Learn how to choose the best suture size and material in this educational video from board-certified plastic surgeon Dr. Michael Zenn. Subscribe for New Videos: bit.ly/3chp13f
Thank you Dr Zenn for the suturing videos. Please make a detailed video on subticuticular suturing and the best way to make any kind od closure look good. Thanks again
I'm a 4th year just starting surgery auditions and this video is fantastic. I feel like a lot of what I saw on clerkships finally makes sense with regards to suture material.
Thank you so much! You have taught me how to become an expert and had to close up a wound not just with different types of knots and suturing techniques. But you actually taught me the difference between the needles be in tapered Or cutter to the actual thread be in monofilament or multi filament. Then you taught me when to use absorbed and non-absorbed sutures. You are literally my teacher at home! Thank you Dr. Zenn! 🙏💜🇺🇸
Dr. Zenn is a brilliant lecturer. I wish TH-cam had more physicians like Dr. Zenn fostering interest in medicine, surgery, and health science research. You see it in the basic sciences a lot but not as much in medicine or surgery.
1,000 Times THANK YOU !!! for these excellent videos. Took a year off and was so rusty . And your absolutely right, we use what we do because some else did or too many choices just pick one you know. !
You made a topic which was so intimidating easy to understand and apply!! I now have the confidence to begin my suture techniques on actual patients 🤗🤗 thank you and God bless❤❤
Thank You very much Dr.Zenn for such a informative and most needed presentation for doctors in training and also for practicing doctors , my deep respects to you.
I’ve been researching types of sutures as I raise chickens and I may need to suture one up sometime (impacted crop, injury, etc.). I am trying to be prepared for emergencies. Avian vets are few and far between. This is the best information I have found on the internet and I have been looking for a while . I would have ordered a less than ideal suture material if I had not seen your videos. I feel more confident now. Thank you very much.
Great video Dr. Zenn. High quality and very informative :) I was wondering if you can make a video about basic and advanced knot tying with different suture materials taking into account delicate structures, suture material physics etc. Some tips and tricks in general :) Wish you all the best!
Great videos! I have seen all of them many, many times through med school and my first years in the art of surgery in Norway. I am a proud owner of your 2 volume books that take an essential place on my book shelf. The basics are the foundation that all is built upon. I can recommend that you consider a video about the main instruments used in the theater and how to use them properly. Amazing how many times I have fumbled around with anatomical forceps until I figured it out. Nobody teaches these basics unless you are lucky to find a mentor. Or you are a book collector like myself and have the essentials from Pye and Bailey etc. Thank you.
I have been looking for a suture class, more depth and practically. You just clicked with me. This is the best presentation and it makes sense. Thank you!!! I’m subscribing to your videos now (I don’t subscribe to anything).
Dr. Zenn, I am new to your videos as I am in NP school. Thank you for your high quality educational material. I am struck by one note. You seem happier now than in your previous Duke "How to Suture" videos. I have worked in the OR as a scrub and circulator RN, and know the culture. What has changed for you?
Seen many as RN, OR-sutured as medic, but wether Monofilament, braided, absorbable or non-absorbable, great overview. Hopefully scrub nurse is arming needle in holder properly. Outstanding explanation & salient memories. Thank you
I work ER and i never use vicril unless its to pull in deeper tissue or to close a void if there is missing tissue. I use ethilon interrupted 90+ percent of the time in case they get infected (15 years in, nothing major but you never know). Patients sometimes get upset that they have to come back to get them removed but i think it is the safest option. I use interrupted most of the time, again if they get infected it might be part of the laceration and you can get by pulling a couple, where if you have a running stitch the whole thing has to come out. I do use running often on impatient, uncooperative, usually intoxicated patients simply for expediency.
I had an open, non-mesh, umbilical hernia repair done. It was a small defect in the fascia, approximately 4 mm. My surgeon wound up closing me with a non-absorbable, monofilament nylon suture. In your opinion, was nylon the best choice here or would prolene have worked better? Does it even matter?
