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PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Surgical SuturesSurgical Sutures
and Need...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
SUTURESSUTURES
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
The Ideal SutureThe Ideal Suture
Moynihan...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Classification of SuturesClassification o...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
AdvantageAdvantage
ABSORBABLE
Broken dow...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
DisadvantageDisadvantage
ABSORBABLE
Time...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
AdvantageAdvantage
MONOFILAMENT
Smooth s...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
DisadvantageDisadvantage
MONOFILAMENT
Ha...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
AdvantageAdvantage
BIOLOGICAL
Handling &...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
DisadvantageDisadvantage
BIOLOGICAL
Abso...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
AbsorbableAbsorbableAbsorbableAbsorbable
...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Absorption TerminologyAbsorption Terminol...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Suture HandlingSuture Handling
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Absorbable SuturesAbsorbable Sutures
WOUN...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Coated VICRYL*Coated VICRYL*
AbsorptionAb...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PROLENE* PolypropylenePROLENE* Polypropyl...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
NEEDLESNEEDLES
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Needle SelectionNeedle Selection
Minimal...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Use of Needle HoldersUse of Needle Holders
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Anatomy of a Surgical NeedleAnatomy of a ...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Eyed NeedlesEyed Needles
Double suture s...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Suture AttachmentSuture Attachment
Chann...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
““Swage”Swage”
Single Armed: satu jarum ...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Needle ShapesNeedle Shapes
¼Circle¼Circle...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Needle Size RangeNeedle Size Range
MICROS...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Needle TypesNeedle Types
Round Bodied
Cut...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Cutting NeedlesCutting Needles
CONVENTION...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Conventional CuttingConventional Cutting
...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Cutting NeedlesCutting Needles
REVERSEREV...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Reverse CuttingReverse Cutting
Sisi “cut...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Taper PointTaper Point
 Tidak ada sisi “...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
TAPERCUT*TAPERCUT*
Kombinasi antara tape...
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PACKAGINGPACKAGING
PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Packaging – Foil PackPackaging – Foil Pac...
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  1. 1. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Surgical SuturesSurgical Sutures and Needlesand Needles
  2. 2. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA SUTURESSUTURES
  3. 3. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA The Ideal SutureThe Ideal Suture Moynihan 1912Moynihan 1912  Monofilament  Use for any procedure  Easy to handle  Minimal tissue reaction  High breaking strength  Hold knots securely  Absorbable  Predictable Absorption  Sterile
  4. 4. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Classification of SuturesClassification of Sutures CHARACTERISTIC Absorbable Nonabsorbable STRUCTURE Monofilament Multifilament MATERIAL Synthetic Biological
  5. 5. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA AdvantageAdvantage ABSORBABLE Broken down by body No foreign body left NONABSORBABLE Permanent Wound Support
  6. 6. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA DisadvantageDisadvantage ABSORBABLE Time of wound support NONABSORBABLE Foreign body left Suture sinus Suture extrusion
  7. 7. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA AdvantageAdvantage MONOFILAMENT Smooth surface Low friction – Less drag – Less tissue trauma No bacterial harbours No capilarity MULTIFILAMENT Strength Soft & pliable Good handling
  8. 8. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA DisadvantageDisadvantage MONOFILAMENT Handling & Knotting Ends/knot burial Strecth MULTIFILAMENT Bacterial harbours Capillary action Tissue trauma – Drag – Cutting
  9. 9. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA AdvantageAdvantage BIOLOGICAL Handling & Knotting Economical SYNTHETICS Resemble natural substances Absorption by hydrolysis Predictable absorption Strong
  10. 10. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA DisadvantageDisadvantage BIOLOGICAL Absorption by enzymatic action Tissue reaction Unpredictable absorption SYNTHETICS Monofilament handling
