Click here to see...

Yeah

This is COOL!

Posted: 10 January, 2010 - 04:28pm
by: Dr. P

Hi

Hi there

Posted: 26 August, 2008 - 09:36am
by: Ricky

Hi Maryam

Do you have an e-mail address? Kindly forward your e-mail address via "contact us" on the mail menu bar of this website.

Posted: 25 August, 2008 - 01:28pm
by: Dr Anton

Click here to have your say...

Click here to be included...

This is a project that you will not find on The Apprentice Doctor® "How to Stitch-Up Wounds" Suturing Course CD-ROM. So if you already have the Suturing Course, this is for you. If you do not have your own set, you probably won't follow what we're talking about below. If you would like to complete this project and understand all the words and concepts covered in it, I strongly recommend you consider ordering a kit for yourself.

INFORMATION

• Patients who are hypersensitive or allergic to commonly used resorbable suture materials (resorbable materials are absorbed over time by the body and do not need to be removed by a medical practitioner)
• Dehiscence of a previously sutured wound (dehiscence is when a wound opens again after the sutures are removed)
• Closing a skin wound where uneven margins or a dog's ear defect is anticipated e.g. a round/elliptical defect
• Some operators use the figure 8 suture as the suturing method of choice when suturing skin wounds/lacerations

REQUIREMENTS

1.    The Suture Kit

1.1.    Tissue forceps

1.2.    A suture needle with an eye

1.3.    Suture thread

1.4.    A needle holder

1.5.    Imitation skin

2.    Good lighting

Use the needle with suture material attached, clipped to the needle holder (see Project 2 and 3 on the CD-ROM)

Use the imitation skin (see Project 4) with the ±7 cm (2,5 inch) cut representing a surgical incision or a laceration in the skin.

You'll start the suture in the region of one of the positional markings on the laceration on the imitation skin, on the far side.

Evert the far side of the laceration with the tissue forceps and insert the needle between five and ten millimeters (about a quarter inch) away from the wound edge.

STEP 4

Take a bite in the depth of the subcutaneous tissue on the near side, twisting the needle to let the needle-tip emerge just below the dermis.

Now mirror the bite on the far side allowing the needle to emerge in the depth of the sub-cutaneous tissue

STEP 6

Place the last section of the suture by penetrating the tissue on the near side just below the dermis, with the needle facing upwards. Allow the needle tip to emerge about three millimeters away from the edge of the wound on the near side.

Tie an "Instrument Square Knot" (see "Project Epsilon") or a Surgeons Knot (see "Project Zeta"). Cut both ends of the suture leaving at least three millimeters of suture material beyond the knot.

Place a second figure-8 suture about three millimeters to the right of the first suture by repeating Steps 4 and 5.

Follow with another couple of figure-8 sutures until you have closed the laceration.

When all is said and done, this is the path of the suture. In top left, then bottom right, then bottom left, then out top right.

POINTS OF INTEREST

• It is removable
  (traditional subcutaneous sutures cannot be removed and need to be resorbable, in other words it must be made of material that can be absorbed by the body's tissue enzymes)
  
• It allows closure of two layers simultaneously
• Compared with the interrupted stitch, ischemia at the edge of the suture is reduced (ischemia is a reduction in the blood supply to the body tissue)
• Being removable, one avoids burying foreign material in the depth of the tissue, minimizing the chances of developing a stitch abscess or related complications
• This technique enables any length difference between the flaps to be evened up when sutured
• It minimizes "dog's ear" defects

What are the disadvantages of using this technique?

• It is a more difficult technique to master and perform properly compared to the interrupted stitch
• Patients experience slightly more discomfort on stitch removal compared to the interrupted stitch

Conclusion

I've been busy recently converting The Apprentice Doctor® "How to Stitch-Up Wounds" Course into a hard-copy book which will be promoted by a really huge publishing company which I can't name right now.

Professor Lemmer was one of my medical school professors and he was kind enough to write this foreword to my new book...

"In any practical endeavor, from writing a book, to painting a picture, to performing a surgical operation, knowledge of the subject, no matter how profound, can never by itself lead to a satisfactory outcome. A sound grounding in the basic skills of the discipline is an essential prerequisite.

Technical skill is the handmaiden of all knowledge applied to practical ends. In the field of practical surgery, suturing technique is the most basic skill, yet all too often, even for those at an advanced level of surgical training, special courses in surgical techniques are sometimes found to be necessary to make up for deficiencies in earlier training.

Dr Anton Scheepers, a practicing maxillofacial and oral surgeon of many years experience, has reduced the topic of surgical suturing in all its variety to basic step-by-step technique, with comments on wound care, and has presented this in a form that will be both educational and skill-promotive.

This manual can serve as an appetite-whetter for high school students interested in careers in any clinical field, as a revision for medical, dental, veterinary and paramedical practitioners, and - dare one say? - it might even be useful in junior specialist surgical training.

The author is to be commended."

J. Lemmer
- Professor Emeritus of Oral Medicine and Periodontology, University of the Witwatersrand, Johannesburg
- Honorary Professor of Periodontology and Oral Medicine
- Honorary Fellow of the Colleges of Medicine

Those of you who have already worked through the "How to Stitch-Up Wounds" kit, I would like your opinion on this project.

Did you find it interesting? A bit more challenging than the other projects?

Let me know in the comments section below.

As always, wishing you all the best,

Dr Anton

This Letter from the Doc was submitted on 12 August, 2008 at 08:19am

Yeah

This is COOL!

Posted on: 10 January, 2010 at 04:28pm
By: Dr. P

Hi

Hi there

Posted on: 26 August, 2008 at 09:36am
By: Ricky

Hi Maryam

Do you have an e-mail address? Kindly forward your e-mail address via "contact us" on the mail menu bar of this website.

Posted on: 25 August, 2008 at 01:28pm
By: Dr Anton

Too Young to Do Anything

Dear Doc,
I'm only ten years old and already am a straight A student. But is there anything else I can do to help me become a Naentologist?

Posted on: 23 August, 2008 at 05:13pm
By: Maryam

Wow!

I can understand the stitching, the technique, and the reasons, but I'll never do it in a million years, 'cos I'll be spending too much time unconscious on the surgery floor.
Some of your Youtube videos, and E.R and even Grey's Anatomy freak me out when it gets all tense and blood-covered everywhere.

But my point is that I admire and respect what doctors, surgeons and nurses can do.
So, study hard y'all and keep up the great work, Doc!

Posted on: 12 August, 2008 at 01:41pm
By: Scared_o_needles

Thanks

This was quite difficult but I think I managed to do it. you're right it's just like the two methods on the CDROM, only combined. Ill have to keep practicing.

Posted on: 12 August, 2008 at 08:49am
By: Ricky