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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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Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

SUMMARY OF KNOTTING AND SUTURING TECHNIQUES


Knotting techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Knottingtechniques

Surgicalknot

Vienneseknot


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

VienneseKnot


Scalpel grips

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Scalpelgrips

fiddle-bow holding

pencil holding


Summary of knotting and suturing techniques

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


Holding of the forceps

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Holding of theforceps


Handling the scissors

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Handlingthescissors

4

1

The thumb-ringfingergrip!


Handling the mathieu needle holder

Department of Surgical Research and Techniques

Basic SurgicalPracticals

HandlingtheMathieuneedleholder

in left hand in right hand


The proper position of the needle in the needle holder

Department of Surgical Research and Techniques

Basic SurgicalPracticals

The properposition of theneedleintheneedleholder

2/3

1/3

tip of the needle

eye of the needle


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Insertion of thethread


Simple interrupted suture

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Simple interrupted suture

  • 1 cm rule!

  • theknot is ontheside

  • slow

  • safe

  • skin

  • fascia

  • muscle


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals


Knot tied using instruments

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Knot tied using Instruments


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals


Suture removal

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Sutureremoval


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

1

2

3

4


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

1

2

4

3


Summary of knotting and suturing techniques

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


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

1

2

4

3


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

1

2

3

4


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Sutureremoval


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

DonatisutureAllgöwersuture

The threadrunsintracutaneouslyononeside of thewound


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Horizontalmattresssuture line

  • 1 cm fromthewoundedge

  • 1 cm parallel tothewoundedge, a doublesuture

  • deepinthesubcutaneouslayer

  • skin

  • incase of higherwoundtension


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

1

2

3

4


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

1

2

3


Running suture line

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


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

2.

1.

3.

4.


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

1.

2.

4.

3.


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Sutureremoval

3.

2.

1.


Summary of knotting and suturing techniques

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


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals


Summary of knotting and suturing techniques

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


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

1.

2.

3.

4.


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals


Summary of knotting and suturing techniques

Department of Surgical Research and Techniques

Basic SurgicalPracticals

Sutureremoval


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