PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Surgical SuturesSurgical Suturesand Needlesand Needles
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
SUTURESSUTURESSUTURESSUTURES
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
The Ideal SutureThe Ideal SutureMoynihan 1912Moynihan 1912
Monofilament Use for any procedure Easy to handle Minimal tissue reaction High breaking strength Hold knots securely Absorbable Predictable Absorption Sterile
Monofilament Use for any procedure Easy to handle Minimal tissue reaction High breaking strength Hold knots securely Absorbable Predictable Absorption Sterile
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Classification of SuturesClassification of Sutures
CHARACTERISTIC Absorbable Nonabsorbable
STRUCTURE Monofilament Multifilament
MATERIAL Synthetic Biological
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
AdvantageAdvantage
ABSORBABLEBroken down by bodyNo foreign body left
ABSORBABLEBroken down by bodyNo foreign body left
NONABSORBABLEPermanent Wound
Support
NONABSORBABLEPermanent Wound
Support
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
DisadvantageDisadvantage
ABSORBABLETime of wound
support
ABSORBABLETime of wound
support
NONABSORBABLEForeign body leftSuture sinusSuture extrusion
NONABSORBABLEForeign body leftSuture sinusSuture extrusion
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
AdvantageAdvantage
MONOFILAMENTSmooth surfaceLow friction
– Less drag– Less tissue trauma
No bacterial harboursNo capilarity
MONOFILAMENTSmooth surfaceLow friction
– Less drag– Less tissue trauma
No bacterial harboursNo capilarity
MULTIFILAMENTStrengthSoft & pliableGood handling
MULTIFILAMENTStrengthSoft & pliableGood handling
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
DisadvantageDisadvantage
MONOFILAMENTHandling & KnottingEnds/knot burialStrecth
MONOFILAMENTHandling & KnottingEnds/knot burialStrecth
MULTIFILAMENTBacterial harboursCapillary actionTissue trauma
– Drag– Cutting
MULTIFILAMENTBacterial harboursCapillary actionTissue trauma
– Drag– Cutting
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
AdvantageAdvantage
BIOLOGICALHandling & KnottingEconomical
BIOLOGICALHandling & KnottingEconomical
SYNTHETICSResemble natural
substancesAbsorption by
hydrolysisPredictable
absorption Strong
SYNTHETICSResemble natural
substancesAbsorption by
hydrolysisPredictable
absorption Strong
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
DisadvantageDisadvantage
BIOLOGICALAbsorption by
enzymatic actionTissue reactionUnpredictable
absorption
BIOLOGICALAbsorption by
enzymatic actionTissue reactionUnpredictable
absorption
SYNTHETICSMonofilament
handling
SYNTHETICSMonofilament
handling
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
AbsorbableAbsorbableAbsorbableAbsorbable
BiologicalBiologicalBiologicalBiological
SyntheticSyntheticSyntheticSynthetic
Plain/F.A. Gut
Chromic Gut
VICRYL*
PDS II*
MONOCRYL*
VICRYL*Rapide
PANACRYL*
* Trademark
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Absorption TerminologyAbsorption TerminologyABSORBABLE SUTURESABSORBABLE SUTURES
Wound support No loss of suture
bulk Strength reduced
Wound support No loss of suture
bulk Strength reduced
Elimination of Suture Material removed
Elimination of Suture Material removed
LOSS OFTENSILE STRENGTH
LOSS OFTENSILE STRENGTH
ABSORPTION OFMASS
ABSORPTION OFMASS
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Suture HandlingSuture Handling
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Absorbable SuturesAbsorbable SuturesWOUND 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
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Catgut AbsorptionCatgut Absorption
PLAIN CHROMIC
Wound Support 7-10 days 17 – 21 days
Mass absorption 60 – 90 days 90 – 110 days
Absorption affected by many factorsAbsorption affected by many factors
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Coated VICRYL*Coated VICRYL*AbsorptionAbsorption
Coated VICRYL* 2/0 at 14 daysMinimal Tissue Reaction
around suture
Chromic Catgut at 14 daysExtensive tissue reaction withacute inflammatory response
Synthetic Absorbable – HydrolysisPredictable absorptionMinimal tissue reactions
