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Suturing; principles, armamentarium and techniques

The document discusses suturing techniques and materials. It provides details on various suturing instruments including needles, needle holders, forceps and scissors. It explains the principles of suturing such as using the appropriate needle and suture size for the tissue. Different types of suture materials are also outlined, categorizing them based on absorbability, source and degradation time. Specific suture materials are described like catgut, collagen and synthetic absorbable sutures. The document serves as a guide for proper suturing methods and selection of instruments and materials.

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In the Name of Allah, the Most Beneficent, the Most Merciful And your Lord has decreed that you worship none but Him. And that you be dutiful to your parents. If one of them or both of them attain old age in your life, say not to them a word of disrespect, nor shout at them but address them in terms of honour (23) (And lower unto them the wing of submission and humility through mercy, and say: "My Lord! Bestow on them Your Mercy as they did bring me up when I was small." (24) Surat Al-'Isrā' Wounds, Wound Healing And Suturing ELHAWARY
Suturing Principles, Armamentarium And Techniques Assistant professor OMFS Cairo University MSA Univesity Umm Ql-Qura University Wounds, Wound Healing And Suturing ELHAWARY
Closure (Suturing) • Approximation of the soft tissue edges to cover the surgical field Wounds, Wound Healing And Suturing ELHAWARY
Closure (Suturing) • Approximation of the soft tissue edges to cover the surgical field • Advantages of suturing: – Promotes healing – Prevents complications • Infection • Hemorrhage • Tissue necrosis – Preserve the normal contour and shape of tissues Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps Point • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps Body • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Swaged end Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Wounds, Wound Healing And Suturing ELHAWARY
Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Opening The Suture Material Wounds, Wound Healing And Suturing ELHAWARY
Opening The Suture Material Wounds, Wound Healing And Suturing ELHAWARY
Opening The Suture Material Wounds, Wound Healing And Suturing ELHAWARY
Opening The Suture Material Wounds, Wound Healing And Suturing ELHAWARY
Opening The Suture Material Wounds, Wound Healing And Suturing ELHAWARY
Opening The Suture Material Wounds, Wound Healing And Suturing ELHAWARY
Opening The Suture Material Wounds, Wound Healing And Suturing ELHAWARY
Opening The Suture Material Wounds, Wound Healing And Suturing ELHAWARY
Grasping the needle holder Wounds, Wound Healing And Suturing ELHAWARY
Grasping the needle holder Wounds, Wound Healing And Suturing ELHAWARY
Grasping the needle holder Wounds, Wound Healing And Suturing ELHAWARY
Grasping the needle holder Wounds, Wound Healing And Suturing ELHAWARY
Grasping the needle Wounds, Wound Healing And Suturing ELHAWARY
Grasping the needle Wounds, Wound Healing And Suturing ELHAWARY
Grasping the needle Wounds, Wound Healing And Suturing ELHAWARY
Grasping the needle Wounds, Wound Healing And Suturing ELHAWARY
Principles of suturing Wounds, Wound Healing And Suturing ELHAWARY
Principles of suturing • Use suture needle of suitable shape and size Wounds, Wound Healing And Suturing ELHAWARY
Principles of suturing • Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured Wounds, Wound Healing And Suturing ELHAWARY
Principles of suturing • Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) Wounds, Wound Healing And Suturing ELHAWARY
Principles of suturing • Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) • Sutures should not be placed under tension Wounds, Wound Healing And Suturing ELHAWARY
Principles of suturing • Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) • Sutures should not be placed under tension • Knots should be tied 2-3 mm away from the incision line Wounds, Wound Healing And Suturing ELHAWARY
Principles of suturing • Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) • Sutures should not be placed under tension • Knots should be tied 2-3 mm away from the incision line • Suture material is cut 4-5 mm away from the knot Wounds, Wound Healing And Suturing ELHAWARY
Principles of suturing • Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) • Sutures should not be placed under tension • Knots should be tied 2-3 mm away from the incision line • Suture material is cut 4-5 mm away from the knot • Superficial sutures must be removed 5 days after surgery to prevent infection / foreign body reaction Wounds, Wound Healing And Suturing ELHAWARY
Suture needles • Patterns of the suture needle according to accessibility: – Straight suture needles – Curved suture needles – Half circle suture needles http://www.burtons.uk.com/products.asp?recnumber=424 Wounds, Wound Healing And Suturing ELHAWARY
Suture needles • Patterns of the suture needle according to accessibility: – Straight suture needles • For skin closure – Curved suture needles • For intraoral suturing • For deep suturing – Half circle suture needles • For intraoral suturing http://www.burtons.uk.com/products.asp?recnumber=424 • For deep suturing Wounds, Wound Healing And Suturing ELHAWARY
Suture needles • Patterns of the suture needle according to cross section: – Round suture needles – Triangular suture needles • Cutting • Reverse cutting http://www.starmedix.com Wounds, Wound Healing And Suturing ELHAWARY
