{"id":791,"date":"2010-12-02T16:54:45","date_gmt":"2010-12-02T16:54:45","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/basic-sutures\/"},"modified":"2024-06-11T16:50:32","modified_gmt":"2024-06-11T15:50:32","slug":"basic-sutures","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/minor-surgery\/skills\/basic-sutures\/","title":{"rendered":"Basic Sutures"},"content":{"rendered":"\n<p><strong>Material<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sterile fenestrated drape.<\/li>\n\n\n\n<li>Needle holder.<\/li>\n\n\n\n<li>Surgical scissors.<\/li>\n\n\n\n<li>Surgical tweezers.<\/li>\n\n\n\n<li>Anatomical tweezers.<\/li>\n\n\n\n<li>1 reabsorbable suture with rounded needle for suturing deeper layers.<\/li>\n\n\n\n<li>Non-reabsorbable suture with a sharp needle for suturing the skin.<\/li>\n\n\n\n<li>Sterile gauze pads 10 \u00d710 cm.<\/li>\n\n\n\n<li>Disinfectants.<\/li>\n\n\n\n<li>Local anaesthetic.<\/li>\n\n\n\n<li>Bandage materials.<\/li>\n\n\n\n<li>Bandage scissors.<\/li>\n<\/ul>\n\n\n\n<p><em><strong>Laboratory Setting<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-vimeo wp-block-embed-vimeo wp-embed-aspect-4-3 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124602781?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture; clipboard-write\"><\/iframe>\n<\/div><\/figure>\n\n\n\n<p><em><strong>Clinical Setting<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-vimeo wp-block-embed-vimeo wp-embed-aspect-4-3 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124602748?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture; clipboard-write\"><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Procedure<\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Ask the patient to lie down and tell them what you are about to do.<\/li>\n\n\n\n<li>Ask the patient about <strong>allergies<\/strong> to <strong>iodine<\/strong> or <strong>local anaesthetics<\/strong>.<\/li>\n\n\n\n<li>Adjust the lighting.<\/li>\n\n\n\n<li><strong>Disinfect<\/strong> the edges of the wound and the surrounding areas.<\/li>\n\n\n\n<li>Put on <strong>sterile gloves<\/strong>.<\/li>\n\n\n\n<li>Cover the wound with a <strong>sterile fenestrated drape<\/strong>.<\/li>\n\n\n\n<li>Administer <strong>infiltration anaesthesia<\/strong> or <strong>guided anaesthesia<\/strong> using the Oberst method; wait until the anaesthesia takes effect.<\/li>\n\n\n\n<li>Place the <strong>atraumatic needle<\/strong> in the small portion of the jaws of the needle holder, approximately halfway along the needle <strong><em>[Figure 18]<\/em><\/strong>.<br><span class=\"jce_caption\" style=\"margin-top: 10px; margin-bottom: 10px; display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"301\" class=\" size-full wp-image-786\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-18.jpg\" alt=\"\"><span style=\"width: 400px; display: block;\"><strong>Figure 18<\/strong><\/span><\/span><\/li>\n\n\n\n<li>Hold the surgical tweezers in a pencil grip <strong><em>[Figure 19]<\/em><\/strong> in one hand. In the other hand, take the needle holder <strong><em>[Figure 20]<\/em><\/strong>.<br><span class=\"jce_caption\" style=\"margin-top: 10px; margin-bottom: 10px; display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"300\" class=\" size-full wp-image-784\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-19.jpg\" alt=\"\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-19.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-19-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\"><strong>Figure 19<\/strong><\/span><\/span><br><span class=\"jce_caption\" style=\"margin-top: 10px; margin-bottom: 10px; display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"300\" class=\" size-full wp-image-785\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-20.jpg\" alt=\"\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-20.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-20-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\"><strong>Figure 20<\/strong><\/span><\/span><\/li>\n\n\n\n<li>Using the tweezers, grip the edge of the wound furthest from you; to minimise tissue damage, the side of the tweezers with one tooth should be placed in the wound margin and the side with two teeth should be placed in the skin.<\/li>\n\n\n\n<li>Position the needle <strong>perpendicularly<\/strong> on the skin approximately 0.5 cm from the wound margin and insert through the skin <strong><em>[Figure 21]<\/em><\/strong>.<br><span class=\"jce_caption\" style=\"margin-top: 10px; margin-bottom: 10px; display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"301\" class=\" size-full wp-image-786\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-21.jpg\" alt=\"\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-21.