How To Suture: Intro To Suturing Like a Surgeon

What's up, guys? Hello, it's good luck. Thanks for watching this video. This video explains how to

suture

with a

surgeon

. So this video is actually going to be a quick and dirty guide on how to

suture

. This is the first video in a series of videos that will teach you about

suturing

, instruments with

suturing

materials and all that good stuff. I would like to thank the people at Medical Creations for supporting my channel by sponsoring this video and for sending me this suture kit that I will be using today. what you get here is a nice little kit like that, so what you get in this kit is a pair of forceps, these are adsence, a hemostatic scalpel with a needle driver and scissors, perfect, you also get a bunch of sutures and one of these pads to fit. wrong, actually this is the old style pad, this is the new way, it's a fantastic little kit if you want to learn and practice at home and the company is called medical creations so let's get to it.

I'm going to get out my healing controller here and my 4 step and some scissors and I already opened a pack of extras on 4 or ring silk suture, I go over the types of sutures and the needles and all that later, but on this one I want to get to To the fun stuff that is Suturing Real Quickly, let's talk about how to place the needle in the needle holder. You wanted an angle of about 90 degrees. Sometimes I angle forward a little bit and that's just because my arms are triangulating the spot I want it to provide. a 90 degree angle to the actual incision site, so sometimes the second thing is how to hold the needle driver.

You should place your thumb and ring finger on the needle driver, not your index finger here, or your index or middle finger on the other. The way you can do it is the way I do it: you put the needle driver in your palm like that and then that gives you more degrees of freedom because you can actually twist it like that, but when you start, if you want, do it. those two that's okay now this is a pick this is a matsan pick because it has teeth this is specifically for the skin so you want to use the tooth pick with skin so if I'm going to try to close this incision right here I'm going to take this screwdriver needle driver and I want to put my finger as close to the tip of the needle driver as possible, that actually makes the tip of the needle driver more stable and therefore the needle more stable and more things you can about rest. hands, elbows or wrists, the more stable you are, I rotate my wrist like this and take the needle so it goes in about 90 degrees to the skin, once it's at the depth I like, I rotate my wrist, okay and I see the needle coming out, you can close the incisions with one or two bites and in this one I'm going to do two bites and you'll notice that what I'm going to do here is pull the needle out a little bit and then I'm going to grab the needle exactly where I want to grab it. for the next bite and that's about two thirds of the way back and at the tip of the needle driver two thirds of the way back on the needle and now what I do is I have this exactly where I want it, this is the nice thing about patting is that I slowly lift it to the right, turn it and I'm actually ready for the next bite.

There it is and I notice I'm getting pale, so I can do this move once I put it on. the second side I can go ahead and put this out now. I don't have to actually hold the needle with my forceps. The reason is that once you put the needle into the tissue, the tissue should remain stable unless the patient is moving all over the place and second. it will stay stable if you hold it with the pliers, so you should hold the fabric with the pliers and not the needle with the force pointing up and if you hold the fabric in place and release the needle, the needle should stay just inside. place and then you can lift it up again, now I can pull it out a little bit more.

I'm going to grab it right where I want the needle driver to go for the next bite, but I'm not actually going to do the next bite because we're going to tie this, so here's another tip, a lot of students I see we have this long suture here, a lot of people like to pull that high, sure, you're going to touch your face, you're going to hit someone else's face if you're doing a real procedure, you're going to do it unsterilized, you're going to place this suture somewhere other than sterile, so here's a little tip, what you can do is just put your four steps here, okay?

You pull this and you want to lower this suture until you have a few centimeters out and the suture is sticking up, that will help you later, so I'm going to release the needle with this hand and now the needle. It's not really that dangerous when it's not attached to something, if it's attached to this you know you can stick someone, so as long as the needle is hanging it usually doesn't cause any damage, it won't go through anything, so what? What I do here is I usually grab a couple of palm links and I'm also palming the clamps with my left hand.

Okay this is right handed and all I do is just place the screwdriver between the tail and the length of the suture and the first one I usually do two turns so this is pretty typical look how long I have a lot of students make a mistake, they do this and then they have nothing, it is tight and they will get stuck. these jaws and when you open them they get caught or trapped. The knees back here make a nice big loop and then when you bring it in, okay, I brought it in behind, I start making that loop and then look how big that loop is. is and then I make another loop and that's nice and big and then I take this tip here that's stuck up for me and then I pass this and I pull it nice and then I put this on and you pull it a little bit a little tight not too tight just approximating the tissue you don't want to strangle the tissue to secure this suture so it doesn't come out on my next cast.

I pull it like this, squeeze it like this and you can even set it up. air it a little bit so that way it's not on the skin and then what I'm going to do is I'm going to put my needle between the long end and the tail again and I'm going to make this big loop. I don't care if it's too big but I don't want too small and then I'm going to do it and this will secure that now going back and forth and I'm going to do a square knot so now I'm going to go this way I didn't lift it up in the air it's okay, bang um um back and forth, okay, maybe I have too much there, but that's essentially a simple suture.

Now this is what we call a simple interrupted suture or no suture. I guess there are a lot of different types of sutures that are tied and sutured and we'll go over them in my other videos, but I'll just do a couple more for you to see and point out a few others. things like that I do it with the palm. I can get more rotation when I palm, that's why I do that. Your assistants might not like that at first, so you might have to put your thumb and ring finger in there, but practice with Paul at home, okay? now I'm just going to do a cross bite here, I'm going to get it up there, come on, okay, not much came out there and I don't have to hold this tissue with this thing, but you might have to.

I hold the scarf to keep the needle in the same place, so if I hold the scarf with this, I pull this across, I set this side of the fabric, these needles are not going anywhere, so I'll pull it out with just a tap, so I'm going to go and I'll be right there because two-thirds of the way back is where I want to grab it right there, okay, and I'm going to get ahead and in this house, what happens in the palm of your hand sometimes is trying to be elegant and I can do this maneuver, this is a long suture, normally you don't use a suture that long, but it's nice that it comes in this kit because you can practice more, so the other thing you want to do is you don't really want to touch the needle too much. because the more you touch it, the more chance you have of getting stuck, so what you can do is grab this suture here or with your finger, lift it up, and then put the needle in a place that you think you can't. you can lift it up, in fact, you can just grab it a little bit, not hold it all the way down, okay, and then turn it a little bit if you want, so this is going to be a figure eight suture stitch.

I'm going to two of them, side by side, this is used for a long time to ligate a blood vessel, put the blood vessel right in the middle there. I also use it for my abdominal incisions which are poor sites for a 12 millimeter port for a laparoscope, so it's called a figure eight because we're going to make a figure eight with that. Look, it looks like an eight, almost more like an lower it with silk, you don't necessarily need to do many casts, usually most people say three, four silk and four, four Vicryl. I usually do four and five extra security. doing just a little bit more so you can watch and you don't have to go back and forth with the silk because it's a polyfilament suture which I'll talk about in the other videos as well, you can do that if you want, okay. that's a lot, you don't really need that many, okay, that's the basics of suturing, now you know how to do it.

I'm going to talk about how to tie hands and different types of sutures and things like that and the other videos, so go ahead. check out those videos and I'll see you in the next one anyway, that's how to suture with a

surgeon

, that's quick and dirty, and I'll see you in the next video. Don't forget to subscribe, like, share, comment below, thanks guys. Too much to watch, see you next time.