Suture needles • Patterns of suture needles according to cross section: – Round suture needles • Round cross section • May be straight, curved or half circle • Suturing of fragile and delicate tissues e.g. oral mucosa and mucous membranes Round needle http://www.starmedix.com Wounds, Wound Healing And Suturing ELHAWARY
Suture needles • Patterns of suture needles according to cross section: – Cutting / Reverse cutting (Atraumatic) suture needles • Triangular cross section • May be straight, curved or half circle • Suturing of dense tissues e.g. oral mucoperiosteum Reverse cutting needle Cutting needle http://www.starmedix.com http://www.starmedix.com Wounds, Wound Healing And Suturing ELHAWARY
Suture materials Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Types of suture material according to resorption: – Non-Absorbable suture materials – Absorbable suture material Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Types of suture material according to resorption: – Non-Absorbable suture materials – Absorbable suture material • Types of suture material according to nature: – Natural – Synthetic Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Types of suture material according to resorption: – Non-Absorbable suture materials – Absorbable suture material • Types of suture material according to nature: – Natural – Synthetic • Types of suture material according to gauge: – 0/00/000/0000/00000/000000 Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Types of suture material according to resorption: – Non-Absorbable suture materials – Absorbable suture material • Types of suture material according to nature: – Natural – Synthetic • Types of suture material according to gauge: – 0/00/000/0000/00000/000000 • Types of suture material according to filament – Monofilament – Multifilament Wounds, Wound Healing And Suturing ELHAWARY
Suture materials Wounds, Wound Healing And Suturing ELHAWARY
Suture materials Non-Absorbable Absorbable Wounds, Wound Healing And Suturing ELHAWARY
Suture materials Non-Absorbable Absorbable • Can’t be resorbed by the body • Used for suturing of: – Skin closure – Routine intraoral closure – Blood vessels ligation Wounds, Wound Healing And Suturing ELHAWARY
Suture materials Non-Absorbable Absorbable • Can’t be resorbed by • Can be resorbed by the body body • Used for suturing of: • Used for suturing of: – Skin closure – Deep tissues – Routine intraoral closure – Fascial layers – Blood vessels ligation – Intraoral closure in cases of: • Inability of the patient to return to remove the sutures • Mentally retarded patients • Epileptic patients • Sutures under surgical stents Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Non-Absorbable suture materials – Silk – Cotton – Nylon Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Non-Absorbable suture materials – Silk • Black or white • Tough suture material • Intraoral suturing – Cotton – Nylon Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Non-Absorbable suture materials – Silk – Cotton • Weak suture material • Intraoral suturing – Nylon Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Non-Absorbable suture materials – Silk – Cotton – Nylon • Very hard suture material • Used for skin closure • Cause mucosal irritation if used intraorally Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Absorbable suture materials – Plain catgut – Chromic catgut – Collagen sutures – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Absorbable suture materials – Plain catgut • Resorbed 5-10 days • Used for suturing of deep fascia and muscles • Occasionally tissue irritant – Chromic catgut – Collagen sutures – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Absorbable suture materials – Plain catgut – Chromic catgut • Resorbed completely after 10-15 days • Non irritant to the tissues • Sutures of ligaments, tendons and severed blood vessels – Collagen sutures – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Absorbable suture materials – Plain catgut – Chromic catgut – Collagen sutures • More uniform physical properties • Prepared from tendons of cattle – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Absorbable suture materials – Plain catgut – Chromic catgut – Collagen sutures – Polyglycolic acids sutures (Dexon) • Synthetic polymer • Resorbed by hydrolysis within 15-30 days – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
Suture materials • Absorbable suture materials – Plain catgut – Chromic catgut – Collagen sutures – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures • Synthetic inert copolymer • The strongest absorbable suture material • Resorbed 60 – 90 days Wounds, Wound Healing And Suturing ELHAWARY
Factors affecting selection of suturing material • Area to be sutured – Deep layers Vs superficial layers – Intraoral surgeries Vs extraoral – Vascular anastomoses are performed with fine-bore non- absorbable materials • Strength of the sutures needed • Tissue reactivity toward suture material Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Size Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Size Color Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Size Color Sterile Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Size Color Single use Sterile Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Size Color Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Size Shape Color Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Size Shape Color Needle length Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Size Shape Color Needle length Cross-section Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Material length Size Shape Color Needle length Cross-section Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