Thank you for making these videos Dr. Zenn. I'm learning to suture and there's alot of info to absorb (no pun intended). I'm NOT fond of silk braid (4-0) there's so much drape to it. (I sew fabric as well.) My respect level for those who suture surgically has gone up by 1,000%. It looks easy to do but my hands don't want to cooperate with the instruments. Again, thank you for the videos.
Thank you so much. very informative video. I was looking for this info and it was delivered perfectly. a great Teacher. I hope I can one day teach what I learned like you do.
Wow!! Thank you! Just starting to train myself, lots of questions, you gave me quite a bit to chew on, TY! I assume the suture material will affect your choice knots. So much to learn.
Great video Dr. Zenn! Do you have the source for the images (e.g., the one about "types of suture material" and the one in which the sutures are organized by color)? I'm currently doing some Anki flashcards from this video to share with fellow students, are you ok with that? If so, having the original source would allow me to add said images with a higher resolution. These types of resources have been really helpful.
Cesar I no longer have the original images but you are welcome to pass the info along in any way to help others. One trip to the OR and you can photograph the charts for suture supplies.
Thanks for your information on suture. I am a patient gotten my Tommy done in July. My suture knots above my bellybutton hurts and I can feel the knots. Am I to worry about this?
Do you know what sutures they use for circumcision? My urologist says they are dissolvable within about a month or so but I didn't ask what kind. Are they inter changeable with surgical glue?
Thanks Dr. Zenn for so interesting lesson. I'm a family doctor with a surgeon's soul, so I try to do my best with my primary care patients. One problem that's been happening to me is when I remove a skin lesion at pretibial region or at scalp of bald patients and there's tension on the suture edges. Which is the best option and with the best esthetics result, considering that silk and polypropilene sutures use to be the material available at my medical consultation?. Perhaps some suture technique is also something to keep in mind in these cases, isn't it?
In those areas, keeping the wound closed is your priority, less on cosmesis. Polypropylene or nylon are best, simple sutures or mattress sutures and leave them in 10 to 14 days.
Do you add steri-strips or other sterile glue-on strips across? I was taught to use them as aid in de-tensioning as a poor man's alternative to the tensioned fascia closures.
Dr. Zenn, could you please make a video with examples of bad sutures, i.e. what common things to avoid? Learning by negative example would be very helpful since, for example, I believe I would better understand what a 90-degree bite and skin eversion are if I would see a non-90-degree suture and the resulting skin inversion. Also I find it difficult in assessing if a suture is sloppy/bad, since you only show your perfectly-executed state-of-the-art sutures :) Thank you very much for your videos!
Very informative video sir..👍 i have seen vicryl sutures which are used for deep layer approximation jutting out through skin after few days, any reason behind this?
Great point. When you place absorbable sutures, the sutures should be placed so the knots get "buried" deep or they will come to the surface (called "spitting"). You accomplish this by starting the suture deep to superficial and the opposite side superficial to deep. Both ends of the suture are now deep so when you tie them the knots stay deep. The other tip is never bring the absorbable suture too close to the skin surface-stay in the deep dermis. Anything close to the epidermis will come out before it is absorbed.
Thanks for these videos. Esstentially, I am a subscriber so that my first aid skills become sharper. To that end, I would conclude, (as a lay person), that a braided/non absorbable suture would be prime for an emergency first aid kit - because treatment is required until medical professionals can attend. (My scenario would be first aid in an environment where transport to a clinic would be delayed sufficiently as to require temporary treatment - such as backwoods, air crash, or any non populated locations while waiting for evacuation for long periods of time). Woild this be a correct conclusion?
Very useful. Choice of needles: Cutting vs. reverse cutting? Nylon vs. poly....nylon is elastic so one must be very aware of tension during tying. Polypropylene is not elastic so the tension applied is the tension that remains. That's a very good thing in some applications. Absorption by hydrolysis produces virtually no inflammation and that's very good. Allergic reactions to gut do occur and can be problematic. You seem not to adhere to the old and perhaps incorrect maxim that only monofilament material should be used in subcuticular repairs to reduce the likelihood of providing a refuge for bacteria.
Reply below with your questions about the video, or any general suturing questions!
Thank you Dr Zenn for the value information, can i ask you please about the best suture material to use in facial dimples ?
