Blades Needle and Suture short presentation

Short presentation on blades and needles

1. Blades Needle and Suture By : Dr Jananee Mentor : Dr Fadzlin

2. The first recorded circumcision was carried out using stones such as jade and flint. Their edges were modified sharp using various techniques. Gradually in 3000 BC metal such as copper, bronze and iron were used as blades after sharpening their edges. In 400 BC, Hippocrates described the first scalpel in surgical use as a “ Macairion ”. The similar instrument was named as “ Scallepellus ” by the Romans which was modified into the present-day word that we use as a “Scalpel”. The concept of Asepsis and sterilization led to more changes in the material and structure of the scalpel. In 1900’s Morgan Parker introduced the principle of disposable blades could be used with a reusable handle. It was from then, Bard-Parker (CR Bard was a medical instrument supplier) handle was manufactured in a large scale and used widely in all surgeries.

3. Blades

4. Some extra information… Blade 11 – Incising for drain , arteriotomy / venotomy, laparascopic Blade 15 – sebaceous cyst, lipoma Blade 22 – mastectomy, hernia surgeries and thyroidectomy, laparotomy

5. Needles

6. Currently, needles are eyeless or ‘atraumatic’ with the suture material embedded within the shank of the needle. The needle has 3 main parts :

7. Sutures

8. Absorbable Sutures Absorbable sutures are broken down by the body via enzymatic reactions or hydrolysis. The time in which this absorption takes place varies between material, location of suture, and patient factors. Absorbable sutures are commonly used for deep tissues and tissues that heal rapidly; as a result, they may be used in small bowel anastomosis, suturing in the urinary or biliary tracts, or tying off small vessels near the skin. For the more commonly used absorbable sutures, complete absorption times will vary: Vicryl rapide = 42 days Vicryl = 60 days Monocryl = ~100 days PDS = ~200 days

9. Non-Absorbable Sutures Non-absorbable sutures are used to provide long-term tissue support, remaining walled-off by the body’s inflammatory processes (until removed manually if required). Uses include for tissues that heal slowly, such as fascia or tendons, closure of abdominal wall, or vascular anastomoses.

10. Suture techniques Interrupted sutures . Interrupted sutures require the needle to be inserted at right angles to the incision and then to pass through both aspects of the suture line and exit again at right angles. Continuous sutures . For a continuous suture, the first suture is inserted in an identical manner to an interrupted suture, but the rest of the sutures are inserted in a continuous manner until the far end of the wound is reached.

11. Mattress sutures . Mattress sutures may be either vertical or horizontal and tend to be used to produce either eversion or inversion of a wound edge. Subcuticular suture. This technique is used in skin where a cosmetic appearance is important and where the skin edges may be approximated easily.

12. References Bailey & Loves Short Practice for surgery 26 th Edition Essential Surgery- Problem,Diagnosis and Treatment by Clive RG Quick Handbook of Clinical Housemanship Procedures - June 2019 Edition: 1st Edition Publisher: Muhamad Izwan ismail

13. Thank you