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Technical Skills – Session 1

Technical Skills – Session 1. Open Basic Suturing Skills. Prep date:Wednesday August 6 th 2008 Instruction/practice date: August 13 th , 2008 Fontbonne Rm 3, St. Joseph Hospital McMaster University. Important Details. PGY1s, need to know where Fontbonne 3 is Come in greens

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Technical Skills – Session 1

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  1. Technical Skills – Session 1 Open Basic Suturing Skills Prep date:Wednesday August 6th 2008 Instruction/practice date: August 13th, 2008 Fontbonne Rm 3, St. Joseph Hospital McMaster University

  2. Important Details • PGY1s, need to know where Fontbonne 3 is • Come in greens • Practice knot tying before you come – we want to see slick, quick knots • PGY2s, will be paired with PGY1s (same pairings as before) for help/supervision.

  3. Important Details • PGY 2s – January presenters (you will be identified and reminded soon): • Need your topics by Sept 5th • If you don’t have a topic, let us know

  4. Goals and Objectives PGYI/II To learn: • One handed and two handed ties • Instrument ties • Suturing technique • Basic stitches • Simple • Running • Subcuticular • Simple Flap construction

  5. Goals and Objectives PGYI • All residents: • practice suturing and tying on turkey skin • Tasks: • Single straight incision, wavy incision Simple interrupted, running and subcuticular • Circle anastomosis Simple interrupted sutures • Z-Plasty, V-Y advancement, Limberg Simple interrupted • Ortho and Plastics residents • Practice stitching tendons on Pig Hocks • advice-teaching from PGYIIs

  6. Goals and Objectives PGYII • To practice suturing and tying • To teach and supervise PGYIs • To try more difficult suturing tasks

  7. Goals and Objectives PGYII • All residents: • Practice suturing and tying on turkey skin • Complex shape • Z-plasty • V-Y advancement flap • Limberg Flap • Plastics/Urology/Gen Surg • Vascular anastomosis if time permits • Orthopaedics/Plastics • Tendon anastomosis

  8. Session Stations • Basic knot-tying station • Practice your one and two-handed ties • Turkey Skin • Suturing on a simple surface Can use this for the Flap sessions • Sheep Lung • Model for thick tissue (thanks to John Evans) Practice deep sutures, follow the curve, don’t “hork” • Pig Hocks • Tendon suturing and thick skin suturing

  9. Evaluation You will be evaluated by: • How well you tie knots. Ensure that an evaluator observes you tying slick, quick one and two-handed knots • How well you suture • Technique (holding the instrument, trajectory of needle, economy of movement and accuracy [placement, spacing etc]) • How much and how well you get stuff done • PGYIIs, by your ability to supervise??

  10. The One Handed Knot -Step 1

  11. The One Handed Knot -Step 2

  12. The One Handed Knot -Step 3

  13. The One Handed Knot -Step 4

  14. The One Handed Knot -Step 5

  15. The One Handed Knot -Step 6

  16. The One Handed Knot -Step 7

  17. The One Handed Knot -Step 8

  18. The One Handed Knot -Step 9

  19. The One Handed Knot -Step 10

  20. The Two-Handed Knot -Step 1

  21. The Two-Handed Knot -Step 2

  22. The Two-Handed Knot -Step 3

  23. The Two-Handed Knot -Step 4

  24. The Two-Handed Knot -Step 5

  25. The Two-Handed Knot -Step 6

  26. The Two-Handed Knot -Step 7

  27. The Two-Handed Knot -Step 8

  28. The Two-Handed Knot -Step 9

  29. The Two-Handed Knot -Step 10

  30. The Two-Handed Knot -Step 11

  31. The Two-Handed Knot -Step 12

  32. The Two-Handed Knot -Step 13

  33. The Two-Handed Knot -Step 14

  34. Z-Plasty

  35. Limberg Flap

  36. V-Y Advancement Flap

  37. Tendon Repair Stitch

  38. Resources for self-directed learning • The web • Many videos already made on how to tie surgical knots (one and two handed and instrument ties) • These slides will be available to you by email. URL: http://video.google.ca/videoplay?docid=8499774419188060835&q=surgical+knot+tying&ei=Vn-XSKTVEYXS-gHYru2gBg&hl=en

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