Stratafix vs V-Loc... What's the difference and does it matter which is used? Thank you!
Can I have your mobile phone number please I would like to contact you for my own business
Thank you Dr Zenn for the suturing videos. Please make a detailed video on subticuticular suturing and the best way to make any kind od closure look good. Thanks again
Is Cat gut and plain gut same?
Surprisingly hard to find information, thanks Dr. Zenn!
I'm just ten and have a suture kit already because of my thirteen year old cousin who watches these videos for practice, he has one too!!
An aspiring doctor here ?
Welcome, future surgeon.
You will become an expert surgeon one day...
I'm a surgeon from a small underdeveloped country.
@@amylwin1271 b99 loo lol
Hoping you are not practicing on each other!!
I'm a 4th year just starting surgery auditions and this video is fantastic. I feel like a lot of what I saw on clerkships finally makes sense with regards to suture material.
Thank you so much! You have taught me how to become an expert and had to close up a wound not just with different types of knots and suturing techniques. But you actually taught me the difference between the needles be in tapered Or cutter to the actual thread be in monofilament or multi filament. Then you taught me when to use absorbed and non-absorbed sutures. You are literally my teacher at home! Thank you Dr. Zenn! 🙏💜🇺🇸
Complete and concise, a wonderful rare quality. Thankyou so much!
Thank you Dr. Zenn. Really helpful.
Dr. Zenn is a brilliant lecturer. I wish TH-cam had more physicians like Dr. Zenn fostering interest in medicine, surgery, and health science research. You see it in the basic sciences a lot but not as much in medicine or surgery.
1,000 Times THANK YOU !!! for these excellent videos. Took a year off and was so rusty . And your absolutely right, we use what we do because some else did or too many choices just pick one you know. !
You made a topic which was so intimidating easy to understand and apply!! I now have the confidence to begin my suture techniques on actual patients 🤗🤗 thank you and God bless❤❤
Great video, Dr. Zenn. This video has been very educational and will continue to serve as a reference in my training.
Thank you Dr Zenn! You are the best👏🫶🏽
Thank you Dr zenn , actually you are my teacher at home , your channel is my best choice in medical .
Thank You very much Dr.Zenn for such a informative and most needed presentation for doctors in training and also for practicing doctors , my deep respects to you.
I’ve been researching types of sutures as I raise chickens and I may need to suture one up sometime (impacted crop, injury, etc.). I am trying to be prepared for emergencies. Avian vets are few and far between. This is the best information I have found on the internet and I have been looking for a while . I would have ordered a less than ideal suture material
if I had not seen your videos. I feel more confident now. Thank you very much.
Best explanation ever... Good job doctor.
Great video Dr. Zenn. High quality and very informative :) I was wondering if you can make a video about basic and advanced knot tying with different suture materials taking into account delicate structures, suture material physics etc. Some tips and tricks in general :) Wish you all the best!
This material is EXCELLENT. Loved this video.
Thank you. I've been looking for literature with this topic. Never thought of looking on TH-cam.
Great videos! I have seen all of them many, many times through med school and my first years in the art of surgery in Norway. I am a proud owner of your 2 volume books that take an essential place on my book shelf. The basics are the foundation that all is built upon. I can recommend that you consider a video about the main instruments used in the theater and how to use them properly. Amazing how many times I have fumbled around with anatomical forceps until I figured it out. Nobody teaches these basics unless you are lucky to find a mentor. Or you are a book collector like myself and have the essentials from Pye and Bailey etc. Thank you.
Can u recommend your book?
Thank you for this lecture, God bless you.
I just lucked into this.
Loved it and learned a lot.
Going to look at your other videos!!!
Thank you!!
Great video, Dr. Zenn!
THANK YOU! I would love to a see a video on one- and two-handed surgical knot tie techniques!
The best suture series!!
Amazing video, explained very well and detailed. Thanks.
Absolutely you are the best doctor who teachs me Suturing , thank you so much 💙💙
Great video, very informative! Thank you Dr. Zenn. Watching from Philippines.