  11. 11. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA AbsorbableAbsorbableAbsorbableAbsorbable BiologicalBiologicalBiologicalBiological SyntheticSyntheticSyntheticSynthetic Plain/F.A. Gut Chromic Gut VICRYL* PDS II* MONOCRYL* VICRYL*Rapide PANACRYL* * Trademark
  12. 12. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Absorption TerminologyAbsorption Terminology ABSORBABLE SUTURESABSORBABLE SUTURES  Wound support  No loss of suture bulk  Strength reduced  Elimination of Suture  Material removed LOSS OF TENSILE STRENGTH ABSORPTION OF MASS
  13. 13. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Suture HandlingSuture Handling
  14. 14. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Absorbable SuturesAbsorbable Sutures WOUND SUPPORT ABSORPTION OF MASS Catgut 7 – 10 60 – 90 VICRYL* Rapide 6 – 14 by 42 Chromic Catgut 17 – 21 90 – 110 MONOCRYL* 14 – 21 90 – 120 Coated VICRYL* 28 – 35 56 – 70 PDS* II up to 56 by 182
  15. 15. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Coated VICRYL*Coated VICRYL* AbsorptionAbsorption Coated VICRYL* 2/0 at 14 days Minimal Tissue Reaction around suture Chromic Catgut at 14 days Extensive tissue reaction with acute inflammatory response Synthetic Absorbable – Hydrolysis Predictable absorption Minimal tissue reactions
  16. 16. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA PROLENE* PolypropylenePROLENE* Polypropylene MINIMAL TISSUE REACTIONMINIMAL TISSUE REACTION Enlarged photomicrograph PROLENE* suture Implanted 6 months
  17. 17. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA NEEDLESNEEDLES
  18. 18. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Needle SelectionNeedle Selection Minimal trauma to tissue Sharpness Bend resistance Corrosion resistance Sterility Size, shape & design
  19. 19. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Use of Needle HoldersUse of Needle Holders
  20. 20. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Anatomy of a Surgical NeedleAnatomy of a Surgical Needle
  21. 21. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Eyed NeedlesEyed Needles Double suture strand Threading time Resterilisation Point maintenance Risk of corrosion Risk of unthreading EyedEyed French / splitFrench / split eyeeye
  22. 22. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Suture AttachmentSuture Attachment Channel Drilled
  23. 23. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA ““Swage”Swage” Single Armed: satu jarum dengan satu benang Double Armed: dua jarum pada satu benang Loop: satu jarum pada satu benang dengan konfigurasi loop
  24. 24. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Needle ShapesNeedle Shapes ¼Circle¼Circle 33 //88 CircleCircle ½ Circle½ Circle 55 //88 CircleCircle ½ Curved½ Curved StraightStraight CompoundCompound CurveCurve J ShapeJ Shape
  25. 25. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Needle Size RangeNeedle Size Range MICROSUTURES 3.75mm – 8mm OPHTHALMIC 5mm – 16mm CARDIOVASCULAR 8mm – 40mm SKIN RANGE 9mm – 60mm G.I. RANGE 13mm – 40mm CLOSURE 30mm – 110mm HAND HELD 55mm – 110mm 110mm110mm 3mm3mm 45 needle sizes from 3mm to 110mm
  26. 26. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Needle TypesNeedle Types Round Bodied Cutting
  27. 27. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Cutting NeedlesCutting Needles CONVENTIONALCONVENTIONAL CUTTINGCUTTING Apex of edges on inside curvature
  28. 28. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Conventional CuttingConventional Cutting PRIME*PRIME* Sisi cutting “di dalam” Prime Geometry meningkatkan penetrasi Dipipihkan pada lokasi genggaman needle holder untuk stabilitas Series: PC Prime, CCS, CPS-3
  29. 29. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Cutting NeedlesCutting Needles REVERSEREVERSE CUTTINGCUTTING Apex of edges on outside curvature
  30. 30. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Reverse CuttingReverse Cutting Sisi “cutting “di luar” Kelebihan desain ini: – Lebih kuat – Mengurangi “tissue cut-out” atau robekan Series: P, PS, FS, M, C, LS, LR, OS, CP Microsurgery: Series G
  31. 31. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Taper PointTaper Point  Tidak ada sisi “cutting”, lebih bersifat “menusuk” dan memperlebar tusukan sejalan dengan membesarnya diameter. Tidak memotong  Digunakan pada Intestinal Anastomosis, Fascia Closure, Gynecology, Hernia dan pada Cardiovascular surgeries  Series: BV, C, C, BB, SH, MH, LH, MO, CT, TP, UR . 22° 12:1 TRU TAPER
  32. 32. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA TAPERCUT*TAPERCUT* Kombinasi antara taper dan cutting, dimana pada ujung bersifat cutting naun “body” bersifat round body Digunakan pada cardiovascular yang mengalami hardening Old TAPERCUT* New TAPERCUT*
  33. 33. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA PACKAGINGPACKAGING
  34. 34. PELATIHAN BEDAH DASAR KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA Packaging – Foil PackPackaging – Foil Pack USP Gauge Metric Gauge Code number Denotes Easy Access packaging Sterilisation Method Manufacture & Expiry date Product description & colour Length Needle description IDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGS

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