly upload more videos of surgery
Will do! Thanks
6:17 to 6:18 what is not shown? Not clear:(
Hi, it’s simply skipped moving the needle from the left to the right and pulling the suture, as it was the same bites repeating to save time in the video.
Thank you so much!
You're welcome!
Gracias
You’re welcome
Good job
Thank you
Beautiful
Thanks!
Thank you
You're welcome
What suture do u use
Hi Sapiri, we usually use a 3-0 Prolene for the core suture and a 5-0 Prolene for the Epitendinous suture.
Excelente 👏👏
Thanks
Gracias muy bueno.
You’re welcome! Glad you’re enjoying the videos
Great great❤
Thank you for your support
❤❤❤❤
❤️