Basic Surgical Practicals

Report
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!
1
Use the belly of the blade
2
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 !
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
Handling the
Mathieu needle holder
in left hand
in right hand
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
The proper position of the needle in the needle
holder
tip of the needle
eye of the needle
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
Insertion of the thread
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
Simple interrupted suture
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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
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
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Department of Surgical
Research and
Techniques
Basic Surgical Practicals
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Department of Surgical
Research and
Techniques
Basic Surgical Practicals
• 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
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Department of Surgical
Research and
Techniques
Basic Surgical Practicals
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Department of Surgical
Research and
Techniques
Basic Surgical Practicals
Suture removal
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
The thread runs
intracutaneously on one
side of the wound
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
• 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
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4
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
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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
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Department of Surgical
Research and
Techniques
Basic Surgical Practicals
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4.
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
Suture removal
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Department of Surgical
Research and
Techniques
Basic Surgical Practicals
Running-lock closure
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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
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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
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Department of Surgical
Research and
Techniques
Basic Surgical Practicals
Department of Surgical
Research and
Techniques
Basic Surgical Practicals
Suture removal

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