Synthetic Absorbable – HydrolysisPredictable absorptionMinimal tissue reactions
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Non AbsorbableNon AbsorbableNon AbsorbableNon Absorbable
BiologicalBiologicalBiologicalBiological
SyntheticSyntheticSyntheticSynthetic
PROLENE*
Silk
ETHIBOND*
MERSILENE*
Stainless Steel
ETHILON*
* Trademark
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
MERSILK*MERSILK*
DRAWBACKSTissue reactionsLoss of strengthUltimately fragmentsForeign body
implanted long term
DRAWBACKSTissue reactionsLoss of strengthUltimately fragmentsForeign body
implanted long termNUROLON* SILK
Greater reaction to biological material
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PROLENE* PolypropylenePROLENE* Polypropylene
MINIMAL TISSUE REACTIONMINIMAL TISSUE REACTION
Enlarged photomicrographPROLENE* suture
Implanted 6 months
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
NEEDLESNEEDLES
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Needle SelectionNeedle Selection
Minimal trauma to tissue
SharpnessBend resistanceCorrosion resistanceSterilitySize, shape & design
Minimal trauma to tissue
SharpnessBend resistanceCorrosion resistanceSterilitySize, shape & design
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Use of Needle HoldersUse of Needle Holders
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Eyed NeedlesEyed Needles
Double suture strandThreading timeResterilisationPoint maintenanceRisk of corrosionRisk of unthreading
Double suture strandThreading timeResterilisationPoint maintenanceRisk of corrosionRisk of unthreading
EyedEyed French / split eyeFrench / split eye
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Suture AttachmentSuture Attachment
ChannelDrilled
ChannelDrilled
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Anatomy of a Surgical NeedleAnatomy of a Surgical Needle
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Needle ShapesNeedle Shapes¼ Circle¼ Circle 33//88 Circle Circle ½ Circle½ Circle 55//88 Circle Circle
½ Curved½ Curved
StraightStraight
CompoundCompound
CurveCurve
J ShapeJ Shape
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM 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 110mm45 needle sizes from 3mm to 110mm
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Needle TypesNeedle Types
Round Bodied
Cutting
Ophthalmic
Round Bodied
Cutting
Ophthalmic
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Round Bodied NeedlesRound Bodied Needles
IntestinalJB NeedleVISIBLACK*BluntETHIGUARD*CC
IntestinalJB NeedleVISIBLACK*BluntETHIGUARD*CC
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Cutting NeedlesCutting Needles
CONVENTIONALCONVENTIONALCUTTINGCUTTINGApex of edges on
inside curvature
CONVENTIONALCONVENTIONALCUTTINGCUTTINGApex of edges on
inside curvature
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Cutting NeedlesCutting Needles
REVERSEREVERSECUTTINGCUTTINGApex of edges on
outside curvature
REVERSEREVERSECUTTINGCUTTINGApex of edges on
outside curvature
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PACKAGINGPACKAGING
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Packaging – Foil PackPackaging – Foil PackUSP GaugeUSP Gauge Metric
GaugeMetricGauge
Code numberCode number
Denotes EasyAccess packagingDenotes EasyAccess packaging
Sterilisation MethodSterilisation Method
Manufacture& Expiry dateManufacture& Expiry date
Product description& colourProduct description& colour
LengthLength
NeedledescriptionNeedledescription
IDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGS
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Packaging – Foil PackPackaging – Foil Pack(Easy Access)(Easy Access)
Tear in direction of arrow
Foil & card open together revealing needle
Arm needle holderWithdraw suture
Tear in direction of arrow
Foil & card open together revealing needle
Arm needle holderWithdraw suture
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
PELATIHAN BEDAH DASARKOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Packaging – RELAY*Packaging – RELAY*
Single overwrapRemove trayPull down flap to
exposeArm needle holderWithdraw suture
Single overwrapRemove trayPull down flap to
exposeArm needle holderWithdraw suture
KINK FREE SUTURE DISPENSEDKINK FREE SUTURE DISPENSED