Suture Set Basic
This suture set, with a skin – small animal, an instrument kit and surgical suture, contains everything needed to get started in the training of basic suture techniques. In addition to our practical suture pad holder and the suture pad small animal, the basic sewing kit also includes surgical instruments and surgical sutures, enabling you to easily start professional training in suture techniques.
The suture kit includes a surgical tweezer, a curved scissor, a needle holder according to Mayo-Hegar and a scalpel. The surgical suture consists of two needle thread combinations with cutting needles. Our suture pads are reusable, tear-resistant and retain their shape and texture even after repeated use. With the practical pad holder the suture pad can be mounted in a vertical or a horizontal position, as required.
Content
skin - small animal
pad holder (S)
needle holder Mayo-Hegar
surgical scissor
surgical tweezer
scalpel
2 needle thread combinations
Surgical Suture: Types, Vs. Stitches, More
Sutures are medical tools used by doctors and surgeons to close a wound. Depending on your condition, a doctor will use the proper suture technique and material to stitch a wound or laceration shut.
Sutures are used by your doctor to close wounds to your skin or other tissues. When your doctor sutures a wound, they’ll use a needle attached to a length of “thread” to stitch the wound shut.
There are a variety of available materials that can be used for suturing. Your doctor will choose a material that’s appropriate for the wound or procedure.
Types of sutures
The different types of sutures can be classified in many ways.
First, suture material can be classified as either absorbable or nonabsorbable.
Absorbable sutures don’t require your doctor to remove them. This is because enzymes found in the tissues of your body naturally digest them.
Nonabsorbable sutures will need to be removed by your doctor at a later date or in some cases left in permanently.
Second, the suture material can be classified according to the actual structure of the material. Monofilament sutures consist of a single thread. This allows the suture to more easily pass through tissues. Braided sutures consist of several small threads braided together. This can lead to better security, but at the cost of increased potential for infection.
Third, sutures can be classified as either being made from natural or synthetic material. However, since all suture material is sterilized, this distinction is not particularly useful.
Types of absorbable sutures
Gut. This natural monofilament suture is used for repairing internal soft tissue wounds or lacerations. Gut shouldn’t be used for cardiovascular or neurological procedures. The body has the strongest reaction to this suture and will often scar over. It’s not commonly used outside of gynecological surgery.
Polydioxanone (PDS). This synthetic monofilament suture can be used for many types of soft tissue wound repair (such as abdominal closures) as well as for pediatric cardiac procedures.
Poliglecaprone (MONOCRYL). This synthetic monofilament suture is used for general use in soft tissue repair. This material shouldn’t be used for cardiovascular or neurological procedures. This suture is most commonly used to close skin in an invisible manner.
Polyglactin (Vicryl). This synthetic braided suture is good for repairing hand or facial lacerations. It shouldn’t be used for cardiovascular or neurological procedures.
Types of nonabsorbable sutures
Some examples of nonabsorbable sutures can be found below. These types of sutures can all be used generally for soft tissue repair, including for both cardiovascular and neurological procedures.
Nylon. A natural monofilament suture.
Polypropylene (Prolene). A synthetic monofilament suture.
Silk. A braided natural suture.
Polyester (Ethibond). A braided synthetic suture.
Sutures vs. stitches
You’ll often see sutures and stitches referred to interchangeably. It’s important to note that “suture” is the name for the actual medical device used to repair the wound. The stitching is the technique used by your doctor to close the wound.
Suture selection and techniques
Suture material is graded according to the diameter of the suture strand. The grading system uses the letter “O” preceded by a number to indicate material diameter. The higher the number, the smaller the diameter of the suture strand.
Suture material is also attached to a needle. The needle can have many different features. It can be of various sizes and also have a cutting or noncutting edge. Larger needles can close more tissue with each stitch while smaller needles are more likely to reduce scarring.
Just like there are many different types of sutures, there are many different suture techniques. Some of them are:
Continuous sutures
This technique involves a series of stitches that use a single strand of suture material. This type of suture can be placed rapidly and is also strong, since tension is distributed evenly throughout the continuous suture strand.
Interrupted sutures
This suture technique uses several strands of suture material to close the wound. After a stitch is made, the material is cut and tied off. This technique leads to a securely closed wound. If one of the stitches breaks, the remainder of the stitches will still hold the wound together.
Deep sutures
This type of suture is placed under the layers of tissue below (deep) to the skin. They may either be continuous or interrupted. This stitch is often used to close fascial layers.
