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SUMMARY OF KNOTTING AND SUTURING TECHNIQUES PowerPoint PPT Presentation


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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. Surgical knot. Viennese knot.

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SUMMARY OF KNOTTING AND SUTURING TECHNIQUES

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Department of Surgical Research and Techniques

Basic SurgicalPracticals

SUMMARY OF KNOTTING AND SUTURING TECHNIQUES


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Knottingtechniques

Surgicalknot

Vienneseknot


Department of Surgical Research and Techniques

Basic SurgicalPracticals

VienneseKnot


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Scalpelgrips

fiddle-bow holding

pencil holding


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Useyourhandto fix theskin

Fiddle-bow holding!

Straight, longincision

1

2

Usethebelly of theblade

Cut epidermis and dermis through sharply

3

4


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Holding of theforceps


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Handlingthescissors

4

1

The thumb-ringfingergrip!


Department of Surgical Research and Techniques

Basic SurgicalPracticals

HandlingtheMathieuneedleholder

in left hand in right hand


Department of Surgical Research and Techniques

Basic SurgicalPracticals

The properposition of theneedleintheneedleholder

2/3

1/3

tip of the needle

eye of the needle


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Insertion of thethread


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Simple interrupted suture

  • 1 cm rule!

  • theknot is ontheside

  • slow

  • safe

  • skin

  • fascia

  • muscle


Department of Surgical Research and Techniques

Basic SurgicalPracticals


Department of Surgical Research and Techniques

Basic SurgicalPracticals


Department of Surgical Research and Techniques

Basic SurgicalPracticals


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Knot tied using Instruments


Department of Surgical Research and Techniques

Basic SurgicalPracticals


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Sutureremoval


Department of Surgical Research and Techniques

Basic SurgicalPracticals

1

2

3

4


Department of Surgical Research and Techniques

Basic SurgicalPracticals

1

2

4

3


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Verticalmattresssuture (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 SurgicalPracticals

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2

4

3


Department of Surgical Research and Techniques

Basic SurgicalPracticals

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2

3

4


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Sutureremoval


Department of Surgical Research and Techniques

Basic SurgicalPracticals

DonatisutureAllgöwersuture

The threadrunsintracutaneouslyononeside of thewound


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Horizontalmattresssuture line

  • 1 cm fromthewoundedge

  • 1 cm parallel tothewoundedge, a doublesuture

  • deepinthesubcutaneouslayer

  • skin

  • incase of higherwoundtension


Department of Surgical Research and Techniques

Basic SurgicalPracticals

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3

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Department of Surgical Research and Techniques

Basic SurgicalPracticals

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Department of Surgical Research and Techniques

Basic SurgicalPracticals

Runningsuture line

  • knot should be tied

    only at the beginning

    and the end

  • fast

  • thetension is distributedequallyalongthelength of thesuture – edema

  • notsosafe

  • peritoneum

  • vessels

  • skin

  • GI tract


Department of Surgical Research and Techniques

Basic SurgicalPracticals

2.

1.

3.

4.


Department of Surgical Research and Techniques

Basic SurgicalPracticals

1.

2.

4.

3.


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Sutureremoval

3.

2.

1.


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Running-lockclosure

  • knot should be tied

    only at the beginning

    and the end

  • lastknot – 3 tails

  • reducestheskintension

  • resultsin more tissueeversion

  • skin


Department of Surgical Research and Techniques

Basic SurgicalPracticals


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Runningintracuticularclosure

  • stitchesruninthesubcuticularplane

  • fast

  • cosmetically/aestheticallyfinescar

  • knot should be tied

    only at the beginning

    and the end

  • skin

  • it is used in theskin with minimal wound tension


Department of Surgical Research and Techniques

Basic SurgicalPracticals

1.

2.

3.

4.


Department of Surgical Research and Techniques

Basic SurgicalPracticals


Department of Surgical Research and Techniques

Basic SurgicalPracticals

Sutureremoval


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