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Title | Description | Subject | Collection |
276 |
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Suturing | The loop is then tightened with the hands in their natural position. This is done four times and then the suture is cut leaving suture ends at .5 cm long. | | Knowledge Weavers Dermatology |
277 |
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Suturing | This demonstrates that a total of four throws should be made when tying the deep dermal suture, and if done properly, square knots are laid down. It is said that square knots provide optimum knot security. | | Knowledge Weavers Dermatology |
278 |
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Suturing | The short arm of the suture is then grasped with the needle holder, and then the non-dominant (left) hand crosses over the right hand as one tightens the knot pulling along the long axis of the wound. | | Knowledge Weavers Dermatology |
279 |
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Suturing | I exit through the other side of the wound as superficially and closely as possible to the wound edge. Generally, I am about a mm away from the wound edge, and just barely entering the dermis. It is crucial to be as superficial within the dermis and as close to the wound edge on the second pass as i... | | Knowledge Weavers Dermatology |
280 |
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Suturing | This demonstrates placing the needle holder on the inside of the long arm of the V using actual suture. | | Knowledge Weavers Dermatology |
281 |
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Suturing | This demonstrates a single loop of suture thrown around the needle holder. | | Knowledge Weavers Dermatology |
282 |
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Suturing | With the needle holders placed inside the long arm (needle bearing end) of V, and | | Knowledge Weavers Dermatology |
283 |
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Suturing | The short and (non-needle bearing end) of the suture is then grasped with the needle holder, and the suture is pulled taut forming a double loop as shown here in cross-section. One cannot tighten the suture by pulling across the wound, and | | Knowledge Weavers Dermatology |
284 |
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Suturing | This demonstrates in cross-sectional view the placement of the deep dermal suture. | | Knowledge Weavers Dermatology |
285 |
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Suturing | The needle holder is placed on the inside of the long arm (needle bearing end) of the V, and the suture is wrapped twice around the needle holder. | | Knowledge Weavers Dermatology |
286 |
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Suturing | This demonstrates cutting the deep dermal suture just above the knot. | | Knowledge Weavers Dermatology |
287 |
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Suturing | The other side of the wound is then rolled open to expose the underlying dermis, and I placed the suture in the under-portion of the dermis as far away from the wound edge as possible. I enter from the side where the wound center, and then exit away from the wound center. | | Knowledge Weavers Dermatology |
288 |
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Suturing | As the suture exits from the wound, the ends of the suture can be lifted to form aV. The long arm of the V is formed by the needle bearing end of the suture. | | Knowledge Weavers Dermatology |
289 |
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Suturing | The needle is then reversed on the needle holder, and I then enter the wound edge as closely and superficially as possible, and | | Knowledge Weavers Dermatology |
290 |
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Suturing | This demonstrates the same maneuver using suture. | | Knowledge Weavers Dermatology |
291 |
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Suturing | This demonstrates the same maneuver using suture as the second throw is tightened with the left hand crossing over the right hand. This must be done to ensure that a square knot is formed. | | Knowledge Weavers Dermatology |
292 |
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Suturing | This third throw is initiated by placing the needle holder on the inside of the long arm (needle bearing end) of the V that is created. | | Knowledge Weavers Dermatology |
293 |
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Suturing | The suture must be rotated in a right-hand direction to ensure that it is tightened along the long axis of the wound until the edges of the wound are pulled together and evert. | | Knowledge Weavers Dermatology |
294 |
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Suturing | The needle holder is placed in the center of this V, and one can then begin to tie the suture. | | Knowledge Weavers Dermatology |
295 |
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Suturing | This demonstrates the vertical mattress suture as it first entered the skin. I enter and exit the skin approximately 2 mm away from the wound edge, and I penetrate about halfway down into the underlying dermis. The important point is that the needle should be the same distance from the wound edge on... | | Knowledge Weavers Dermatology |
296 |
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Suturing | A double loop is placed around the needle holder. | | Knowledge Weavers Dermatology |
297 |
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Suturing | A single loop is placed around the needle holder as shown. | | Knowledge Weavers Dermatology |
298 |
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Suturing | The short arm of the suture is grasped. The throw is then tightened by pulling the hands back into their natural positions. | | Knowledge Weavers Dermatology |
299 |
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Suturing | This demonstrates the placement of the suture in a vertical mattress prior to tying. | | Knowledge Weavers Dermatology |
300 |
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Suturing | The wound edges should pull together easily if wound has been properly undermined. The needle should be grasped two-thirds of the way from the point of the needle with the needle holders. This allows one to use a majority of the needle when suturing, but the needle is not grasped so far away from th... | | Knowledge Weavers Dermatology |