The suture packaging Material Material length Size Shape Color Needle length Cross-section Expiration date Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
Suturing techniques Wounds, Wound Healing And Suturing ELHAWARY
Suturing techniques • Interrupted sutures • Continuous sutures • Continuous with lock suture • Horizontal mattress suture • Vertical mattress suture Wounds, Wound Healing And Suturing ELHAWARY
Suturing Materials & Techniques INTERRUPTED SUTURES Wounds, Wound Healing And Suturing ELHAWARY
Manual of Minor Oral Surgery for the General Dentist By Karl R. Koerner 2006 by Blackwell Munksgaard, Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Hesham El-Hawary www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Key suture Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Key suture X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Key suture Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Key suture Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Key suture X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Rule of Halves X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Rule of Halves X X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Rule of Halves X X X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Suturing Materials & Techniques CONTINUOUS SUTURES Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Suturing Materials & Techniques CONTINUOUS WITH LOCK SUTURES Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Suturing Materials & Techniques HORIZONTAL MATTRESS SUTURE Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Eversion of the edges Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Manual of Minor Oral Surgery for the General Dentist By Karl R. Koerner 2006 by Blackwell Munksgaard, Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos © Springer-Verlag Berlin Heidelberg 2007 Oral Surgery by Fragiskos D. Fragiskos © Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Suturing Materials & Techniques VERTICAL MATTRESS SUTURES Wounds, Wound Healing And Suturing ELHAWARY
Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com 1 4 3 2 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com 1 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com 1 2 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com 3 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com 4 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com 1 4 3 2 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary From the inner aspect Ass. Prof OMFS www.elhawarydentalclinic.com 1 4 2 3 Wounds, Wound Healing And Suturing ELHAWARY
Dr. Hesham El-Hawary From the inner aspect Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
Thank you Dr. Hesham El-Hawary Ass. Professor OMFS Facebook: Hesham El-Hawary Twitter: @elhawary_hesham Email: hesham@elhawarydentalclinc.com Website: www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY

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Suturing; principles, armamentarium and techniques

  • 1.
    In the Nameof Allah, the Most Beneficent, the Most Merciful And your Lord has decreed that you worship none but Him. And that you be dutiful to your parents. If one of them or both of them attain old age in your life, say not to them a word of disrespect, nor shout at them but address them in terms of honour (23) (And lower unto them the wing of submission and humility through mercy, and say: "My Lord! Bestow on them Your Mercy as they did bring me up when I was small." (24) Surat Al-'Isrā' Wounds, Wound Healing And Suturing ELHAWARY
  • 2.
    Suturing Principles, Armamentarium And Techniques Assistant professor OMFS Cairo University MSA Univesity Umm Ql-Qura University Wounds, Wound Healing And Suturing ELHAWARY
  • 3.
    Closure (Suturing) • Approximationof the soft tissue edges to cover the surgical field Wounds, Wound Healing And Suturing ELHAWARY
  • 4.
    Closure (Suturing) • Approximationof the soft tissue edges to cover the surgical field • Advantages of suturing: – Promotes healing – Prevents complications • Infection • Hemorrhage • Tissue necrosis – Preserve the normal contour and shape of tissues Wounds, Wound Healing And Suturing ELHAWARY
  • 5.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 6.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 7.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps Point • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 8.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps Body • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 9.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Swaged end Wounds, Wound Healing And Suturing ELHAWARY
  • 10.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 11.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 12.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
  • 13.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 14.
    Suturing Instruments Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 15.
    Wounds, Wound HealingAnd Suturing ELHAWARY
  • 16.
    Wounds, Wound HealingAnd Suturing ELHAWARY
  • 17.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Wounds, Wound Healing And Suturing ELHAWARY
  • 18.
    Suturing Instruments • Suturing needle • Suturing material • Needle holder • Tissue forceps • Suture scissor Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
  • 19.
    Opening The SutureMaterial Wounds, Wound Healing And Suturing ELHAWARY
  • 20.
    Opening The SutureMaterial Wounds, Wound Healing And Suturing ELHAWARY
  • 21.
