Not made of reactive materials.

Chapter I

Preliminary.

Knowledge required suturing wounds in surgery because the surgery makes cuts and sutures aiming to reunite the severed tissue and improve the process of grafting and tissue healing and also prevents open wound that will result in the entry of microorganisms / infection.

Suturing material quality is covering certain conditions. The first is the convenience to be used or to be held. Then sufficient protection on each appliance. Should always sterile. Fairly elastic. Not made of reactive materials. Enough power to wound healing. The ability for biodegradation of chemicals to prevent the destruction of foreign bodies.

Chapter II

Suture material.

The use of tools and material quality tailoring is covering certain conditions. The first is the convenience to be used or to be held. Then sufficient protection on each appliance. Should always sterile. Fairly elastic. Not made of reactive materials. Enough power to wound healing. The ability for biodegradation of chemicals to prevent the destruction of foreign bodies.

II.a. Instruments.

1. Needle holder.

Another name or nald voeder needle holder.
Kind used varies, the type of wood Crille (shaped like a clamp) and the type of Mathew Kusten (triangular shape). To this the suturing needle holder as the holder of a sewing needle and thread as concluding.

                                                  Type of wood Crille

                                                   Mathew types Kusten

                                                       Needle Holder

2. Cut.

* Scissors Yarn.

There are two kinds of scissors thread scissors yarn is crooked and straight usefulness for thread cutting operation, smoothed the wound. Provision of each of the pieces.

* Cut out dissection.

Scissors, there are two types, namely straight and crooked. Usually tapered edges. There are two frequently used, the type and the type of Metzenbaum Mayo. The usefulness of this scissors is to open up the network, freeing small tumor from the surrounding tissue, to esksplorasi and smoothing the wound.

dissecting scissors

* Scissors bandages / dressings.

Usefulness is to cut bandages and plasters.

3. Knife Surgery.

      Consisting of two parts, namely the handle and the blade (mess / bistouri / blade). In the old model scalpels, blades and handles together, so that when the blades should be sharpened blunt back. In the new model, the blades can be replaced. Usually the blade is only to be disposable.

      There are two numbers handle of a knife that is often used, namely handles number 4 (for large blade) and the handle number 3 (for a small blade). This is in order scalpel to cut various organs / parts of the body. Blade adapted to the body part to be slashed.

                     

Knife Surgery.

Knife Surgery.

4. Clamp (Clamp).

* Clamps pean artery.

There are two types, namely straight and crooked. Its purpose is to hemostasis especially for thin and soft tissue.

* Clamps Kocher.

There are two types of clamps are straight and crooked. Not intended for hemostasis. Distinctive trait is to have teeth on the edges (like teeth on sirurgis tweezers). The point is to clamp the tissue, especially in order not to miss the tissue clamp, and this is made possible by the teeth on the tip of the clamp.

* Clamps Mosquito.

Similar to clamp the artery pean, but size, smaller. Its use is for hemostasis, especially for thin and soft tissue.

* Clamps Allis.

Its use is for soft tissue clamping and clamping a small tumor.

* Clamp Babcock.

Its use is to clamp tumor rather large and fragile.

* Towel clamp (clamp Doek).

Its use is to clamp doek / fabric operation.

5. Retractors (Wound Hook).

* Retractors langenbeck.

Its use is unfold the wound.

* US army double ended retractor.

Its use to uncover the wound.

* Retractors Volkman.

Its use is to uncover the wound. The use of adjusted to the width of the wound retractor. Nothing has two gears, 3 gear and 4 gear. 2 gears for small wounds, 4 gear for large wounds. There is also a blunt-toothed retractor.

6. Needle.

      Many kinds. For sewing leather used which have a triangular for easy slicing the skin (scherpe nald). Is being used to sew the muscles which have a round (round nald). There are semicircular and there is also a form of a quarter circle.

      Its use is to stitch the wound and sew other damaged organs. Provision of customized needs.

7. Tweezers

    - Tweezers sirurgis.

Its use is to clamp tissue during the dissection and suturing wounds, members of marks on the skin before the start of the incision.

   - Tweezers anatomical.

Its use is to pinch the screen while pressing the wound, pinning thin and soft tissue.

8. Yarn.

* Seide / silk.

Made of silk fibers, fibers composed of 70% protein and 30% additional material such as adhesive. It was black and white. Silk is not as slick as usual because it was combined with an adhesive. Is not absorbed by the body. On the use of on the outside, the thread should be reopened.

