Dermatology
Wound Closure Materials and Instruments
Built from Dermatology, 5th Edition
What’s inside
18 sections · 86 slides
Overview
- What this topic covers
Introduction
Why the right suture and instrument choice changes the outcome
- Why this knowledge matters
Suture History and Properties
Where sutures come from, and the properties used to describe them
- A brief history of the suture
- The ideal suture (that does not exist)
- Two categories: absorbable and non-absorbable
- How wound strength returns over time
- Suture classification: absorbable vs non-absorbable
- Suture configuration: mono- vs multifilament
- USP size: what the zeros mean
- Coefficient of friction and elasticity
- Memory and plasticity
- Pliability, tensile strength, and tissue reactivity
Absorbable Sutures
Sutures that the body breaks down, and do not need removal
- Absorbable sutures at a glance
- Commonly used absorbable sutures.
- Commonly used absorbable sutures. (continued)
- Commonly used absorbable sutures. (continued)
- Surgical gut (catgut)
- Polyglycolic acid and polyglactin 910
- Polydioxanone and polyglyconate
- Poliglecaprone 25: fast, low-reactivity monofilament
- Evidence on poliglecaprone 25 vs polyglactin 910
- Glycomer 631 and polyglytone 6211
Non-absorbable Sutures
Sutures resistant to breakdown, typically used on the skin surface
- Non-absorbable sutures at a glance
- Commonly used non-absorbable sutures.
- Silk
- Nylon
- Polypropylene
- Polyester and polybutester
Suture Selection
Matching suture material and size to the site and the wound
- General principle of suture selection
- Sutures by anatomic site
- Commonly utilized sutures by site.
- Selection for larger and truncal wounds
- Fast-absorbing gut: evidence on outcomes
- Alternatives to suturing
- MicroMend skin closure device
Suture Complications
Reactions, abscesses, and extrusion - and how to manage them
- What causes suture-related complications
- Suture reactions
- Suture abscess and extrusion
- Suture reactions and abscesses: additional examples
- Managing a suture reaction
Needles
Needle anatomy, shape, point type, and manufacturer naming
- What makes a good needle
- Needle anatomy: shank, body, point
- Needle body shapes
- Needle point types
- Taper point needles
- Needle nomenclature by manufacturer
- Needle size and packaging
Instruments: General Principles
Quality, care, and sample tray setups
- Instrument quality and materials
- Keeping instruments in good condition
- Facial surgical instrument tray
- Trunk or extremity surgical instrument tray
Curettes
Scraping instruments for cutaneous neoplasms
- Curettes
Scalpels
Handles and blades used in cutaneous surgery
- Scalpel handles
- Scalpel blades
- Scalpel handles and blades
Needle Holders
Jaw types and models for different needle sizes and sites
- Smooth vs serrated jaws
- Popular needle holder models
- Webster vs Mayo-Hegar needle holders
- Olsen-Hegar scissors/needle holders
Scissors
Types used for cutting tissue, undermining, sutures, and dressings
- Scissor types in cutaneous surgery
- Gradle and tissue scissors
- Delicate eye scissors and suture-cutting scissors
- Standard scissors
- Undermining and bandage-cutting scissors
- Lister bandage-cutting scissors
- Suture-removal scissors and forceps
Forceps
Handling tissue and needles safely during closure
- Forceps: teeth, weight, and use
- Forceps by size and site
Hemostats and Skin Hooks
Controlling bleeding and handling tissue gently
- Hemostats
- Skin hooks
Special Instruments and Sterilization
Fine work near the eye, and how instruments are kept clean
- Fine instruments for eye-area surgery
- Eyelid tray
- Eye shields and chalazion clamps
- Blade remover
- How instruments are sterilized
- Sterilization methods.
- Sterilization methods. (continued)
Summary
Pulling the wound-closure toolkit together
- Key takeaways
References
Source citations from the chapter
- References
- References (continued)
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- References (continued)
- Dermatology, 5th Edition (2-Volume Set)