Sutures are materials used in surgery for a variety of reason ranging from surgical repair of wounds, ligature, etc. There are a wide variety of sutures with different characteristics that must be born in mind while choosing a suture
This PPT is oriented mainly towards sutures / needles & knots. Their types, uses and techniques of using it. Mainly for MBBS students as well as other medically oriented people.
This PPT is oriented mainly towards sutures / needles & knots. Their types, uses and techniques of using it. Mainly for MBBS students as well as other medically oriented people.
Suture Materials and Suturing Techniques - Presented by Dr. Prasanjit Das and group as a part of Dhaka Dental College, OMS Department weekly presentation program.
Suturing 101 - Basic Surgical Skills for Medical Students and Junior DoctorsAaron Sparshott
This an introduction to suturing for medical students and junior doctors. It covers not only surgical technique, but wound management principles, local anaesthesia, tetanus and anatomy.
For the full guide go to IVLine.org
GOALS OF SUTURING, CLASSIFICATION OF SUTURE MATERIALS According to source, CLASSIFICATION OF SUTURE MATERIALS According to Structure, CLASSIFICATION OF SURGICAL NEEDLES, IDEAL PROPERTIES OF NEEDLES, BODY OF NEEDLE, SUTURE SIZES, THE EYE OF THE NEEDLE, PRINCIPLES OF SUTURE SELECTION, Gut/ Chromic Gut, SILK, Collagen SUTURE, Vicryl (Polyglactin 910), Dexon and PGA, SURGICAL COTTON, GLYCOLIC ACID (MAXON) POLYGLYCONATE, NYLON, Polymerized Caprolactam, Polymerized Caprolactam, Polypropylene, Stainless Steel, Anesthetic Solutions, Wound Preparation, Principles And Techniques, Wound antisepsis and sterile technique, Wound antisepsis and sterile technique, Wound antisepsis and sterile technique, The interrupted suture, The full surgeon s knot, The full surgeon s knot, The simple or spiral continuous suture technique, The locked continuous suture, The locked and secured continuous suture, The external horizontal mattress suture The buried horizontal mattress suture, The buried vertical mattress suture, The simple anchored (sling) suture, The sliding anchored (sling) suture, The continuous sling suture, Suturing Tips and Approaches by Anatomic Location, How to Care for Stitches (Sutures), Removal of suture, Principle of suture removal, Reasons for failure of sutures, Possible complications of leaving sutures for many days, Other Methods of Wound Closure, Ligating Clips, Tissue Adhesives,
Principles of use and abuse of suture 1Drkabiru2012
Academic presentation during junior residency rotation at Aminu Kano Teaching Hospital Surgery Department, General Surgery unit by
Dr kabiru SALISU
kbmed2003@yahoo.com
Fracture nonunion is a debilitating complication of fracture healing.
Effective management requires adequate understanding of its pathogenesis and risk factors.
Options of management could be operative or non operative.
An effective treatment protocol must ensure careful rehabilitation of the patient
Principles of Management of the multiply injured patientCHRIS ALUMONA
The multiply injured or polytraumatised patient is at a greater risk of morbidity and mortality than patients with isolated injuries. This risk is greater than the sum of the risks of their individual injuries. A high index of suspicion is needed to recognise immediately life threatening injuries and promptly address them. The principles of management is captured with the ATLS protocol and every trauma surgeon should be conversant with this indispensable tool.
Surgical management of benign multinodular goitreCHRIS ALUMONA
According to the WHO about 200 million people are living with goitres worldwide. Of the benign cases, endemic goitres make up the bulk in iodine deficiency belts. Goitres may be simple or toxic. The aetiopathogenesis and surgical management of this condition is detailed in a practical sense in this presentation.
Surgical diathermy involves the intra cellular conversion of high frequency alternating current to thermal energy in order to generate a variety of tissue effect during surgery
Surgical management of pancreatic pseudocyst..by dr chris alumonaCHRIS ALUMONA
Pancreatic pseudocyst is the commonest cystic lesion of the pancreas but generally rare. It commonly complicates pancreatitis and resolves spontaneously with conservative management. Indications for intervention include complications and to rule out malignancy
Antibiotics are crucial tools in surgery and there use has seen drastic reduction in morbidity and mortality in surgical patients. They are however only adjuncts to established surgical principles of sepsis and anti sepsis, and source control of infection.
Surgical hemostasis is one of the pillars of modern surgery. Adequate hemostasis in a surgical patient involves a detailed perioperative clinical evaluation and investigation, and various intra operative techniques and options. Ensuring adequate surgical hemostasis reduces morbidity and mortality by modulating the metabolic response to trauma, decreasing the incidence of post operative anemia, reduces rates of surgical site infection and ultimately improving wound healing
Principles of surgery. Day case surgery is a rapidly evolving surgical sub speciality that seeks to eliminate the need for prolonged admission in surgical patients and the attendant complications of prolonged immobilization. It is based on the documented evidence that most post op patients does not require specialised post op care and hence can be allowed to recover at home. This form of surgery appeals to patients and their families due to the fact that it allows only minimal interruption of patient's social life
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
2. OUTLINE
• Introduction
• Historical Perspective
• Statement of Surgical Importance
• The Ideal Suture
• Suture characteristics
• Applications in surgery
• Classification
• Some common sutures
• Sterilization
• Selecting a Suture
• Suturing techniques
• Knotting Techniques
• Suture Removal
• Needles
• Complications
• Recent Advances (staples, barbed sutures, glues etc
• References
3. Introduction
• Sutures are medical devices used to co-apt
tissues following trauma or surgery.