Available in various sizes, ranging from the number 00000 (5 zeros is the smallest size for the surgery department) to number 3 (which is the largest size). The most commonly used is the number 00 (2 zero) and 0 (1 zero) and the number one. The greater the smaller its many zeros thread

Its purpose is to sew leather, tying the arteries (especially the large arteries), as teugel (control).

Yarn must be sterile, because if not will be a nest of germs (focal infections), since the bacteria are protected in the stitching thread, while the thread itself can not be absorbed by the body.

* Plain catgut.

Originally he is cat (cat) and the gut (intestine). The first thread is made from the intestines of cats, but this time made from the intestines of sheep or cow intestines. Can be absorbed by the body, the absorption takes place within 7-10 days, and the color is white and yellowish.

Available in various sizes, ranging from 00000 (5 zeros which is the smallest size) to number 3 (the largest size). Frequently used numbers 000 (3 zeros), 00 (2 zero), 0 (1 zero), the number 1 and number 2.

Its purpose is to bind small source of bleeding, sewing subcutaneous and can also be used to sew up loose skin, especially for the area (abdomen, face) that is not a lot of moving and extensive small wound.

Plain catgut should be knotted at least 3 times, because the body will expand, if concluded two times will be open again. Plain catgut should not be submerged in lisol because it will expand and become soft, making it unusable.

* Chromic catgut.

In contrast to plain catgut, before the spun yarn is added chrome. With the chrome, then the thread will be harder and stronger, and longer absorption, ie 20-40 days. The color is brown and bluish. This yarn is available in sizes 000 (3 zeros is the smallest size) to number 3.

Its use in suturing wounds that are considered not docked within ten days, to sew the tendon in patients who are not cooperative and when mobilization should be done immediately.

* Nylon. (Dafilon, monosof, dermalonEthilon).

A synthetic yarn in packaging atraumatis (direct yarn together with a sewing needle) and made of nylon, strong leboh of seide or catgut. Is not absorbed by the body, and does not cause irritation to the skin or other body tissue.

The color is dark blue. Available in sizes 10 to one zero zero. Penggunanan on plastic surgery, larger size commonly used skin, a small number used in eye surgery.

* Ethibond.

A synthetic yarn (made from polytetra methylene adipate). Available in packs atraumatis. Gentle, strong, body reaction to a minimum, it is not absorbed, and the colors green and white. The size of 7 zero to number 2. Its use in cardiovascular surgery and urology.

* Vitalene / prolene / surgilen.

A synthetic yarn (made from polymer profilen). Very strong and soft, are not absorbed, blue. Available in packs atraumatis. The size of the 10 zero to number 1. Used in microsurgery, particularly for heart and blood vessels, eye surgery, plastic surgery, is also suitable for sewing leather.

* Poly glicolic As Polisorb, Dexon, Vicryl.

A synthetic yarn in packaging atraumatis. Absorbed by the body, and does not cause a reaction in the body tissues. In subcutaneous last for three weeks, the muscle last for 3 months. This yarn is very soft and the color purple.

The size of the 10 zero to number 1. Usage on eye surgery, orthopedics, urology and plastic surgery.

* Supramid.

A synthetic yarn, in packaging atraumatis. Is strong, soft, flexible, minimum body reaction and not absorbed. It was black and white. Used to sew cutis and subcutaneous.

* Linen (catoon).

Made with natural cotton fiber by way of spinning. Gentle, strong enough and easily knotted, not absorbed, the body's reaction to a minimum, are white.

Available in 4 sizes zero to one zero. Used to sew the intestine and skin, especially facial skin.

* Steel wire.

A metallic thread made of stainless steel polifilamen. Very strong, non-corrosive, and reaction to the minimum body. Easily knotted. Metallic white color. Contained in packaging and packaging atraumatis usual. The size of 6 zero to number 2. To sew the tendon.

Chapter III.

Suture technique.

III.1. GOAL

Basic stitches are making adequate pressure on the wound closed without distance but also loose enough to avoid ischemia and necrosis. Stitches can also aim to take care of hemostasis or bleeding that occurs. Can be for first aid measures. Reduce post-operative pain. Stitching is also the maker of the bond restrictions on the network until healed and no longer needed. Stitches can also prevent bone that may be exposed to healing old wounds and resorption that is not necessary. It is also necessary in action flap.

III.2. Suture principle.

Full knot should be tight, and strong so it will not be separated. To avoid bacterial infection, the knot is placed on the incision line. Knot should be made small. Do not tie too tight to avoid damaging the threads. Do not do a lot of movement that would damage the stitches. Avoid damaging the material hecting by pinning using needle holder except when going binding. Do not be too strong feared necrosis. Traction should be adequate.

III. 3. TYPES stitches.

Interrupted sutures.