    Opening The SutureMaterial Wounds, Wound Healing And Suturing ELHAWARY
  • 22.
    Opening The SutureMaterial Wounds, Wound Healing And Suturing ELHAWARY
  • 23.
    Opening The SutureMaterial Wounds, Wound Healing And Suturing ELHAWARY
  • 24.
    Opening The SutureMaterial Wounds, Wound Healing And Suturing ELHAWARY
  • 25.
    Opening The SutureMaterial Wounds, Wound Healing And Suturing ELHAWARY
  • 26.
    Opening The SutureMaterial Wounds, Wound Healing And Suturing ELHAWARY
  • 27.
    Grasping the needleholder Wounds, Wound Healing And Suturing ELHAWARY
  • 28.
    Grasping the needleholder Wounds, Wound Healing And Suturing ELHAWARY
  • 29.
    Grasping the needleholder Wounds, Wound Healing And Suturing ELHAWARY
  • 30.
    Grasping the needleholder Wounds, Wound Healing And Suturing ELHAWARY
  • 31.
    Grasping the needle Wounds,Wound Healing And Suturing ELHAWARY
  • 32.
    Grasping the needle Wounds,Wound Healing And Suturing ELHAWARY
  • 33.
    Grasping the needle Wounds,Wound Healing And Suturing ELHAWARY
  • 34.
    Grasping the needle Wounds,Wound Healing And Suturing ELHAWARY
  • 35.
    Principles of suturing Wounds,Wound Healing And Suturing ELHAWARY
  • 36.
    Principles of suturing •Use suture needle of suitable shape and size Wounds, Wound Healing And Suturing ELHAWARY
  • 37.
    Principles of suturing •Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured Wounds, Wound Healing And Suturing ELHAWARY
  • 38.
    Principles of suturing •Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) Wounds, Wound Healing And Suturing ELHAWARY
  • 39.
    Principles of suturing •Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) • Sutures should not be placed under tension Wounds, Wound Healing And Suturing ELHAWARY
  • 40.
    Principles of suturing •Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) • Sutures should not be placed under tension • Knots should be tied 2-3 mm away from the incision line Wounds, Wound Healing And Suturing ELHAWARY
  • 41.
    Principles of suturing •Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) • Sutures should not be placed under tension • Knots should be tied 2-3 mm away from the incision line • Suture material is cut 4-5 mm away from the knot Wounds, Wound Healing And Suturing ELHAWARY
  • 42.
    Principles of suturing •Use suture needle of suitable shape and size • Use suture material that is of suitable type and size for the tissues being sutured • Good bite (2:3 mm from the free edge of the soft tissue) • Sutures should not be placed under tension • Knots should be tied 2-3 mm away from the incision line • Suture material is cut 4-5 mm away from the knot • Superficial sutures must be removed 5 days after surgery to prevent infection / foreign body reaction Wounds, Wound Healing And Suturing ELHAWARY
  • 43.
    Suture needles • Patternsof the suture needle according to accessibility: – Straight suture needles – Curved suture needles – Half circle suture needles http://www.burtons.uk.com/products.asp?recnumber=424 Wounds, Wound Healing And Suturing ELHAWARY
  • 44.
    Suture needles • Patternsof the suture needle according to accessibility: – Straight suture needles • For skin closure – Curved suture needles • For intraoral suturing • For deep suturing – Half circle suture needles • For intraoral suturing http://www.burtons.uk.com/products.asp?recnumber=424 • For deep suturing Wounds, Wound Healing And Suturing ELHAWARY
  • 45.
    Suture needles • Patternsof the suture needle according to cross section: – Round suture needles – Triangular suture needles • Cutting • Reverse cutting http://www.starmedix.com Wounds, Wound Healing And Suturing ELHAWARY
  • 46.
    Suture needles • Patternsof suture needles according to cross section: – Round suture needles • Round cross section • May be straight, curved or half circle • Suturing of fragile and delicate tissues e.g. oral mucosa and mucous membranes Round needle http://www.starmedix.com Wounds, Wound Healing And Suturing ELHAWARY
  • 47.
    Suture needles • Patternsof suture needles according to cross section: – Cutting / Reverse cutting (Atraumatic) suture needles • Triangular cross section • May be straight, curved or half circle • Suturing of dense tissues e.g. oral mucoperiosteum Reverse cutting needle Cutting needle http://www.starmedix.com http://www.starmedix.com Wounds, Wound Healing And Suturing ELHAWARY
  • 48.
