Materials required
Skin suturing
- Wound should be closed with minimum tension
- Edges of skin should gape slightly to allow swelling due to inflammation. If wound is closed tightly edge necrosis may occur
- Needle should be held at a point 2/3rd from tip of the needle
- Needles are inserted at right angles to the skin for simple suture using a supination pronation movement of the wrist
- Entry and exit points should be nearly the same distance from the wound edge as the thickness of skin being closed
- The edge of wound is gently lifted with forceps while the needle is inserted
- Edges should be everted slightly. If suture is enters and exits from the skin at an acute angle wound may become inverted with poor healing
- As the suture is tightened, knot should be drawn to one side to facilitate suture removal
- When a non-absorbable suture is to be removed, it is cut immediately beneath the knot and pulled out by knot. This results in contaminated part of suture material being lifted away without being drawn through the wound
- The ends of knot should be left long enough to be easy to grasp while removing yet not too long to get tangled with nearby structures
- As a general rule each suture should be separated by a gap that is twice the thickness of skin
- Stay sutures should be applied in wounds with curves or zigzags for correct orientation
- Non absorbable skin sutures should be removed when wound has healed to prevent scarring, infection and irritation. It is removed from face after 3-5 days, 5-7 days from scalp, 7 days from back, 10 days from abdomen and 10-14 days from limbs
- Any suture with pus or signs of infections should be removed immediately
Types of wound closure
Simple interrupted– most commonly used, good for shallow wounds without edge tension
Continuous (running sutures)– good for long wounds with minimal tension
Locking continuous - useful in wounds under moderate tension or in those requiring additional hemostasis because of oozing from the skin edges
Subcuticular – good for cosmetic results
Vertical mattress – useful in maximizing wound eversion, reducing dead space, and minimizing tension across the wound
Horizontal mattress – good for fragile skin and high tension wounds
Tension suture – for support in wound under very high tension
Classification of suture material
Non-absorbable
- Not biodegradable and permanent
- Tensile strength lasts for more than 60 days
- Nylon
- Prolene(polypropylene)
- Stainless steel
- Silk (natural, can break down over years)
Absorbable
Degraded via inflammatory response
- Vicryl (polyglactin)
- PDS (polydioxanone)
- Chromic Cat gut (natural)
Natural Suture
Biological
Cause inflammatory reaction
- Silk (from silkworm fibers)
- Catgut (connective from cow or sheep)
- Chromic catgut
Synthetic
Synthetic polymers
Do not cause intense inflammatory reaction
- Vicryl
- PDS
- Prolene
- Nylon
Monofilament
- Single strand of suture material
- Minimal tissue trauma
- Smooth tying but more knots needed
- Harder to handle due to memory
- Less chance of infection
- Examples: nylon, prolene, PDS
Multifilament (braided)
- Fibers are braided or twisted together
- More tissue resistance
- Easier to handle
- Fewer knots needed
- More chances of infection
- Examples: vicryl, silk, chromic catgut
Suture Selection
- Do not use dyed sutures on the skin
- Use monofilament on the skin as multifilament harbor BACTERIA
- Non-absorbable cause less scarring but must be removed
- Location and layer, patient factors, strength, healing, site and availability
- Silk and synthetic sutures are employed most often
- Gut sutures are used only when retrieval is difficult.
Other materials
Metal sutures, clips and staples are available
mbbs in Philippines
ReplyDeleteEvery year, almost 8000 foreign students take admission in Philippines Medical universities and out of which around 50% are Indian students. The standard of education in Philippines universities is well known around the world. Thousands of doctors from these medical universities are sent to various countries like USA and UK every year. There are around 2299 higher educational institutions and 40 medical colleges. The main benefits of pursuing MD degree from
Top Medical Colleges in Philippines :
EMILIO AGUINALDO COLLEGE OF MEDICINE
UNIVERSITY OF PERPETUAL HELP SYSTEM DALTA
LYCEUM NORTHWESTERN UNIVERSITY
DAVAO MEDICAL SCHOOL FOUNDATION
SOUTHWESTERN UNIVERSITY
Top Searched Topics on MBBS in Philippines
study mbbs in philippines
philippines medical colleges list
best medical colleges in philippines for indian students
philippines medical colleges
best medical colleges in philippines
mci approved medical colleges in philippines
for more information contact us : +91 90329 55688
UV GULLAS COLLEGE OF MEDICINE is one of Top Medical College in Philippines in Cebu city. International students have the oppertunity to study medicine in phillipines at affordable cost and world class University. The college has successful alumni who have achieved well in the fields of law, business, politics, academe, medicine, sports and other endeavors. At University of the Visayas, we prepare students for a global competition.
ReplyDeleteDirect MBBS Admissions Open: 2020-21
Mobile No: +91 90329 55688
Apply Now: https://www.careerplus.org.in/philippines-medical-college/uv-gullas-college-of-medicine
MBBS in Philippines Wisdom Overseas is authorized India's Exclusive Partner of Southwestern University PHINMA, the Philippines established its strong trust in the minds of all the Indian medical aspirants and their parents. Under the excellent leadership of the founder Director Mr. Thummala Ravikanth, Wisdom meritoriously won the hearts of thousands of future doctors and was praised as the “Top Medical Career Growth Specialists" among Overseas Medical Education Consultants in India.
ReplyDeleteWhy Southwestern University Philippines
5 years of total Duration
3D simulator technological teaching
Experienced and Expert Doctors as faculty
More than 40% of the US returned Doctors
SWU training Hospital within the campus
More than 6000 bedded capacity for Internship
Final year (4th year of MD) compulsory Internship approved by MCI (No need to do an internship in India)
Vital service centers and commercial spaces
Own Hostel accommodations for local and foreign students
Safe, Secure, and lavish environment for vibrant student experience
All sports grounds including Cricket, Volleyball, and others available for students