Most used because it is simple and easy. Each stitch knotted itself. Can be carried on the skin or other body parts, and is suitable for areas that many moves because each stitch mutually supporting one another.

Interrupted sutures (interupted suture), each node stands alone. In cosmetics coarse yarn / large or tense when menyimpulnya will give the former is less good, that bleak picture of a centipede.

Stitches single node.

Synonyms: Disconnected Stitches Simple, Simple Inerrupted Suture. Is a frequently used type of stitch. Also used for stitching the situation.

Technique :

** Do needling with the distance between half to 1 cm edge of the wound and tissue subkutannya simultaneously take all the needle is perpendicular to the direction of the line or injuries.

** Single Node done with absorbable thread to the distance between 1cm.

** Node in place on the edge of the wound on one of the puncture.

** The thread is cut approximately 1 cm.

Stitch mattress Horizontal

Synonyms: Horizontal Mattress suture, Interrupted mattress
Stitches by stabbing like a knot, before knotted followed by stabbing aligned as far as 1 cm from the first stitch.
Gives a strong seam.

Vertical Stitch Mattress.

Synonyms: Vertical Mattress suture, Donati, Near to near and far to far.
Sew seams with depth below the wound was followed by sewing the edges of the wound. Usually produces rapid wound healing because in dekatkannya edges of the wound by stitching it.

Stitch Matras Modifications

Synonyms: Half Buried Mattress Suture
Modification of horizontal mattress stitch the wound area but across the region subkutannya.

Continuous stitching.

Often called doorloven. Knot only on the ends of the seams, so there are only two nodes. Let one of these stitches will open it fully open. This suture is rarely used to sew leather. In cosmetic scar as the interrupted sutures. Continuous sutures can be done faster than interrupted sutures.

Stitch baste simple.

Synonyms: Simple running suture, Simple continuous, continuous over and over
This seam is very simple, the same as we baste shirt. Usually produces good cosmetic results, its use is not recommended in loose connective tissue.

Stitch baste Feston.

Synonyms: Running locked suture, suture Interlocking
Continuous stitching with thread linking the previous stitch, used often used in stitching the peritoneum. Is a variation of the usual running suture.

Stitch baste horizontal.

Synonyms: Horizontal Running suture
Interspersed with a continuous seam stitching horizontal direction.
  

Stitches intradermal.

      Memeberikan most excellent cosmetic results (only a single line only). Can not be used for areas that many moves. Most good for the face. There are various modifications of this intradermal stitches. It takes a lot of practice to memahirkan this way intradermal suturing.

Stitches intrakutan knot.

Synonyms: Subcutaneus interupted suture, Buried intradermal suture, Interrupted dermal stitch.
Suture knot on intrakutan area, usually used to sew area in the later sewn on the outside as well with a simple knot.

Stitches baste intrakutan.

Synonyms: Running subcuticular suture, Suture baste subcuticular
Baste stitches were done under the skin, stitching is known to produce good cosmetic

CHAPTER IV

CONCLUSION.

Suture material

Berkualiatas suturing material is covering certain conditions. The first is the convenience to be used or to be held. Then sufficient protection on each appliance. Should always sterile. Fairly elastic. Not made of reactive materials. Enough power to wound healing. The ability for biodegradation of chemicals to prevent the destruction of the object or suturing wounds need some good preparation tools, materials and some other equipment. The sequence technique should also be understood by the operator and his assistant.

Tools needed:
-- Naald Voeder (Needle Holder) or the needle holder is usually the fruit.
-- Surgical tweezers Tweezers Chirrurgis or one fruit
-- Cut a piece of yarn.
-- sewing needle, depending on the size of just two pieces only.

Materials needed:
- seide sewing thread or silk
- Sewing Thread Cat gut chromic and plain.

Etc:
* Doek sterile hole
* sterile gauze
* sterile Handscoon

Surgery techniques.
Sequence wound suturing techniques (suture techniques)
1. Preparation tools and materials
2. Preparation of assistant and operator
3. Disinfection of the operating field
4. Anesthesia operating field
5. debridement and excision of the wound edges
6. suturing wounds
7. wound care

Various kinds of stitches:
1. Single Node Stitches
2. Stitch mattress Horizontal
3. Vertical Stitch Mattress
4. Stitch Matras Modifications
5. Stitch baste sederhan
6. Stitches baste Feston
7. Stitch baste horizontal
8. Stitch Node intrakutan
9. Stitch baste intrakutan.
Thank you for reading this article. Written and posted by Bambang Sunarno. sunarnobambang86@gmail.com
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DatePublished: June 27, 2015 at 15:51

Tags : Not made of reactive materials.

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