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- 1. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Surgical SuturesSurgical Sutures and Needlesand Needles
- 2. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA SUTURESSUTURES
- 3. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA The Ideal SutureThe Ideal Suture Moynihan 1912Moynihan 1912 Monofilament Use for any procedure Easy to handle Minimal tissue reaction High breaking strength Hold knots securely Absorbable Predictable Absorption Sterile
- 4. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Classification of SuturesClassification of Sutures CHARACTERISTIC Absorbable Nonabsorbable STRUCTURE Monofilament Multifilament MATERIAL Synthetic Biological
- 5. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA AdvantageAdvantage ABSORBABLE Broken down by body No foreign body left NONABSORBABLE Permanent Wound Support
- 6. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA DisadvantageDisadvantage ABSORBABLE Time of wound support NONABSORBABLE Foreign body left Suture sinus Suture extrusion
- 7. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA AdvantageAdvantage MONOFILAMENT Smooth surface Low friction – Less drag – Less tissue trauma No bacterial harbours No capilarity MULTIFILAMENT Strength Soft & pliable Good handling
- 8. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA DisadvantageDisadvantage MONOFILAMENT Handling & Knotting Ends/knot burial Strecth MULTIFILAMENT Bacterial harbours Capillary action Tissue trauma – Drag – Cutting
- 9. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA AdvantageAdvantage BIOLOGICAL Handling & Knotting Economical SYNTHETICS Resemble natural substances Absorption by hydrolysis Predictable absorption Strong
- 10. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA DisadvantageDisadvantage BIOLOGICAL Absorption by enzymatic action Tissue reaction Unpredictable absorption SYNTHETICS Monofilament handling
- 11. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA AbsorbableAbsorbableAbsorbableAbsorbable BiologicalBiologicalBiologicalBiological SyntheticSyntheticSyntheticSynthetic Plain/F.A. Gut Chromic Gut VICRYL* PDS II* MONOCRYL* VICRYL*Rapide PANACRYL* * Trademark
- 12. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Absorption TerminologyAbsorption Terminology ABSORBABLE SUTURESABSORBABLE SUTURES Wound support No loss of suture bulk Strength reduced Elimination of Suture Material removed LOSS OF TENSILE STRENGTH ABSORPTION OF MASS
- 13. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Suture HandlingSuture Handling
- 14. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Absorbable SuturesAbsorbable Sutures WOUND SUPPORT ABSORPTION OF MASS Catgut 7 – 10 60 – 90 VICRYL* Rapide 6 – 14 by 42 Chromic Catgut 17 – 21 90 – 110 MONOCRYL* 14 – 21 90 – 120 Coated VICRYL* 28 – 35 56 – 70 PDS* II up to 56 by 182
- 15. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Coated VICRYL*Coated VICRYL* AbsorptionAbsorption Coated VICRYL* 2/0 at 14 days Minimal Tissue Reaction around suture Chromic Catgut at 14 days Extensive tissue reaction with acute inflammatory response Synthetic Absorbable – Hydrolysis Predictable absorption Minimal tissue reactions
- 16. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA PROLENE* PolypropylenePROLENE* Polypropylene MINIMAL TISSUE REACTIONMINIMAL TISSUE REACTION Enlarged photomicrograph PROLENE* suture Implanted 6 months
- 17. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA NEEDLESNEEDLES
- 18. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Needle SelectionNeedle Selection Minimal trauma to tissue Sharpness Bend resistance Corrosion resistance Sterility Size, shape & design
- 19. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Use of Needle HoldersUse of Needle Holders
- 20. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Anatomy of a Surgical NeedleAnatomy of a Surgical Needle
- 21. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Eyed NeedlesEyed Needles Double suture strand Threading time Resterilisation Point maintenance Risk of corrosion Risk of unthreading EyedEyed French / splitFrench / split eyeeye
- 22. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Suture AttachmentSuture Attachment Channel Drilled
- 23. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA ““Swage”Swage” Single Armed: satu jarum dengan satu benang Double Armed: dua jarum pada satu benang Loop: satu jarum pada satu benang dengan konfigurasi loop
- 24. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Needle ShapesNeedle Shapes ¼Circle¼Circle 33 //88 CircleCircle ½ Circle½ Circle 55 //88 CircleCircle ½ Curved½ Curved StraightStraight CompoundCompound CurveCurve J ShapeJ Shape
- 25. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Needle Size RangeNeedle Size Range MICROSUTURES 3.75mm – 8mm OPHTHALMIC 5mm – 16mm CARDIOVASCULAR 8mm – 40mm SKIN RANGE 9mm – 60mm G.I. RANGE 13mm – 40mm CLOSURE 30mm – 110mm HAND HELD 55mm – 110mm 110mm110mm 3mm3mm 45 needle sizes from 3mm to 110mm
- 26. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Needle TypesNeedle Types Round Bodied Cutting
- 27. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Cutting NeedlesCutting Needles CONVENTIONALCONVENTIONAL CUTTINGCUTTING Apex of edges on inside curvature
- 28. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Conventional CuttingConventional Cutting PRIME*PRIME* Sisi cutting “di dalam” Prime Geometry meningkatkan penetrasi Dipipihkan pada lokasi genggaman needle holder untuk stabilitas Series: PC Prime, CCS, CPS-3
- 29. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Cutting NeedlesCutting Needles REVERSEREVERSE CUTTINGCUTTING Apex of edges on outside curvature
- 30. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Reverse CuttingReverse Cutting Sisi “cutting “di luar” Kelebihan desain ini: – Lebih kuat – Mengurangi “tissue cut-out” atau robekan Series: P, PS, FS, M, C, LS, LR, OS, CP Microsurgery: Series G
- 31. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Taper PointTaper Point Tidak ada sisi “cutting”, lebih bersifat “menusuk” dan memperlebar tusukan sejalan dengan membesarnya diameter. Tidak memotong Digunakan pada Intestinal Anastomosis, Fascia Closure, Gynecology, Hernia dan pada Cardiovascular surgeries Series: BV, C, C, BB, SH, MH, LH, MO, CT, TP, UR . 22° 12:1 TRU TAPER
- 32. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA TAPERCUT*TAPERCUT* Kombinasi antara taper dan cutting, dimana pada ujung bersifat cutting naun “body” bersifat round body Digunakan pada cardiovascular yang mengalami hardening Old TAPERCUT* New TAPERCUT*
- 33. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA PACKAGINGPACKAGING
- 34. PELATIHAN BEDAH DASAR KOLEGIUMILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Packaging – Foil PackPackaging – Foil Pack USP Gauge Metric Gauge Code number Denotes Easy Access packaging Sterilisation Method Manufacture & Expiry date Product description & colour Length Needle description IDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGS