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SUMMARY OF KNOTTING AND SUTURING TECHNIQUES

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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  1. Department of Surgical Research and Techniques Basic SurgicalPracticals SUMMARY OF KNOTTING AND SUTURING TECHNIQUES

  2. Department of Surgical Research and Techniques Basic SurgicalPracticals Knottingtechniques Surgicalknot Vienneseknot

  3. Department of Surgical Research and Techniques Basic SurgicalPracticals VienneseKnot

  4. Department of Surgical Research and Techniques Basic SurgicalPracticals Scalpelgrips fiddle-bow holding pencil holding

  5. 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

  6. Department of Surgical Research and Techniques Basic SurgicalPracticals Holding of theforceps

  7. Department of Surgical Research and Techniques Basic SurgicalPracticals Handlingthescissors 4 1 The thumb-ringfingergrip!

  8. Department of Surgical Research and Techniques Basic SurgicalPracticals HandlingtheMathieuneedleholder in left hand in right hand

  9. Department of Surgical Research and Techniques Basic SurgicalPracticals The properposition of theneedleintheneedleholder 2/3 1/3 tip of the needle eye of the needle

  10. Department of Surgical Research and Techniques Basic SurgicalPracticals Insertion of thethread

  11. Department of Surgical Research and Techniques Basic SurgicalPracticals Simple interrupted suture • 1 cm rule! • theknot is ontheside • slow • safe • skin • fascia • muscle

  12. Department of Surgical Research and Techniques Basic SurgicalPracticals

  13. Department of Surgical Research and Techniques Basic SurgicalPracticals

  14. Department of Surgical Research and Techniques Basic SurgicalPracticals

  15. Department of Surgical Research and Techniques Basic SurgicalPracticals Knot tied using Instruments

  16. Department of Surgical Research and Techniques Basic SurgicalPracticals

  17. Department of Surgical Research and Techniques Basic SurgicalPracticals Sutureremoval

  18. Department of Surgical Research and Techniques Basic SurgicalPracticals 1 2 3 4

  19. Department of Surgical Research and Techniques Basic SurgicalPracticals 1 2 4 3

  20. 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

  21. Department of Surgical Research and Techniques Basic SurgicalPracticals 1 2 4 3

  22. Department of Surgical Research and Techniques Basic SurgicalPracticals 1 2 3 4

  23. Department of Surgical Research and Techniques Basic SurgicalPracticals Sutureremoval

  24. Department of Surgical Research and Techniques Basic SurgicalPracticals DonatisutureAllgöwersuture The threadrunsintracutaneouslyononeside of thewound

  25. Department of Surgical Research and Techniques Basic SurgicalPracticals Horizontalmattresssuture line • 1 cm fromthewoundedge • 1 cm parallel tothewoundedge, a doublesuture • deepinthesubcutaneouslayer • skin • incase of higherwoundtension

  26. Department of Surgical Research and Techniques Basic SurgicalPracticals 1 2 3 4

  27. Department of Surgical Research and Techniques Basic SurgicalPracticals 1 2 3

  28. 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

  29. Department of Surgical Research and Techniques Basic SurgicalPracticals 2. 1. 3. 4.

  30. Department of Surgical Research and Techniques Basic SurgicalPracticals 1. 2. 4. 3.

  31. Department of Surgical Research and Techniques Basic SurgicalPracticals Sutureremoval 3. 2. 1.

  32. 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

  33. Department of Surgical Research and Techniques Basic SurgicalPracticals

  34. 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

  35. Department of Surgical Research and Techniques Basic SurgicalPracticals 1. 2. 3. 4.

  36. Department of Surgical Research and Techniques Basic SurgicalPracticals

  37. Department of Surgical Research and Techniques Basic SurgicalPracticals Sutureremoval

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