How to Tie Knots Like a Surgeon: 4 Common Stitches

Buck Parker, M.D.
30 Oct 201914:54
EducationalLearning
32 Likes 10 Comments

TLDRIn this informative tutorial, Dr. Buck guides viewers through various suturing techniques, focusing on the running suture, interrupted suture, vertical mattress, and horizontal mattress stitches. He emphasizes the importance of not strangulating tissue with sutures and provides tips for efficient suturing, such as using a one-handed knot and managing suture length. The video also showcases how to apply a locking stitch for hemostasis in cases of heavy bleeding, particularly on the scalp. Dr. Buck demonstrates the horizontal mattress stitch for distributing tension across a larger area and the vertical mattress stitch for approximating edges under tension. He advises caution with mattress sutures to avoid constricting blood vessels. The video is sponsored by Medical Creations, offering a comprehensive suture kit with a discount code for viewers.

Takeaways
  • ๐Ÿงต The video discusses various types of suturing techniques, including running suture, interrupted suture, vertical mattress, and horizontal mattress.
  • ๐Ÿ“ฆ Dr. Buck is sponsored by Medical Creations, which provides a suture kit that includes a pad, sutures, and scalpels with a discount code mentioned in the video.
  • ๐Ÿฉบ The importance of using the correct suture material is highlighted, with nylon monofilament being used in the demonstration.
  • ๐Ÿ‘† Demonstration of how to properly place a needle on the needle driver, emphasizing positioning and angle for stability.
  • ๐Ÿคš Techniques for one-handed knot tying are shown, with a focus on not strangulating the tissue to maintain blood supply.
  • ๐Ÿ”„ Tips for managing the suture thread during the procedure, including winding it around the hand for better control.
  • ๐Ÿฉน The running stitch is explained as a continuous stitch without tying after each pass, which can speed up the suturing process.
  • โœ‚๏ธ Interrupted sutures are tied individually and are simpler, often used in situations where multiple sutures are applied simultaneously.
  • ๐Ÿ›ก๏ธ Mattress sutures, both vertical and horizontal, are used for areas with tension, providing extra strength to prevent the suture from pulling through the tissue.
  • ๐Ÿ“ Horizontal mattress sutures distribute force over a larger area to reduce pressure and tension on the tissue.
  • ๐Ÿ” Vertical mattress sutures are used to approximate edges tightly, useful for areas that are difficult to bring together, but care must be taken not to apply too much tension.
Q & A
  • What is the name of the person presenting the suture tutorial in the video?

    -Dr. Buck

  • What are the different types of suturing techniques discussed in the video?

    -The video covers running suture, interrupted suture, vertical mattress, and horizontal mattress techniques.

  • What is the material of the suture used in the video?

    -The suture used in the video is made of nylon, which is a monofilament.

  • What is the term used for a running suture when it is used in an emergency situation like a severe head wound?

    -It is sometimes referred to as a 'whip stitch'.

  • How should the needle be positioned on the needle driver for optimal control?

    -The needle should be as close to the tip of the needle driver as possible, with about two-thirds of the needle shank on the way back and at a 90-degree angle.

  • What is the importance of not tying the suture too tight when suturing tissue?

    -Tying the suture too tight can strangulate the tissue, cutting off blood supply and leading to tissue death, which can cause the suture to come out and the wound to open.

  • What is the purpose of a locking stitch in suturing?

    -A locking stitch is good for hemostasis, especially in areas like the scalp where bleeding can be heavy. It helps to secure the suture more effectively.

  • How does the interrupted suture differ from the running suture?

    -An interrupted suture is done by itself and tied at each point, whereas a running suture involves placing multiple sutures in a row without tying after each one.

  • Why are mattress sutures beneficial for areas with high tension?

    -Mattress sutures, both vertical and horizontal, help distribute the tension across a larger area, reducing the force on any single point and making it less likely for the suture to pull through the tissue.

  • What is the main difference between a vertical mattress suture and a horizontal mattress suture?

    -A vertical mattress suture involves two sutures on each side of the wound, one far and one near, creating a 'box' effect. In contrast, a horizontal mattress suture involves a single suture that goes across the wound, distributing the force along a horizontal plane.

  • What is the recommended way to manage the suture during the procedure to avoid contamination?

    -The suture should be controlled by winding it up in the hand or using the forceps to hold the tissue, ensuring that the loop does not get caught on something and that the unsterile portion of the field does not come into contact with the suture.

Outlines
00:00
๐Ÿ˜€ Introduction to Suturing Techniques

Dr. Buck introduces various suture techniques in this tutorial video. He begins by showing his suture kit from Medical Creations, which includes a pad, sutures, and scalpels. He highlights the importance of using the right tools such as a needle driver and forceps. The video covers different types of sutures including running suture (also known as whip stitch), vertical mattress, and horizontal mattress. Dr. Buck emphasizes the need for careful handling to avoid damaging tissue and ensuring proper blood supply to the tissue.

05:02
๐Ÿ“š Running Suture and Interrupted Suture Techniques

The paragraph explains the process of performing a running suture, which involves continuous stitching without tying after each stitch. Dr. Buck demonstrates how to attach the needle to the needle driver and execute the stitch with precision. He also discusses the use of a one-handed knot for securing the suture. Furthermore, he explains the concept of interrupted sutures, where each stitch is tied individually. The paragraph also touches upon locking stitches, which are beneficial for hemostasis in cases of heavy bleeding, particularly on the scalp.