    Suture materials Wounds, WoundHealing And Suturing ELHAWARY
  • 49.
    Suture materials •Types of suture material according to resorption: – Non-Absorbable suture materials – Absorbable suture material Wounds, Wound Healing And Suturing ELHAWARY
  • 50.
    Suture materials •Types of suture material according to resorption: – Non-Absorbable suture materials – Absorbable suture material • Types of suture material according to nature: – Natural – Synthetic Wounds, Wound Healing And Suturing ELHAWARY
  • 51.
    Suture materials •Types of suture material according to resorption: – Non-Absorbable suture materials – Absorbable suture material • Types of suture material according to nature: – Natural – Synthetic • Types of suture material according to gauge: – 0/00/000/0000/00000/000000 Wounds, Wound Healing And Suturing ELHAWARY
  • 52.
    Suture materials •Types of suture material according to resorption: – Non-Absorbable suture materials – Absorbable suture material • Types of suture material according to nature: – Natural – Synthetic • Types of suture material according to gauge: – 0/00/000/0000/00000/000000 • Types of suture material according to filament – Monofilament – Multifilament Wounds, Wound Healing And Suturing ELHAWARY
  • 53.
    Suture materials Wounds, WoundHealing And Suturing ELHAWARY
  • 54.
    Suture materials Non-Absorbable Absorbable Wounds, Wound Healing And Suturing ELHAWARY
  • 55.
    Suture materials Non-Absorbable Absorbable • Can’t be resorbed by the body • Used for suturing of: – Skin closure – Routine intraoral closure – Blood vessels ligation Wounds, Wound Healing And Suturing ELHAWARY
  • 56.
    Suture materials Non-Absorbable Absorbable • Can’t be resorbed by • Can be resorbed by the body body • Used for suturing of: • Used for suturing of: – Skin closure – Deep tissues – Routine intraoral closure – Fascial layers – Blood vessels ligation – Intraoral closure in cases of: • Inability of the patient to return to remove the sutures • Mentally retarded patients • Epileptic patients • Sutures under surgical stents Wounds, Wound Healing And Suturing ELHAWARY
  • 57.
    Suture materials • Non-Absorbable suture materials – Silk – Cotton – Nylon Wounds, Wound Healing And Suturing ELHAWARY
  • 58.
    Suture materials • Non-Absorbable suture materials – Silk • Black or white • Tough suture material • Intraoral suturing – Cotton – Nylon Wounds, Wound Healing And Suturing ELHAWARY
  • 59.
    Suture materials • Non-Absorbable suture materials – Silk – Cotton • Weak suture material • Intraoral suturing – Nylon Wounds, Wound Healing And Suturing ELHAWARY
  • 60.
    Suture materials • Non-Absorbable suture materials – Silk – Cotton – Nylon • Very hard suture material • Used for skin closure • Cause mucosal irritation if used intraorally Wounds, Wound Healing And Suturing ELHAWARY
  • 61.
    Suture materials • Absorbablesuture materials – Plain catgut – Chromic catgut – Collagen sutures – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
  • 62.
    Suture materials • Absorbablesuture materials – Plain catgut • Resorbed 5-10 days • Used for suturing of deep fascia and muscles • Occasionally tissue irritant – Chromic catgut – Collagen sutures – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
  • 63.
    Suture materials • Absorbablesuture materials – Plain catgut – Chromic catgut • Resorbed completely after 10-15 days • Non irritant to the tissues • Sutures of ligaments, tendons and severed blood vessels – Collagen sutures – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
  • 64.
    Suture materials • Absorbablesuture materials – Plain catgut – Chromic catgut – Collagen sutures • More uniform physical properties • Prepared from tendons of cattle – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
  • 65.
    Suture materials • Absorbablesuture materials – Plain catgut – Chromic catgut – Collagen sutures – Polyglycolic acids sutures (Dexon) • Synthetic polymer • Resorbed by hydrolysis within 15-30 days – Polyglactin-910 (Vicryl) sutures Wounds, Wound Healing And Suturing ELHAWARY
  • 66.
    Suture materials • Absorbablesuture materials – Plain catgut – Chromic catgut – Collagen sutures – Polyglycolic acids sutures (Dexon) – Polyglactin-910 (Vicryl) sutures • Synthetic inert copolymer • The strongest absorbable suture material • Resorbed 60 – 90 days Wounds, Wound Healing And Suturing ELHAWARY
  • 67.