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-21-300x226.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\"><strong>Figure 21<\/strong><\/span><\/span><\/li>\n\n\n\n<li>With a <strong>supinating hand motion<\/strong>, bring the needle through the wound margin in an arc, similar to the curve of the needle. For wounds that do not extend beyond the cutis and have no tension in the wound margins, proceed directly to <strong>Step 17<\/strong>. For deeper wounds, suturing in two stages (<em>making a stitch from the wound margin to the center of the wound, then refastening the needle and completing the stitch from the wound center to the opposite wound marging<\/em>) provides a better end result; see <strong>Step 13<em> [Figure 22]<\/em><\/strong>.<br><span class=\"jce_caption\" style=\"margin-top: 10px; margin-bottom: 10px; display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"300\" class=\" size-full wp-image-787\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-22.jpg\" alt=\"\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-22.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-22-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\"><strong>Figure 22<\/strong><\/span><\/span><\/li>\n\n\n\n<li>Open the needle holder and refasten it to the portion of the needle entering in the wound.<\/li>\n\n\n\n<li>Pull the needle through the skin and out of the wound in a curved path.<\/li>\n\n\n\n<li>Reposition the needle in the correct position in the needle holder.<\/li>\n\n\n\n<li>Pull the thread through the skin, leaving a sufficient amount to be tied later (<em>about 2 cm if tying with the needle holder or at least 10 cm if tying by hand<\/em>).<\/li>\n\n\n\n<li>Using the tweezers, grip the edge of the wound closest to you and turn the wound margin outward <strong><em>[Figure 23]<\/em><\/strong>.<br><span class=\"jce_caption\" style=\"margin-top: 10px; margin-bottom: 10px; display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"300\" class=\" size-full wp-image-788\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-23.jpg\" alt=\"\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-23.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-23-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\"><strong>Figure 23<\/strong><\/span><\/span><\/li>\n\n\n\n<li>With a <strong>curving motion<\/strong>, insert the needle into the wound margin bringing it as deep along the wound bed as possible, and continue through until the needle point appears through the skin <strong><em>[Figures 23, 24]<\/em><\/strong>.<br><span class=\"jce_caption\" style=\"margin-top: 10px; margin-bottom: 10px; display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"300\" class=\" size-full wp-image-789\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-24.jpg\" alt=\"\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-24.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-24-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\"><strong>Figure 24<\/strong><\/span><\/span><\/li>\n\n\n\n<li>Open the needle holder when it is adjacent to the wound margin and use it to grip the needle again on the outer side of the skin <strong><em>[Figure 25]<\/em><\/strong>.<br><span class=\"jce_caption\" style=\"margin-top: 10px; margin-bottom: 10px; display: inline-block;\"><img loading=\"lazy\" decoding=\"async\" width=\"400\" height=\"300\" class=\" size-full wp-image-790\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-25.jpg\" alt=\"\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-25.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-25-300x225.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><span style=\"width: 400px; display: block;\"><strong>Figure 25<\/strong><\/span><\/span><\/li>\n\n\n\n<li>Pull the needle in a <strong>curved path<\/strong> through the tissue using the tweezers to fixate the exiting point of the needle in the wound.<\/li>\n\n\n\n<li>Using thumb and forefinger, grip the needle securely and open the needle holder.<\/li>\n\n\n\n<li>Tie the <strong>thread in a knot<\/strong> with the aid of the needle holder.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Material Laboratory Setting Clinical Setting Procedure<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[76],"tags":[146],"class_list":["post-791","post","type-post","status-publish","format-standard","hentry","category-skills","tag-minor-surgery"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Basic Sutures - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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