Department of Surgical Research and Techniques

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Presentation transcript:

Department of Surgical Research and Techniques Basic Surgical Practicals SUMMARY OF KNOTTING AND SUTURING TECHNIQUES

Department of Surgical Research and Techniques Basic Surgical Practicals Knotting techniques Viennese knot Surgical knot

Department of Surgical Research and Techniques Basic Surgical Practicals Viennese Knot

Department of Surgical Research and Techniques Basic Surgical Practicals Scalpel grips fiddle-bow holding pencil holding

Department of Surgical Research and Techniques Basic Surgical Practicals Use your hand to fix the skin Fiddle-bow holding! Straight, long incision 1 2 Use the belly of the blade Cut epidermis and dermis through sharply 3 4

Department of Surgical Research and Techniques Basic Surgical Practicals Holding of the forceps

Department of Surgical Research and Techniques Basic Surgical Practicals Handling the scissors 4 1 The thumb-ring finger grip !

Handling the Mathieu needle holder Department of Surgical Research and Techniques Basic Surgical Practicals Handling the Mathieu needle holder in left hand in right hand

The proper position of the needle in the needle holder Department of Surgical Research and Techniques Basic Surgical Practicals The proper position of the needle in the needle holder 1/3 2/3 eye of the needle tip of the needle

Department of Surgical Research and Techniques Basic Surgical Practicals Insertion of the thread

Simple interrupted suture Department of Surgical Research and Techniques Basic Surgical Practicals Simple interrupted suture 1 cm rule! the knot is on the side slow safe skin fascia muscle

Department of Surgical Research and Techniques Basic Surgical Practicals

Department of Surgical Research and Techniques Basic Surgical Practicals

Department of Surgical Research and Techniques Basic Surgical Practicals

Knot tied using Instruments Department of Surgical Research and Techniques Basic Surgical Practicals Knot tied using Instruments

Department of Surgical Research and Techniques Basic Surgical Practicals

Department of Surgical Research and Techniques Basic Surgical Practicals Suture removal

Department of Surgical Research and Techniques Basic Surgical Practicals 1 2 3 4

Department of Surgical Research and Techniques Basic Surgical Practicals 1 2 4 3

Department of Surgical Research and Techniques Basic Surgical Practicals Vertical mattress suture (Donati) wide-wide-close-close four punctures in the same vertical line 1,5 cm and 1-2 mm in the subcutaneous layer and superficial knot on the side skin slow wide and deep and superficial wound closure

Department of Surgical Research and Techniques Basic Surgical Practicals 1 2 4 3

Department of Surgical Research and Techniques Basic Surgical Practicals 1 2 3 4

Department of Surgical Research and Techniques Basic Surgical Practicals Suture removal

Department of Surgical Research and Techniques Basic Surgical Practicals Donati suture Allgöwer suture The thread runs intracutaneously on one side of the wound

Department of Surgical Research and Techniques Basic Surgical Practicals Horizontal mattress suture line 1 cm from the wound edge 1 cm parallel to the wound edge, a double suture deep in the subcutaneous layer skin in case of higher wound tension

Department of Surgical Research and Techniques Basic Surgical Practicals 1 2 3 4

Department of Surgical Research and Techniques Basic Surgical Practicals 1 2 3

Department of Surgical Research and Techniques Basic Surgical Practicals Running suture line knot should be tied only at the beginning and the end fast the tension is distributed equally along the length of the suture – edema  not so safe peritoneum vessels skin GI tract

Department of Surgical Research and Techniques Basic Surgical Practicals 2. 1. 3. 4.

Department of Surgical Research and Techniques Basic Surgical Practicals 1. 2. 4. 3.

Department of Surgical Research and Techniques Basic Surgical Practicals Suture removal 3. 2. 1.

Department of Surgical Research and Techniques Basic Surgical Practicals Running-lock closure knot should be tied only at the beginning and the end last knot – 3 tails reduces the skin tension results in more tissue eversion skin

Department of Surgical Research and Techniques Basic Surgical Practicals

Department of Surgical Research and Techniques Basic Surgical Practicals Running intracuticular closure stitches run in the subcuticular plane fast cosmetically/aesthetically fine scar knot should be tied only at the beginning and the end skin it is used in the skin with minimal wound tension

Department of Surgical Research and Techniques Basic Surgical Practicals 1. 2. 3. 4.

Department of Surgical Research and Techniques Basic Surgical Practicals

Department of Surgical Research and Techniques Basic Surgical Practicals Suture removal