Sutures 08 Sutures skid pan

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Sutures 08 Sutures skid pan

This subsection has text from an interactive multimedia training program on basic 
surgical skills called PrimeSkills in Surgery.
You can use this subsection on its own or follow the whole program (further details at the end of 
this subsection).


The aim in this skid pan is for you to safely work within the limits of the strength and characteristics of


sutures.


The method is for you to go beyond these limits on the work bench and not in the operating theatre.


Use this skid pan as often as you wish until you feel confident.


Use 3/0 Vicryl (Ethicon W9890) as a standard.


1 Break an unknotted suture.


Hold the suture between an artery forcep and a needle holder.


Steadily increase the pull until the suture breaks.


Vicryl will stretch slightly and Prolene gives a slight springiness before breaking.


Usually, however, breakage happens without warning.


This will be at about 2500gm.


2 Break a knotted suture.


Tie a simple overhand knot in the suture.


Hold the knotted suture between an artery forcep and a needle holder.


Steadily increase the pull until the suture breaks.


This will be at about 2000gm. i.e. 500gm. less than the unknotted suture.


3 Break the swage.


Tie a simple overhand knot in the suture.


Hold the needle with a needle holder.


Hold the knotted suture with an artery forcep.


Steadily increase the pull until the suture breaks away from the needle.


The swage will not give any warning before it breaks.


This will be at about 1000gm. i.e. 1000gm. less than the knotted suture.


4 Crush the suture with needle holders.


Crush the unknotted suture as hard as possible once with the needle holder.


Hold the suture between an artery forcep and a needle holder.


Steadily increase the pull until the suture breaks.


This will be at about 2800gm. i.e. 200gm. less than the strength of an undamaged suture.


Next subsection, click on Sutures 09 Exercises
Last subsection, click on  Sutures 07 How to use sutures
Surgical Education and Training page, click on Surgical Education and Training
Whole program on WikiSurgery, click on PrimeSkills in Surgery
Whole program on CD-ROM, click on Michael Edwards