Intro to sutures

instruments needed to do sutures

• Needle holder- Used to place the needle and allow for precise maneuvering during suturing.

• surgical forceps -used to grasp tissue and provide stability during the suturing process.

• Scissors-used to cut the suture material to the desired length and to trim tissue if necessary.

• Surgical needle- A needle specifically designed for stitching together soft tissue and comes in various shapes and sizes to accommodate different surgical procedures.

  Types of suture techniques

• Interrupted Sutures: Individual sutures are placed separately, allowing for greater control and adjustment during closure.

• Continuous Sutures: A single suture passes through tissue in a series of stitches, providing a quicker closure method.

• Mattress Sutures: This technique involves taking bites through the tissue at an angle, creating tension and better alignment of wound edges.

• Subcuticular Sutures: Placed just beneath the skin surface, this technique minimizes scarring and is commonly used in cosmetic surgery.

  
  

1. Interrupted Sutures

   • Used when greater control and adjustment during closure are required.

   • Ideal for areas where tension is a concern or precise alignment is necessary.

2. Continuous Sutures

   • Provides a quicker closure method by passing a single suture through tissue in a series of stitches.

   • Commonly used in long wounds or areas where speed is essential.

3. Mattress Sutures

   • Takes bites through the tissue at an angle to create tension and better alignment of wound edges.

   • Useful for deep wounds and provides good support.

4. Subcuticular Sutures

   • Placed just beneath the skin surface to minimize scarring.

   • Commonly used in cosmetic surgery to enhance aesthetic

     # Study Notes on Suture Techniques by Michael Zen

5. ## Overview

6. In this tutorial, Michael Zen discusses 10 different suturing techniques along with a stapling method for skin closure, emphasizing the importance of practice using the Vada suture skill simulator for lifelike training.

### General Suturing Principles

- **Practice Importance**: Mastery of suturing requires consistent practice.

- **Training Material**: Traditional methods are often impractical; modern simulators provide a cost-effective solution.

### Basic Knot Tying

- **Instrument Tie Steps**:

- Insert the suture through the skin.

- Leave about a ¼ to ½ inch tail.

- Wrap the long end twice around the needle driver to create a surgeon's knot.

- Pull the short end to lock.

- Finalize with a single wrap to secure.

### **Suture Techniques**

1. **Simple Suture**:

- Entry and exit should be at 90°.

- Only one part to the technique (needle goes in one side, out the other).

- Maintain equal spacing between stitches.

2. **Simple Buried Suture**:

- Designed to hide the knot beneath the skin.

- Points are deep in the dermis to reduce tension at the surface.

3. **Vertical Mattress Suture**:

- Approach: Far-far and near-near technique.

- Good for wounds needing additional tension as it engages more tissue.

4. **Horizontal Mattress Suture**:

- Takes equal bites horizontally.

- Reduces tension on skin edges, effective for quick closures.

5. **Figure of Eight Suture**:

- Similar to horizontal but creates an "8" pattern.

- Useful for more robust areas like the fascia.

6. **Running Suture**:

- Fastens wound closures with continuous sutures.

- Similar to a sewing machine motion.

7. **Running Locking Suture**:

- Locks each stitch as it's tied, valuable for larger wounds that gape open.

8. **Subcuticular Closure**:

- Ideal for cosmetic results, performed beneath the skin's surface.

### Closing Deeper Layers

- **Closing Fascia**: Surgical discretion calls for absorbable or permanent sutures, often starting with ends to relieve tension.

- **Dermis Closure**: Also preferred for strength, the same techniques are applicable.

### Skin Closure

- **Tension Consideration**: Use vertical mattress suture for closures under tension.

- **Skin Stapling**:

- Fast and effective.

- Keys to success include proper skin approximation and handling of the stapler device.

### Staple Removal

- **Technique**: Use a staple remover for painless extraction; alternatively, a needle driver or clamp can work but may be uncomfortable.

### Conclusion

The demonstrated suturing techniques are essential for anyone looking to improve their skills in wound management and surgery. Mastery involves meticulous practice and attention to detail, particularly during closure for optimal healing and cosmetic outcomes.