Thank you Dr.Zen for sharing. I am a midwife in Suriname and your training video's helps me a lot.🙏🙏thank you
This was very helpful!! Thank you!!
Very good presentation, thanks for your time!
Thank you dr. zenn very helpful
Thank you for this lecture dr
Thank u very much Dr. Zen
sir thank u so much for all the great details in one video
Thank you much Dr.Zenn, you're the man!
Are you from Michigan? Agree Good Video
@@healthproff3053 Maybe.. maybe not...who is asking?
Thanks for your videos, I really appreciate them!
thank you sooo much Dr.!!
I have been looking for a suture class, more depth and practically. You just clicked with me. This is the best presentation and it makes sense. Thank you!!! I’m subscribing to your videos now (I don’t subscribe to anything).
This has been very helpful!😊
Thank you sir for giving very important accepts of suturing..
Excellent review of suture types and closure techniques. Succinct and enjoyable.
Thanks Mike
Thank you !!! From 🇵🇪
Dr. Zenn, I am new to your videos as I am in NP school. Thank you for your high quality educational material. I am struck by one note. You seem happier now than in your previous Duke "How to Suture" videos. I have worked in the OR as a scrub and circulator RN, and know the culture. What has changed for you?
Thank you very much dr for this nice presentation
I love you doctor ❤, and thank you for your help ❤❤❤
Thank you so much for posting for informative video
What a great lesson! Do you also have one for manual knot tying in different situations? (Vessel ligation, fascia, subcutis, etc.)
Thank you Dr its been so helpfull
Thank you Sir. I learned without paying money to workshops.
Very useful content.... keep it up 👍🏻
Sir your video is really very good explanation in a very short time. Thanks and please keep it up. As a doctor I appreciate your lecture very much
Thank you, great stuff!
thank you for the information
Seen many as RN, OR-sutured as medic, but wether Monofilament, braided, absorbable or non-absorbable, great overview. Hopefully scrub nurse is arming needle in holder properly. Outstanding explanation & salient memories. Thank you
Excellent presentation sir. love from India
Thank you for this lecture, Dr. Zenn.
Just found your channel, subscribed instantly!
Great Sir..💙
I need this amazing power point ❤
thank you so much for very informative video
I work ER and i never use vicril unless its to pull in deeper tissue or to close a void if there is missing tissue. I use ethilon interrupted 90+ percent of the time in case they get infected (15 years in, nothing major but you never know). Patients sometimes get upset that they have to come back to get them removed but i think it is the safest option. I use interrupted most of the time, again if they get infected it might be part of the laceration and you can get by pulling a couple, where if you have a running stitch the whole thing has to come out. I do use running often on impatient, uncooperative, usually intoxicated patients simply for expediency.
I had an open, non-mesh, umbilical hernia repair done. It was a small defect in the fascia, approximately 4 mm. My surgeon wound up closing me with a non-absorbable, monofilament nylon suture. In your opinion, was nylon the best choice here or would prolene have worked better? Does it even matter?
You are a good person, Dr. Zenn, some are jealous to teach.
I am Dr. Micheale from Tigray ( Ethiopia) and I am dental surgeon , now starting learning ur lecture
Thank you for a Great video! How long does it take for redness to go away after prolene sutures are removed?
It looks a very easy to do xx
Love this video!
Thanks for your sharing
Thank you 🙏
Thank you for making these videos Dr. Zenn. I'm learning to suture and there's alot of info to absorb (no pun intended). I'm NOT fond of silk braid (4-0) there's so much drape to it. (I sew fabric as well.) My respect level for those who suture surgically has gone up by 1,000%. It looks easy to do but my hands don't want to cooperate with the instruments. Again, thank you for the videos.
Thank you so much. very informative video. I was looking for this info and it was delivered perfectly. a great Teacher. I hope I can one day teach what I learned like you do.
Thanks alot. It help me alot
Wow!! Thank you! Just starting to train myself, lots of questions, you gave me quite a bit to chew on, TY!
I assume the suture material will affect your choice knots. So much to learn.
Your videos are great!!!!
