(general surgery lab 1) dr. haydar muneer
TRANSCRIPT
General Surgery
Suturing lab
Suture may define as Any strand of material used to ligate blood vessels or to approximate tissue
1. Absorbable: Suture that is completely broken downby the body (dissolving suture)
2. Non-absorbable: Suture is not broken down (permanent suture)
2 basic types
Needle
Needle holder
Tissue forceps
Needle holder
grasping
Instrument handling
Suturing technique
The simple interrupted suture is the gold
standard and the most commonly employed suture.
same depth on each side of the incision or wound, otherwise the edges will overlap.
Sutures are usually placed approximately 5 to 7 mm apart and 1 to 2 mm fromthe skin edge,
Simple Interrupted Suture
Vertical mattress sutures may be
used when eversion of the skin edges is desired and cannot be accomplished with simple sutures alone.
Vertical mattress sutures tend to leave the most obvious and unsightly cross-hatching if not removed early
Vertical Mattress Suture
Horizontal mattress sutures
also provide approximation of the skin edges with eversion.
They are particularly advantageous in thick glabrous skin (feet and hand).
Horizontal mattresssuture
known as running simple sutures
can be placed rapidly but depend on the wound edges being more-or-less approximated beforehand.
A continuous suture is not nearly as precise as interrupted sutures
Continuous Over-and-Over Suture
Skin staples are particularly useful
as a time saver for long incisions or to position a skin closure or flap temporarily before suturing.
Staples must be removed early to prevent skin marks and are ideal for the hair-bearing scalp
Skin Staples
Skin tapes can effectively
approximate the wound edges, although buried sutures are often required in addition to skin tape to approximate deeper layers.
Skin tapes can also be used after skin sutures are removed to provide added strength to the closure
Skin Tapes
Skin adhesives have been developed,
and may have a role in wound closure, especially in areas where there is no tension on the closure, or where strength of closure has been provided by a layer of buried dermal sutures. Adhesives, by themselves, however, do not evert the wound edges.
Skin Adhesives
Thank You