Buried sutures
This type of suture is applied so that the suture knot is found inside (that is, under or within the area that is to be closed off). This type of suture is typically not removed and is useful when large sutures are used deeper in the body.
Purse-string sutures
This is a type of continuous suture that is placed around an area and tightened much like the drawstring on a bag. For example, this type of suture would be used in your intestines in order to secure an intestinal stapling device.
Subcutaneous sutures
These sutures are placed in your dermis, the layer of tissue that lies below the upper layer of your skin. Short stitches are placed in a line that is parallel to your wound. The stitches are then anchored at either end of the wound.
Suture removal
When your sutures are removed will depend on where they are on your body. According to American Family Physician, some general guidelines are as follows:
scalp: 7 to 10 days
face: 3 to 5 days
chest or trunk: 10 to 14 days
arms: 7 to 10 days
legs: 10 to 14 days
hands or feet: 10 to 14 days
palms of hands or soles of feet: 14 to 21 days
To remove your sutures, your doctor will first sterilize the area. They’ll pick up one end of your suture and cut it, trying to stay as close to your skin as possible. Then, they’ll gently pull out the suture strand.
Suture bones
You may have heard the word “sutures” in reference to a bone or bones. This is because the area where the bones of your skull meet is called a suture. Your skull has many of them. They allow the skull to increase in size throughout development and then fuse together when growth is complete. This is not related to the sutures that a physician or surgeon may place to close a wound.
The takeaway
Sutures are used by your doctor to stitch shut wounds or lacerations. There are many different types of suture materials available. Additionally, there are many suture techniques that can be used. Your doctor will choose both the correct suture material and technique to use for your condition. Talk to your doctor about any concerns you have about sutures before your procedure.
Surgical instrument
Tools designed for use during surgery
A surgical instrument is a medical device for performing specific actions or carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it.[1] Over time, many different kinds of surgical instruments and tools have been invented. Some surgical instruments are designed for general use in all sorts of surgeries, while others are designed for only certain specialties or specific procedures.
Classification of surgical instruments helps surgeons to understand the functions and purposes of the instruments. With the goal of optimizing surgical results and performing more difficult operations, more instruments continue to be invented in the modern era.[2]
History
Many different kinds of surgical instruments and tools have been invented and some have been repurposed as medical knowledge and surgical practices have developed. As surgery practice diversified, some tools are advanced for higher accuracy and stability while some are invented with the completion of medical and scientific knowledge.
Two waves in history contributed significantly to the development of surgical tools.
In the 1900s, inventions of aseptic surgeries (maintenance of sterile conditions through good hygiene procedures) on the basis of existing antiseptic surgeries (sterilization of tools before, during, and after surgery) led to the manifestations of sale and use of instrument sterilizers, sterile gauze, and cotton. [3] Most importantly, instruments were advanced to be readily and effectively sterilized by replacing wooden and ivory handles with metals.[3] For safety and comfort concerns, the tools are made with as few pieces as possible.[3]
Hand surgery emerged as a specialty during World War II, and the tools used by early hand surgeons remain in common use today, and many are identified by the names of those who created them.[citation needed]
Individual tools have diverse history development. Below is a brief history of the inventors and tools created for five commonly used surgical tools.