• Surgical stitches
• Natural or synthetic materials
• Application continue to evolve
4. Historical Perspective
• Tendon strips , Acacia thorns: East Africa
• Black ants: South America
• Horse hair, cotton, leather: India (1000BC)
• Linen, silk, metal clips: Roman empire
5. Statement of Surgical Importance
• Sutures are crucial in surgical repair of
wounds, a proper understanding of their
properties, interactions with body tissues,
principle of use and complications are
necessary to ensure good wound healing and
safety
6. The Ideal Suture
• Sterile
• Predictable: tissue behaviour, tensile strength
• Minimal tissue activity:
– non electrolytic,
– non capillary,
– non allergenic,
– non carcinogenic,
– non thrombogenic (in vascular surgery)
7. The Ideal Suture cont
• Easy to handly
• High knot security
• High tensile strength
• Favourable absorption profile
• Resistant to infection
• Readily available
• cheap
10. Suture Characteristics cont
• Strength: depends on
– Constituent material: absorbable or non-
absorbable
– Thickness/diametre
– Handling
• (tensile strength vs material in vivo strength)
11. Suture Characteristics cont
• Tensile Behaviour:
– Elasticity; memory
– Plasticity; kinking
• Knot integrity
• Absorbability:
– Absorbable: in biliary and urinary tract surgery
– Non absorbable: in vascular anastomosis, artificial
grafts, prosthesis
12. Suture Characteristics cont
• Biological behaviour:
– Depends on constituent material
– Degradation: Proteolysis vs Hydrolysis
– Transmission of infection
– Local recurrence of gut tumours
16. Sterilization of sutures
• Gamma Radiation
• Ethylene Oxide
• Autoclave
• Catgut are package in alcohol solution to
retain flexibility
17. Selecting Suture
• Surgeon factor
– Training, Experience, Preference
• Nature of tissue
• Region of the body
• Suture
– Size
– Structure
– Tensile strength
– Absorbability
18. Suture Techniques
• Interrupted sutures
– Inserted and exited at
right angle to the incision
– Needle should be rotated
through tissue without
dragging
• Continuous sutures
– Needs an assistant to
maintain tension
19. • Mattress suture
– Vertical or horizontal
– Used for accurate
approximation of wound
edges
– To produce invertion or
evertion of wound edges
– Horizontal mattress used
to secure hemostasis
20. • Subcuticular suture
– Used on the skin
– For cosmesis
– Absorbable or non
absorbable may be used
21. Knotting Techniques
• Must be firm without strangulating the tissue
• Must be unable to slip or unravel
• Must be as small as possible to minimize amount of
foreign material
• Tension must not be exerted on the tissue while
securing the knot
• The suture material must not be sawed during tying
• The suture thread must not be grasped with
instruments
• Multiple throws must be used for sutures with memory
• Cut sutures 1-2mm from knot to avoid unraveling
22.
23. Suture Removal
• When depends on the site
• Head and face: 3-5 days
• Arms and hands: 7-10 days
• Chest: 7-10 days
• Abdomen: 7-10 days
• Lower limbs: 10-14 days
• Infection
27. Complications of sutures
• Failure
• Tissue reaction
• Infection
• Abscess and sinus formation
• Malignancy
• Scarring
28. Recent Trends
• Staples and clips
• Absorbable clips from PDS
• Stapling guns for bowel anastomosis
• Skin adhesives eg Dermabond
• Barbed sutures: knots not needed. Used in
laparoscopic surgeries
29. Conclusion
• Sutures are very common and indispensible
tools in surgery however it must be born in
mind that they are foreign bodies. Hence
necessary principles of use must be applied
for safety of the patient
30. Refrences
• Bailey, H., Love, R. J. M. N., Mann, C. V., & Russell, R. C. G. Bailey
and Love short practice of surgery. 27th Edition. London: Chapman
& Hall medical. (2018)
• Archampong E. Q., Naaeder S. B., Ugwu B. Baja’s Principle and
practice of Surgery. 5th Edition. Ghana Publishing Corporation.
(2015)
• M.A.R Alfallouji. Post-graduate surgery, candidates guide,2nd
edition
• Clinical surgery Alfred Cusheri etal 2nd edition
• www.e.medicine.com
• https://periobasics.com/sutures-and-suturing-techniques/
• https://camls-us.org/wp-content/uploads/2018/05/10.30am-
Handout-Cherpelis-Needles-2018.pdf