    Factors affecting selectionof suturing material • Area to be sutured – Deep layers Vs superficial layers – Intraoral surgeries Vs extraoral – Vascular anastomoses are performed with fine-bore non- absorbable materials • Strength of the sutures needed • Tissue reactivity toward suture material Wounds, Wound Healing And Suturing ELHAWARY
  • 68.
    The suture packaging Wounds,Wound Healing And Suturing ELHAWARY
  • 69.
    The suture packaging Wounds,Wound Healing And Suturing ELHAWARY
  • 70.
    The suture packaging Material Wounds, Wound Healing And Suturing ELHAWARY
  • 71.
    The suture packaging Material Size Wounds, Wound Healing And Suturing ELHAWARY
  • 72.
    The suture packaging Material Size Color Wounds, Wound Healing And Suturing ELHAWARY
  • 73.
    The suture packaging Material Size Color Sterile Wounds, Wound Healing And Suturing ELHAWARY
  • 74.
    The suture packaging Material Size Color Single use Sterile Wounds, Wound Healing And Suturing ELHAWARY
  • 75.
    The suture packaging Material Size Color Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
  • 76.
    The suture packaging Material Size Shape Color Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
  • 77.
    The suture packaging Material Size Shape Color Needle length Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
  • 78.
    The suture packaging Material Size Shape Color Needle length Cross-section Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
  • 79.
    The suture packaging Material Material length Size Shape Color Needle length Cross-section Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
  • 80.
    The suture packaging Material Material length Size Shape Color Needle length Cross-section Expiration date Single use Needle code Sterile with life size picture Wounds, Wound Healing And Suturing ELHAWARY
  • 81.
    Suturing techniques Wounds, WoundHealing And Suturing ELHAWARY
  • 82.
    Suturing techniques • Interrupted sutures • Continuous sutures • Continuous with lock suture • Horizontal mattress suture • Vertical mattress suture Wounds, Wound Healing And Suturing ELHAWARY
  • 83.
    Suturing Materials &Techniques INTERRUPTED SUTURES Wounds, Wound Healing And Suturing ELHAWARY
  • 84.
    Manual of MinorOral Surgery for the General Dentist By Karl R. Koerner 2006 by Blackwell Munksgaard, Wounds, Wound Healing And Suturing ELHAWARY
  • 85.
    Oral Surgery byFragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
  • 86.
    Oral Surgery byFragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
  • 87.
    Oral Surgery byFragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
  • 88.
    Oral Surgery byFragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
  • 89.
    Oral Surgery byFragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
  • 90.
    Oral Surgery byFragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
  • 91.
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    Key suture Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
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    Key suture X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
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    Key suture Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
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    Key suture Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
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    Key suture X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
  • 102.
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    Rule of Halves X X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
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    Rule of Halves X X X Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
  • 105.
    Suturing Materials &Techniques CONTINUOUS SUTURES Wounds, Wound Healing And Suturing ELHAWARY
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    Oral Surgery byFragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
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    Suturing Materials &Techniques CONTINUOUS WITH LOCK SUTURES Wounds, Wound Healing And Suturing ELHAWARY
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    Oral Surgery byFragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Oral Surgery by Fragiskos D. Fragiskos Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
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    Suturing Materials &Techniques HORIZONTAL MATTRESS SUTURE Wounds, Wound Healing And Suturing ELHAWARY
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    Eversion of theedges Dr. Hesham El-Hawary Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
  • 117.
    Manual of MinorOral Surgery for the General Dentist By Karl R. Koerner 2006 by Blackwell Munksgaard, Wounds, Wound Healing And Suturing ELHAWARY
  • 118.
    Oral Surgery byFragiskos D. Fragiskos © Springer-Verlag Berlin Heidelberg 2007 Oral Surgery by Fragiskos D. Fragiskos © Springer-Verlag Berlin Heidelberg 2007 Wounds, Wound Healing And Suturing ELHAWARY
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    Suturing Materials &Techniques VERTICAL MATTRESS SUTURES Wounds, Wound Healing And Suturing ELHAWARY
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    Dr. Hesham El-Hawary Fromthe inner aspect Ass. Prof OMFS www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY
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    Thank you Dr. Hesham El-Hawary Ass. Professor OMFS Facebook: Hesham El-Hawary Twitter: @elhawary_hesham Email: hesham@elhawarydentalclinc.com Website: www.elhawarydentalclinic.com Wounds, Wound Healing And Suturing ELHAWARY