We don't remove intradermal sutures. We use absorbable material and close the surface of the skin with dermal glue. This causes less irritation because the sutures don't catch on things. Of course, different wounds require different suture patterns.
I wish I had this system when I started surgery. Purchased it at the end of my MS3 year, and I have to say it's great. I will say this, though: the running sub-Q suture is more difficult to perform correctly on this model than it is in real life...If you can do it right here, you're golden in the OR.
Nice demonstration of technique. Aberdeen's knot at the end may be favored, the suture should be absorbable. However excellent technique for budding surgeons.
For a running subcuticular suture, you would use an absorbable suture like a Chromic or a Vicryl. Your body will just degrade and absorb it over time as the incision heals so there's no need to get it out. This closure technique is simply done for cosmetic reasons.
The normal technique is a continuous subcuticular suture, using 3-0 / 4-0 prolene / nylon. The ends of the suture are left out in a knot on the surface of the skin. After the wound heals (approx. 10 days), one can carefully remove the suture material by pulling it out slowly using the needle holders.
@OsakaUE The advantages are not having to schedule a post-op or follow up visit for suture removal, no scarring from suture holes and not having to worry about non-compliant patients. These sutures are absorbed by the body through controlled breakdown occurring at a predictable rate.
you are thinking of the epidermis, the very top layer. skin also includes the next layer, the dermis, which is thicker, and is where this suturing is taking place.
I’ve watched multiple ER pediatrician’s perform these procedures. I appreciate when they pay attention to details. I also noticed everyone had their specific techniques. I also appreciated when they would wet the sutures before the procedure for a smoother pass. I miss my days working in the ER. I loved my patients and my job. I miss working with my friends. I😊🫶🏾
This is what I wanna ask. Nylon is non absorbable suture. So I wonder how to remove the end of suture if you bury it in the subcutaneous. If it remains underneath skin, it would irritate and form the granulation I guess
The needle should never be touched with the fingers! When the tip of the needle comes out through the skin, it should be grasped with the Adsons, not the needle driver, and immediately reloaded properly on the needle driver using instruments only. It's faster and a lot safer!
The other reason you don't grip the needle with your fingers should be the risk of needle poke injury and body fluid precautions should you poke a hole in your glove and put yourself at risk for contracting HIV/HEP.
the video was a bit confusing at times...also, there's gotta be a way to do this without grabbing the needle with your hands, though I"ve met an attending who tells me to use my fingers if I feel it's easier...
+SnorkFlirt i was teached to never touch it. If you know your way around with the tweezer (is that the word?) you are faster. And it looks so much better ;)
"Since you're just learning surgery... Do as I say, not as I do... Don't touch the needle even though everyone you'll ever work with does..." - All of my attendings thus far (ortho, cardiothoracic, plastics, gen surg, trauma, neurosurg).
If you watch this video, have the patience to watch completely, otherwise totally misleading. Any way done by some novice rather than someone with real hands on experience...
We don't remove intradermal sutures. We use absorbable material and close the surface of the skin with dermal glue. This causes less irritation because the sutures don't catch on things. Of course, different wounds require different suture patterns.
hmm... one thing I would comment on is that you should avoid gripping the needle by the tip, since it's so delicate and easy to blunt/snap off.
I wish I had this system when I started surgery. Purchased it at the end of my MS3 year, and I have to say it's great. I will say this, though: the running sub-Q suture is more difficult to perform correctly on this model than it is in real life...If you can do it right here, you're golden in the OR.
Nice demonstration of technique. Aberdeen's knot at the end may be favored, the suture should be absorbable. However excellent technique for budding surgeons.
For a running subcuticular suture, you would use an absorbable suture like a Chromic or a Vicryl. Your body will just degrade and absorb it over time as the incision heals so there's no need to get it out. This closure technique is simply done for cosmetic reasons.
isnt this intradermal I am confused
Is this method more for cosmetic purposes and or deep tissue wounds, rather than shallow lacerations?
I'd love to see a MS do this in front of my attending!
The normal technique is a continuous subcuticular suture, using 3-0 / 4-0 prolene / nylon. The ends of the suture are left out in a knot on the surface of the skin. After the wound heals (approx. 10 days), one can carefully remove the suture material by pulling it out slowly using the needle holders.
@Oxidized181 no need to take out the sutures b/c they absorb
@OsakaUE The advantages are not having to schedule a post-op or follow up visit for suture removal, no scarring from suture holes and not having to worry about non-compliant patients. These sutures are absorbed by the body through controlled breakdown occurring at a predictable rate.
How will you remove the nylon after healing?
you are thinking of the epidermis, the very top layer. skin also includes the next layer, the dermis, which is thicker, and is where this suturing is taking place.
what if i have a laceration and got my stotches off but it didnt really heal and my doctor just put a steri stripe
whats the material called that you are using to suture?
wouldnt that depend on what you are suturing? thanks
I like it
I was only a C.M.A. so we were never taught a sub q suture but I really like it
how do you get it out after it heals? o.O do you get out?
