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Suturing Workshop Dr Samantha Murton MBChB Otago , FRNZCGP

Suturing Workshop Dr Samantha Murton MBChB Otago , FRNZCGP. Registrar Training September 1 st 2011 Auckland. Preparation. The 12 things you need Drawing Langers lines Margins – N aevi , benign appearing 1-2mm - BCC 3-5mm - SCC 5-10mm

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Suturing Workshop Dr Samantha Murton MBChB Otago , FRNZCGP

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  1. Suturing WorkshopDr Samantha MurtonMBChBOtago, FRNZCGP Registrar Training September 1st 2011 Auckland

  2. Preparation • The 12 things you need • Drawing • Langers lines • Margins – Naevi, benign appearing 1-2mm - BCC 3-5mm - SCC 5-10mm - Melanoma 5 – 20mm

  3. Anaesthesia • 1% lignocaine with 1:100,000 adrenaline, variety of others • No adrenaline on digits • 7 minutes to full effect of adrenaline

  4. Elliptical excision • The shape of the hull of a boat • Try to get a good amount of fat under lesion

  5. Suture Material • Absorbable and non-absorbable • 3.0 to 6.0 • How long to leave it in • Face 5 days • Neck/scalp 5-7 days • Trunk 7 – 10 days • Back and limbs 10 – 14 days

  6. Types of Suturing Styles • Interrupted • Continuous • Mattress • Subcuticular

  7. How to Make it look good

  8. Subcuticular • Use absorbable suture • Evert the skin

  9. Deep Sutures • Most wounds could do with them • Helps with haemostasis • Takes tension off skin • Absorbable suture • Bury the knot

  10. Dressing • Steristrips along wound take the tension off • Some may require pressure dressing for a couple of days • Skin adhesive may help with dressings to stick • Micropore • Suture guide/care of wound guide

  11. Rhomboid Flap • Good on back or places where adequate tissue to move and big lesion to excise • Make sure well marked out • No tension on wound • Close flap wound first then defect • Continuous suture

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