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SIM SUTURE - 7. Running Subcuticular Suture

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Advanced Suture techniques are explained in this lesson.
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The Sim*Suture Module will help the learner practice skills of simple interrupted and running suture, instrument tying, vertical mattress sutures, and running subcuticular sutures. As with all our modules, practice outside the simulation lab is encouraged with the availability of all necessary supplies: suture pad (with printed lines to guide placement of sutures), surgical instruments, and suture material. The exercise book provides the opportunity for the learner to practice in any convenient locale. Enough suture material is provided to place over 250 single needle passes. The time required for this module is about 4-6 hours. Curriculum offers opportunity for formal objective skills assessment (OSATS) when the module is completed.

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6 сен 2024

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Комментарии : 101

@maarakailet1 11 лет назад

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.

@TheChouse27 11 лет назад

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.

@drrktiwari 10 лет назад

Nice demonstration of technique. Aberdeen's knot at the end may be favored, the suture should be absorbable. However excellent technique for budding surgeons.

@hellapinoy123 12 лет назад

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.

@alteredgenes1 11 лет назад

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.

@inefficientworker6444 9 лет назад

I'd love to see a MS do this in front of my attending!

@bigkat08 12 лет назад

@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.

@craigclermond8001 8 лет назад

isnt this intradermal I am confused

@Avlovian 12 лет назад

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.

@lilvergo 12 лет назад

@Oxidized181 no need to take out the sutures b/c they absorb

@TheSigp220 12 лет назад

Is this method more for cosmetic purposes and or deep tissue wounds, rather than shallow lacerations?

@nicoleg3359 11 лет назад

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.

@lupoed 2 года назад

How will you remove the nylon after healing?

@dionnedunsmore9996 2 года назад

I like it I was only a C.M.A. so we were never taught a sub q suture but I really like it

@mightymadman Год назад

I'm sure Rudiger will be fine with this technique 💪🏿

@greenilizer 12 лет назад

what if i have a laceration and got my stotches off but it didnt really heal and my doctor just put a steri stripe

@JennLonhon 12 лет назад

how do you get it out after it heals? o.O do you get out?

@mdselimsha2697 6 лет назад

Beautiful Teaching.Unbeavle

@0o0o0radha0o0o0 13 лет назад

whats the material called that you are using to suture?

@mamicholo 12 лет назад

wouldnt that depend on what you are suturing? thanks

@Sugastack Год назад

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😊🫶🏾

@suturethis576 5 лет назад

Interesting pad!

@artemsavchuk7467 7 лет назад

Ok how you take that suture off after a week if the nods a buried deep?

@scienceunravelled3709 7 лет назад

You use an absorbable suture for this kind of technique.

@sharnicxx6327 7 лет назад

At it again with another classic stitch up

@42302917 13 лет назад

Excelent video, but how you remove the suture?? Thanks!!

@paprykazesloika 8 лет назад

Terrific manual for the leyman. Thanks !

@johnallardyce4164 8 лет назад

+Prepper * layman or layperson.

@edieuro95 11 лет назад

they might be using dissolvable stitches

@saurabhsinha4782 4 года назад

Nice

@grplast84 9 лет назад

GREAT VIDEO

@dunlopempire 11 лет назад

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.

@diarysexologist 7 лет назад

Cool channel!

@DEEPJYOTICHAUDHURI 2 года назад

Extremely helpful

@d2hpdGVtMHVzZQ0K 10 лет назад

I don't know what any of this is but I feel like I learned something.

@glorielysf8291 8 лет назад

+whitem0use same

@ahmedsaleh1986 12 лет назад

you use dissolvible sutures so you dont have to remove them

@enaebner470 8 лет назад

seeing how you grab the tip of the needle, even with the needle driver makes me cringe!

@Yupthereitism 4 года назад

Shut up

@TheTAREKMAHMED 11 лет назад

very good video continue ...

@adityapatil2995 6 лет назад

Follow rules of sterlization

@OlvinEmanuelOrtez 9 лет назад

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...

@Ana66389 9 лет назад

+olvin ortez they pull it out usually its self absorbing ones

@dunmill9632 6 лет назад

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

@sabplana 12 лет назад

Use an absorbable suture for subcuticular sutures.

@catpaws1913 7 лет назад

watching so many surgical videos Incase I need them.

@Astharot90 12 лет назад

maybe you have to use absorbable thread

@jdsun 8 лет назад

"YoUUuuu do nottTT touch needle!" --- grouchy Chinese guy.

@wiglett1 10 лет назад

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!

@isaacregi1901 Год назад

Not necessarily true.

@jetandarkumar5004 Год назад

0ł

@Wty-7373 Год назад

your hand is clean

@wallabysydney7672 6 лет назад

Holy fuck OKAY GUYS WE GET IT don't touch the needle. how many times is the same comment going to be made

@jjtt6866 4 года назад

I just use qlue.

@TheiNeko 9 лет назад

А где у нас такую кожу купить?

@angieest10 9 лет назад

Wow thanks!

@chirpchirpy123 12 лет назад

O_o Looks too painful! [Fingers crossed] I hope I or all of us never attempt to have real surgery!

@JennLonhon 11 лет назад

Interesting. Thanks :)

@markfaber6892 8 лет назад

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...

@al3xi5lave 11 лет назад

It's absorbable suture, monocryl is the best for this, ( I don´t like this type of suturing thought)

@Djhotrhymez 12 лет назад

@Oxidized181 that's what I was thinking.

@johnm.3374 11 лет назад

Who says you get a clean cut like that?

@francescomonaca4684 10 лет назад

What material is that?

@AhmedTarek-uz5nw 10 лет назад

i think it is 4 0 silk as it is black , proline is blue and vicryl is violet

@francescomonaca4684 10 лет назад

And what about the rubber sheet? Is it silicone or anything else?

@wafeeq11 9 лет назад

ahmed tarek how to remove it?

@darkflamecosplay9508 8 лет назад

It kind of looks like Nylon?

@JUrb1000 7 лет назад

and how would you remove the suture?

@akedo789 8 лет назад

Make me music video by Britney spears brought me to this LOL Watching this makes me ooooh oooh oooh oooh.....

@drbaburaj 12 лет назад

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...

@GuitarDoco 9 лет назад

Excellent....Thank you

@tanyairenegranger9706 8 лет назад

hkkvh rodd hd og jf jf og uformell ixxi iåygffvbcgn

@zeeshanalikhan9004 2 года назад

How many stitches apply in c section can u olz tell me

@jamesmancusi6747 Год назад

Which layer?

@crystaltrasolinepac 11 лет назад

Avoid handling the needle with your fingers! Use instruments to handle the needle.

@MrWachowsky 11 лет назад

You just pull it out... I got my stitch removed that way.

@PapaSumoto 8 лет назад

Don't touch the needle with your hands

@jamesmancusi6747 Год назад

NEVER load the needle with your fingers - it's a great way to get stuck!

@bessiemwale4724 3 года назад

My 5 year wants to be a surgeon.so here we are watching this.🤔

@SimVivo 3 года назад

Fantastic! Love to see that interest from the little ones.

@egytiger881 11 лет назад

you leave it...it gets absorbed

@skunkycatog 8 лет назад

why the Fuck am I watching this lol

@Scipio12345 9 лет назад

Wow dude comon, dont touch the needle. Thats like the first thing you learn.

@Scipio12345 8 лет назад

+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 ;)

@myspringatgate2007 6 лет назад

"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).