Ok how you take that suture off after a week if the nods a buried deep?
You use an absorbable suture for this kind of technique.
Beautiful Teaching.Unbeavle
I’ve watched multiple ER pediatrician’s perform these procedures.
I appreciate when they pay attention to details.
I also noticed everyone had their specific techniques.
I also appreciated when they would wet the sutures before the procedure for a smoother pass.
I miss my days working in the ER. I loved my patients and my job.
I miss working with my friends. I😊🫶🏾
I'm sure Rudiger will be fine with this technique 💪🏿
seeing how you grab the tip of the needle, even with the needle driver makes me cringe!
Shut up
At it again with another classic stitch up
Excelent video, but how you remove the suture?? Thanks!!
Terrific manual for the leyman. Thanks !
+Prepper * layman or layperson.
Interesting pad!
Hi, is he using nylon?? and if thats going under the skin it wont be absorbe by the body?? could some one explain this please...
+olvin ortez they pull it out usually its self absorbing ones
This is what I wanna ask. Nylon is non absorbable suture. So I wonder how to remove the end of suture if you bury it in the subcutaneous. If it remains underneath skin, it would irritate and form the granulation I guess
they might be using dissolvable stitches
The needle should never be touched with the fingers! When the tip of the needle comes out through the skin, it should be grasped with the Adsons, not the needle driver, and immediately reloaded properly on the needle driver using instruments only. It's faster and a lot safer!
Not necessarily true.
0ł
your hand is clean
I don't know what any of this is but I feel like I learned something.
+whitem0use same
The other reason you don't grip the needle with your fingers should be the risk of needle poke injury and body fluid precautions should you poke a hole in your glove and put yourself at risk for contracting HIV/HEP.
GREAT VIDEO
Extremely helpful
you use dissolvible sutures so you dont have to remove them
Use an absorbable suture for subcuticular sutures.
What material is that?
i think it is 4 0 silk as it is black , proline is blue and vicryl is violet
And what about the rubber sheet? Is it silicone or anything else?
ahmed tarek how to remove it?
It kind of looks like Nylon?
Nice
Follow rules of sterlization
maybe you have to use absorbable thread
the video was a bit confusing at times...also, there's gotta be a way to do this without grabbing the needle with your hands, though I"ve met an attending who tells me to use my fingers if I feel it's easier...
А где у нас такую кожу купить?
watching so many surgical videos Incase I need them.
very good video continue ...
It is not good... You should not ever touch the needle. We v'done that with a corps skin, and never forget the rule).
"YoUUuuu do nottTT touch needle!" --- grouchy Chinese guy.
Don't touch the needle with your hands
Wow dude comon, dont touch the needle. Thats like the first thing you learn.
+SnorkFlirt i was teached to never touch it. If you know your way around with the tweezer (is that the word?) you are faster. And it looks so much better ;)
"Since you're just learning surgery... Do as I say, not as I do... Don't touch the needle even though everyone you'll ever work with does..." - All of my attendings thus far (ortho, cardiothoracic, plastics, gen surg, trauma, neurosurg).
It's absorbable suture, monocryl is the best for this, ( I don´t like this type of suturing thought)
Avoid handling the needle with your fingers! Use instruments to handle the needle.
O_o Looks too painful! [Fingers crossed] I hope I or all of us never attempt to have real surgery!
I just use qlue.
Holy fuck OKAY GUYS WE GET IT don't touch the needle. how many times is the same comment going to be made
@Oxidized181 that's what I was thinking.
Excellent....Thank you
hkkvh rodd hd og jf jf og uformell ixxi iåygffvbcgn
Wow thanks!
Who says you get a clean cut like that?
Interesting. Thanks :)
Make me music video by Britney spears brought me to this LOL
Watching this makes me ooooh oooh oooh oooh.....
If you watch this video, have the patience to watch completely, otherwise totally misleading. Any way done by some novice rather than someone with real hands on experience...
My 5 year wants to be a surgeon.so here we are watching this.🤔
Fantastic! Love to see that interest from the little ones.
why the Fuck am I watching this lol
You just pull it out...
I got my stitch removed that way.
NEVER load the needle with your fingers - it's a great way to get stuck!
and how would you remove the suture?
you leave it...it gets absorbed
How many stitches apply in c section can u olz tell me
Which layer?
Я НЕ ХИРУРГ НО ЗНАЮ НЕЛЬЗЯ КАСАТЬСЯ ИГЛЫ РУКАМИ.ТОЛЬКО ПИНЦЕТОМ
Tasuvar ansri
Be like water my friend (Bruce Lee)..
Make a number 8
ياغزا
Hey bop
باخلد
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Good info thx
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