Thank you so much sir
Thank you alot .
thank you very much for the great informations. please adjust the voice quality
Thank you
Thanks
Very helpful video ..thanku sir
Great information sir...
Thanks for the vedio
Good explanation think you very much
Amazing video
Great video Dr. Zenn! Do you have the source for the images (e.g., the one about "types of suture material" and the one in which the sutures are organized by color)? I'm currently doing some Anki flashcards from this video to share with fellow students, are you ok with that? If so, having the original source would allow me to add said images with a higher resolution. These types of resources have been really helpful.
Cesar I no longer have the original images but you are welcome to pass the info along in any way to help others. One trip to the OR and you can photograph the charts for suture supplies.
@drzenn sir what's the best for closure of stump after amputation ?
Thanks for your information on suture. I am a patient gotten my Tommy done in July. My suture knots above my bellybutton hurts and I can feel the knots. Am I to worry about this?
Do you know what sutures they use for circumcision? My urologist says they are dissolvable within about a month or so but I didn't ask what kind. Are they inter changeable with surgical glue?
Thanks Dr. Zenn for so interesting lesson. I'm a family doctor with a surgeon's soul, so I try to do my best with my primary care patients. One problem that's been happening to me is when I remove a skin lesion at pretibial region or at scalp of bald patients and there's tension on the suture edges. Which is the best option and with the best esthetics result, considering that silk and polypropilene sutures use to be the material available at my medical consultation?. Perhaps some suture technique is also something to keep in mind in these cases, isn't it?
In those areas, keeping the wound closed is your priority, less on cosmesis. Polypropylene or nylon are best, simple sutures or mattress sutures and leave them in 10 to 14 days.
Do you add steri-strips or other sterile glue-on strips across? I was taught to use them as aid in de-tensioning as a poor man's alternative to the tensioned fascia closures.
Thank you Dr Zenn. Greetings from Mexico.
Dr. Zenn, could you please make a video with examples of bad sutures, i.e. what common things to avoid? Learning by negative example would be very helpful since, for example, I believe I would better understand what a 90-degree bite and skin eversion are if I would see a non-90-degree suture and the resulting skin inversion. Also I find it difficult in assessing if a suture is sloppy/bad, since you only show your perfectly-executed state-of-the-art sutures :) Thank you very much for your videos!
Thank you very much, Dr. Zenn for the inormations, really helpful for me in the remote areas too
Thanks for the information, sir..but , i very much wish for more information on suture needle, sir..it would be very useful.. thank you
❣️❣️❣️thanks a lot
Very informative video sir..👍 i have seen vicryl sutures which are used for deep layer approximation jutting out through skin after few days, any reason behind this?
Great point. When you place absorbable sutures, the sutures should be placed so the knots get "buried" deep or they will come to the surface (called "spitting"). You accomplish this by starting the suture deep to superficial and the opposite side superficial to deep. Both ends of the suture are now deep so when you tie them the knots stay deep. The other tip is never bring the absorbable suture too close to the skin surface-stay in the deep dermis. Anything close to the epidermis will come out before it is absorbed.
@@DrZenn ok sir. Thanks for the explanation 👍
Thank you im very interested to kearn how to suture
Thanks for these videos. Esstentially, I am a subscriber so that my first aid skills become sharper. To that end, I would conclude, (as a lay person), that a braided/non absorbable suture would be prime for an emergency first aid kit - because treatment is required until medical professionals can attend. (My scenario would be first aid in an environment where transport to a clinic would be delayed sufficiently as to require temporary treatment - such as backwoods, air crash, or any non populated locations while waiting for evacuation for long periods of time). Woild this be a correct conclusion?
Very useful. Choice of needles: Cutting vs. reverse cutting? Nylon vs. poly....nylon is elastic so one must be very aware of tension during tying. Polypropylene is not elastic so the tension applied is the tension that remains. That's a very good thing in some applications. Absorption by hydrolysis produces virtually no inflammation and that's very good. Allergic reactions to gut do occur and can be problematic. You seem not to adhere to the old and perhaps incorrect maxim that only monofilament material should be used in subcuticular repairs to reduce the likelihood of providing a refuge for bacteria.
Awesome 😊👍