What knots and suturing techniques should an MS3 know before away rotation?

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tdod

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All I know is simple sutures and vertical mattress sutures. Are there any knots (i.e. for securing a central line) or advanced sutures I should know to make myself useful during my away?

Thanks!

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All I know is simple sutures and vertical mattress sutures. Are there any knots (i.e. for securing a central line) or advanced sutures I should know to make myself useful during my away?

Thanks!
I would learn how to do a basic two handed tie for securing central lines. If you can do that and an instrument tie, you're good.
 
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All I know is simple sutures and vertical mattress sutures. Are there any knots (i.e. for securing a central line) or advanced sutures I should know to make myself useful during my away?

Thanks!


Your mom ties knots.

Lol. Simple interrupted, vertical/horizontal mattress, and how to open a beer bottle.

Good luck, homey.
 
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Agreed with TurkeyJerky above, knowing an instrument tie and two hand tie will get you by. The rest is all icing. Ultimately the most important thing is being a teachable human. You're a medical student, so don't be afraid to ASK and be a gracious learner. Most residents and attendings would be happy to teach you (assuming you aren't asking mid-resuscitation or something... it happens o_O )
 
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How often do you guys actually do mattress sutures? I think i've done one maybe once a year? Although I do extensively use corner stitches and figure-of-8s fairly frequently (esp considering I wasn't taught these in med school)
 
How often do you guys actually do mattress sutures? I think i've done one maybe once a year? Although I do extensively use corner stitches and figure-of-8s fairly frequently (esp considering I wasn't taught these in med school)

Outside of suturing in chest tubes, I've never used a horizontal mattress for anything else. And I've put in only a few vertical mattress sutures in my career. I mainly stick to simple interrupted sutures and if the wound is huge and gaping and needs a deeper closure, I do a two layered repair.
 
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All I know is simple sutures and vertical mattress sutures. Are there any knots (i.e. for securing a central line) or advanced sutures I should know to make myself useful during my away?

Thanks!

Simple interrupted, running, vertical and horizontal mattresses.

Instrument, one-handed, and two-handed ties.

Done. Anything else as far as sutures/ties is gravy. Depending on where you go, you may not even use mattresses or hand ties in the first place.
 
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Outside of suturing in chest tubes, I've never used a horizontal mattress for anything else. And I've put in only a few vertical mattress sutures in my career. I mainly stick to simple interrupted sutures and if the wound is huge and gaping and needs a deeper closure, I do a two layered repair.
Good point--I use em for chest tubes too.
 
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IDK about what knots for MS3... but I'd recommend learning a hangman's knot before you're an intern and have to do off-service rotations on IM.

<makes hanging motion in the air and sticks tongue out>

Those guys are boring as hell (as a generalization. Obviously exceptions exist)
 
A running locking stitch is my personal favorite, partly because it's hemostatic, partly because it looks tidy and it's fast. (I learned it from a facial plastics guy I rotated with at the end of med school in my "goof off time," and is my go-to out of habit now.)

Agreed with the others: Instrument ties, one and two handed ties, running and interrupted. Mattresses are few and far between.

One handed ties are perfect for wrapping presents in ribbon.
 
Ya, at least two handed tie, instrument tie and simple interrupted, comfortably laying down a one handed tie and knowing corner stitch will make you look boss.

Be aware, I'm going to use this as an opportunity to rant. My recommendation as someone who has supervised med students closing lacs, do all of this: get them numbed and clean off ALL the dried blood from everywhere, and then once the wound is clean and exposed give the senior a call or grab them and ask them if they want to take a look at the wound. I always like to visualize how deep a wound is after it's cleaned and before the med student sutures, then they'll give you the go ahead to lay down some stitches. I usually watch them throw one or two sutures including complex ones like corner or mattress, and if they seem confident and are doing a nice job I'll step out and do other things. If you do these things, your senior resident will like you and you will get a good evaluation on at least your lac closing skills.

I get irritated when I give a med student a lac and then 10 minutes later they call me, and I go in the room, the patient isn't anesthetized, and the suture kit is closed, there's no suture in the room, the patient isn't washed out, or they're sort of washed out but there's still dried blood everywhere and you have no idea the actual extent of the lacerations. This makes more work for me and makes me want to never give you another procedure. I would say proper numbing and cleaning of a wound is more important to me than actual skill throwing sutures. I'm happy to sit in there with you and help you learn how to throw stitches if you haven't done it before, but please put some effort into preparing the patient, this takes no skill.
 
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