Practicing Surgery

[blaqmamba]

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Just starting my surgery rotation, and although I have spent time in the OR before, I don't have any experience with suturing (or pretty much anything else for that matter).

Any ideas where/how I could get some good practice suturing (ie, technique, efficiency, and the different knots)? I was thinking to possibly look online for some practice kits, but no clue where I might a good one

any other advice going into the rotation is appreciated

 

[VisionaryTics]

Just starting my surgery rotation, and although I have spent time in the OR before, I don't have any experience with suturing (or pretty much anything else for that matter).

Any ideas where/how I could get some good practice suturing (ie, technique, efficiency, and the different knots)? I was thinking to possibly look online for some practice kits, but no clue where I might a good one

any other advice going into the rotation is appreciated

This e-book is really nice for learning the basics of suturing, both practical and theoretical concerns.

I bought a bunch of cheap suture through amazon, and practiced tying knots (know two handed and instrument ties). I would also grab opened, but unused suture at the end of cases. You can buy pig feet to practice suturing, but it's not much like human skin. Just practice on it so you can get used to having instruments in your hands.

In any case, you'll probably be terrible the first few times on a human. Your hands will shake, the lighting will be off, you'll bend the needle, the anesthesiologist will be waking the patient up, etc. Don't worry. Work hard at it, and it will come together.

Grab Surgical Recall if you don't already have it.

 

[VivaLaVida]

Be nice to the scrub nurses! They will gift you things 🙂

 

[PB n J]

...the anesthesiologist will be waking the patient up...

My personal favorite.

 

[WhitJord85]

Be nice to the scrub nurses! They will gift you things 🙂

Best advice here! Definitely make friends with the scrub nurses... they can and may gift you more suture and sometimes loan you good instruments to borrow. They also can sometimes give you good tips and help you out. Also if you have free time with a resident you might ask for pointers.
As said before just practice. You can even just throw sutures in your scrubs just to practice with the instruments in your hands and trying to make the sutures the same length and width. Really just familiarity with the instruments will help you tremendously.

 

[neusu]

For tying: Ask the circulator or scrub nurse for a package of silk ties. Practice tying knots on your scrubs, steering wheel, wherever you can. Learn to throw both hands, two handed, and one handed knots (I only do one handed and have to remember from mnemonics how to do two handed anymore).

For suturing: As mentioned, get ahold of a needle driver and some suture. The best place to get a needle driver is a kit such as a laceration repair, central line, chest tube, ventricular drain, or another. Just ask the resident or surgeon beforehand if you can have it so it doesn't go to central supply or waste. After that, ask the circulator for left over suture or new suture (if you're good with the nurses, they reward you). Buy either pigs feet or chicken legs and sew the skin together. It doesn't look or feel like human skin, but you are going more for the motor skills at this point. Learn to do interrupted and subcuticular running stitches.

Then you'll be a beast in the OR.

There are videos on youtube for knot tying and suturing. PM me if you still have questions..

 

[Kaustikos]

In any case, you'll probably be terrible the first few times on a human. Your hands will shake, the lighting will be off, you'll bend the needle, the anesthesiologist will be waking the patient up, etc. Don't worry. Work hard at it, and it will come together.

That was the WORST for one of my closures. Simple lap incision... and I'm trying not to **** it up. But I notice that everyone's waiting for me and the patient is waking up. 😱

 

[gonesurfing]

I bought only a suture model for like $20. Then everything else u will gather along the way. The best is having a Lac kit from the ED. It has EVERYTHING u need to practice at home.

Get ties and sutures from scrub nurses. They will give them to u in a bag. U can also sew chicken and pigs feet but I just got a model cuz I'm too broke I buy meat lol.

But ya you'll gather things along the way. Just keep an eye out for used instruments and stuff. Then practice practice practice!

 

[Gfliptastic]

Aside from what has been said about being really nice to scrub nurses...because they will gift their favorite students MANY sutures (and jerks none), if you don't ask to assist in closing, you won't get your chance to practice on real alive skin (as opposed to buying pig feet).

It looks a lot better to ask the attending if you can assist in closing while he/she is still in the room, however, you can also ask the intern/resident too. Depending on when you start surgery, by the time the intern gets closer to extern, they are "bored" of closing.

Go for trocar defects when you get good. Those are small. And usually only a very few carefully done stitches are needed for those.

Initially ask for the large incision, since those don't necessarily have to be absolutely precise. I am surprised to see how inexact the process can be, but then see a follow up patient in clinic months later have a very neatly healed scar.

Something really rewarding when your attending scrubs out, the intern chills, and the nurse hands YOU the drivers and suture. 🙂