Knife to scalpel to electrocautery
Primitive knives were made of perishable materials such as sharp leaf margins or bamboo.[5] After the Dark Ages, Muslims, and later European countries started to develop surgical instruments, scalpels, for cutting.[5]
In 1904, King Gillette developed a double-edged safety razor blade with a disposable blade.[5] After 10 years, Morgan Parker, an engineer, developed and patented another type of disposable scalpel, consisting of an overlapping blade locked into a metal handle that allows for easily replacing dull and used blades with fresh sterile blades.[5] Compared to the Gillette ones, this new blade provides stability whilst still being able to exchange blades between uses.[5]
Despite the knowledge that heat can control bleeding since the sixth-century BC, it was not until the 18th-century that people started to use electricity to generate heat for cautery. William Stewart Halsted was the pioneer of the technique, which later was called Diathermy.[6]
In 1900, physician Joseph Rivière used electrical current to treat a benign carcinomatous ulcer on the dorsum of his patient's hand.[7] Then in 1907, Physician Karl Franz Nagelschmidt used diathermy to treat lesions as well as the coagulation of vascular tumors and hemorrhoids.[8]
In the early 1900s, William T. Bovie proposed the use of different current (flow of electrical charge of the carrier) for cutting and coagulation.[5] Bovie collaborated with Dr. Harvey Cushing, which led to the birth of “Bovie”, a diathermy apparatus. It allows for careful dissection of tissue while maintaining hemostasis.[5]
Retractors
During the Renaissance, retractors were lacking so the surgeons uses their fingers to supply the necessary retraction of tissue exploration.[9] Albucasis, a pioneer of modern medicine, devised numerous hooks for surgical retraction including circumcisions, tracheostomies, hemorrhoidectomies, and central extractions in his famous book Al Tasreef Liman ‘Ajaz ‘Aan Al-Taleef around 1000 AD.[10]
In the 19th century, Doyen abdominal retractors were invented by French surgeon Eugène-Louis Doyen.[9] The doyen retractors are auto-static, self-retaining retractors that are used primarily in abdominal OB/GYN procedures. It facilitates the completion of difficult surgeries by providing improved exposure.[9]
In the late 19th century, Nicholas Senn, an early adopter of Listerism, felt that having a smooth surface on a surgical instrument was important to help to prevent infection.[9] Thus, he developed what is now called the Senn retractor, a double-ended retractor with an end of three bent prongs that may be dull or sharp, and it was often used in plastic or vascular surgery procedures.[9]
The Weitlaner retractor, invented by Franz Weitlaner in 1905, is a self-retaining, finger ring retractor with a cam ratchet lock used for holding back tissue and exposing a surgical site that allows the surgeon to activate using a single hand.[11] His invention inspired the invention of more retractors, such as Adson-Beckman retractors for general surgery and Chung retractors for orthopedic surgery. [9]
Forceps
Back in the 6th century BC, laboring caused a high mortality rate for both mothers and newborns due to the hours or days of the lasting delivery process.[12] This problem led to the establishment of forceps-assisted delivery in the 16th century by the Chamberlen family.[12] Forceps were later developed over several centuries by leading obstetricians of the time including James Simpson, Neville Barnes, and Christian Kielland.[13]
Michael Ellis DeBakey invented one of the most common and well-known DeBkey forceps.[14] The vascular atraumatic forceps (DeBakey)were widely used for grasping vascular tissue and causing minimal damage to the vessels.[14] This invention led to the development of the Dacron aortic graft for the repair of aortic aneurysms.
Around the mid 1900s, Alfred Washington Adson, a pioneer in neuroscience at Mayo Clinic, invented Adson forceps that allows the lifting and removal of neural tissue.[14]
Hemostats are forceps that aim to obliterate the lumen of vessels and to obtain adherence to the crushed surfaces and vascular hemostasis.[15] Originally, this notion of crushing did not exist and arterial catch forceps simply clamped vessels temporarily prior to ligature or cautery.[16]
In 1867, Eugene Koeberle, who accidentally found arterial forceps with a catch closure came away spontaneously without the need for ligature, and invented “pince hémostatique,” which have pin and hole catches. [17]
In 1882, the Kocher clamp was created by Emil Theodor Kocher, who significantly contributed to thyroidectomies (removal of all or a part of the thyroid gland) and decompressive craniotomy.[15] This invention decreases the risk of contamination while cutting dense tissue.
Later, Dr. William Henry Welch and William Stewart Halsted contributed to the invention of clamps and Halsted-Mosquito Hemostats, which were used to clamp small blood vessels.[15] Kelly clamp, invented by Howard Kelly, has similar functions but it can clamp larger vessels due to the slightly larger jaw.[18]
Accordingly, the nomenclature of surgical instruments follows certain patterns, such as a description of the action it performs (for example, scalpel, hemostat), the name of its inventor(s) (for example, the Kocher forceps), or a compound scientific name related to the kind of surgery (for example, a tracheotomy is a tool used to perform a tracheotomy).[19]
Classification
There are several classes of surgical instruments:[20]
Terminology
The expression surgical instrumentation is somewhat interchangeably used with surgical instruments,[26] but its meaning in medical jargon is the activity of providing assistance to a surgeon with the proper handling of surgical instruments during an operation, by a specialized professional, usually a surgical technologist or sometimes a nurse or radiographer.[27][28][29]
An important relative distinction regarding surgical instruments is the amount of bodily disruption or tissue trauma that their use might cause the patient. Terms relating to this issue are 'atraumatic' and minimally invasive.[30]