10:03
๐Ÿ› ๏ธ mattress Sutures for Tension Management

Dr. Buck moves on to mattress sutures, which are used when there is tension on the wound that makes it difficult to approximate the edges. He differentiates between vertical and horizontal mattress sutures, explaining that the horizontal mattress provides extra strength by distributing force over a larger area, which is useful in situations with high tension. The vertical mattress is described as being particularly effective for bringing wound edges together firmly. Caution is advised while tying these sutures to avoid constricting blood vessels and causing tissue death. The paragraph concludes with a reminder to subscribe and a thank you to the sponsor, Medical Creations.

Mindmap
Keywords
๐Ÿ’กSuturing
Suturing refers to the process of using stitches to close a wound or coapt the edges of a surgical incision. In the video, Dr. Buck demonstrates different suturing techniques, which are essential for medical professionals to manage wounds effectively and promote healing.
๐Ÿ’กRunning Suture
A running suture, also known as a whip stitch, is a technique where stitches are placed continuously along the wound without tying a knot after each one. It is used when speed is necessary, such as in emergency situations, and is demonstrated by Dr. Buck in the tutorial.
๐Ÿ’กInterrupted Suture
An interrupted suture involves placing and tying individual stitches separately along a wound. Each stitch is independent, which allows for adjustments if one stitch fails. Dr. Buck shows how to perform this type of suture in the video, emphasizing its simplicity and common use in surgery.
๐Ÿ’กVertical Mattress Suture
The vertical mattress suture is a type of suturing that brings the edges of a wound together with two sutures on each side, creating a 'box' effect. It is particularly useful for areas under tension, as it helps to distribute the tension more evenly. Dr. Buck explains its application and the importance of careful tension to avoid tissue damage.
๐Ÿ’กHorizontal Mattress Suture
A horizontal mattress suture is used to approximate tissue that has some tension, preventing the suture from pulling out. It spreads the force across a larger area, reducing pressure and tension on the tissue. Dr. Buck demonstrates this technique, noting its utility in situations where standard sutures might not hold due to tension.
๐Ÿ’กNeedle Driver
A needle driver is a surgical instrument used to hold and maneuver the suturing needle. In the video, Dr. Buck uses a needle driver to precisely place the sutures, emphasizing the importance of handling the needle correctly to avoid contamination and ensure a secure stitch.
๐Ÿ’กForceps
Forceps are a type of surgical instrument used to grasp, hold, or manipulate tissue during surgery. Dr. Buck mentions using an Adson forceps, which are specifically designed for fine manipulation and are used to hold the tissue steady while suturing.
๐Ÿ’กScalpel
A scalpel is a small, sharp blade used for cutting through skin and other tissues during surgery. Although not the primary focus of the video, Dr. Buck mentions scalpels as part of the suture kit provided by Medical Creations, indicating their broader use in surgical procedures.
๐Ÿ’กSuture Kit
A suture kit is a collection of instruments and materials needed to perform suturing, typically including sutures, a needle driver, forceps, and sometimes scalpels. Dr. Buck introduces a suture kit from Medical Creations, which is used to demonstrate the suturing techniques in the video.
๐Ÿ’กKnot Tying
Knot tying is a critical skill in suturing, as it secures the suture in place. Dr. Buck demonstrates one-handed knot tying techniques, which are efficient and minimize the risk of contaminating the surgical site. Proper knot tying ensures that the wound edges stay approximated during the healing process.
๐Ÿ’กHemostasis
Hemostasis refers to the process of stopping or controlling bleeding during surgery. Dr. Buck discusses the use of a locking stitch for hemostasis, particularly in cases of heavy bleeding from the scalp, highlighting its importance in managing bleeding quickly and effectively.
Highlights

Dr. Buck introduces a suture tutorial video covering different types of suturing techniques.

Suturing techniques include running suture, interrupted suture, vertical mattress, and horizontal mattress.

The video is sponsored by Medical Creations, providing a suture kit with a discount code for viewers.

Nylon monofilament suture, commonly used in hospitals, is demonstrated with different colors available from various manufacturers.

Running stitch, also known as whip stitch, is explained with its application in emergency situations.

Technique for attaching the needle to the needle driver is shown, emphasizing stability and precision.

Importance of not strangulating tissue with sutures to maintain blood supply is highlighted.

Assistants can help manage suture length, but if unavailable, the surgeon can self-manage.

Running stitch speed tips include grabbing the needle in the correct spot for the next stitch.

Locking stitch is introduced as an option for hemostasis in cases of heavy bleeding, like scalp wounds.

Interrupted suture technique is demonstrated, used when closing bowels or when multiple sutures are needed.

Mattress sutures are shown to be effective for areas with tension, with a focus on horizontal mattress first.

Horizontal mattress suture helps distribute forces over a larger area, reducing pressure and risk of suture pull-through.

Vertical mattress suture is detailed for situations where tissue edges need to be approximated under tension.

Care must be taken when tying mattress sutures not to constrict blood vessels to the point of tissue death.

The video concludes with thanks to the sponsor and an invitation for viewers to subscribe and watch future videos.

Transcripts
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