Incision through the rectus abdominis
- Peritoneal layer of the suture:
Interrupted suture with 1-0 or 2-0 multi-strand braided synthetic absorbable suture, stitch length 1.0cm, margins 0.5cm.
Continuous suture with 1-0 synthetic absorbable suture, playing at least six single-junction
- Sheath of the suture:
Work with 1-0 or 2-0 multi-strand braided synthetic absorbable suture with 1-0 interrupted sutures or synthetic absorbable continuous suture sheath, but it is necessary to strengthen with interrupted suture
- Subcutaneous tissue of the suture
3-0 or 4-0 with a multi-strand braided synthetic absorbable suture interrupted sutures do
Clinical study found that non-closure of subcutaneous tissue can also, more beautiful after wound healing, subcutaneous tissue with few complications.
- The skin suture
- Can be interrupted sutures, skin stapling devices and skin stapler suture method
Abdominal incision
Peritoneal layer of the seam incision through the rectus abdominis contract
White line of suture
--1-0 Multi-strand braided synthetic absorbable suture to do simple interrupted sutures
New development is the peritoneum and the white line as a level of suture, said suture fascia layer,
- Continuous suture with 1-0 trap lines, fight six or more single knot, knot cut stump left lane of not less than 0.5cm.
Oblique incision under the costal margin
Peritoneal layer of the seam incision through the rectus abdominis contract
Muscle and fascia of the suture
- 1-0 or 2-0 with a multi-strand braided synthetic absorbable suture line continuous or interrupted, margins should be appropriately increased, at least 1cm
Subcutaneous tissue and skin incision through the rectus abdominis contract sewing
Maxwell cut
Peritoneal layer
- With 3-0 synthetic absorbable suture interrupted or continuous suture
A suture above the external oblique aponeurosis
Subcutaneous tissue and skin
- With 3-0 synthetic absorbable suture can not be interrupted or continuous suture of skin
Suture
- 3 ~ 4cm needle margin
Gastrointestinal anastomosis expert consensus
Manual suture material
- Ideal for gastrointestinal anastomosis Foshion suture should have the following characteristics: non-allergenic, non-carcinogenic, tension enough, easy to knot, and the surface is not conducive to bacterial adhesion, absorbed in the body caused only a slight tissue reaction
- Absorbable suture absorption in the body by hydrolysis, tissue reaction to light, the same retention. Currently the most common type of gastrointestinal anastomosis is 3-0 or 4-0, can be used for the gastrointestinal tract and lined with full-thickness suture suture
Silk is made woven silk nonabsorbable sutures, and its in vivo tissue reaction to suture-related infections are still higher than absorbable suture. Current can be 3-0 or 1 for the gastrointestinal tract lined with silk suture.
In the digestive tract reconstruction, consistent foreign body granuloma as silk incidence rate and consistent knot residual edema, ulceration, bleeding etc incidence was significantly higher than can be absorbed by line, recommend use of absorbable sutures
Hand match
Simple anastomosis
- Currently the most widely used method is to use absorbable suture line through the layer will be lined with a continuous suture to suture the submucosa
Specific method is to use two 3-0 or 4-0 absorbable suture in the bowel mesentery and the mesentery edge, respectively, each stitch edge traction lines, tie lines after the end of retention, but also to ensure that the needle is convenient operation from the distribution. From the beginning of mesangial edge, lined and continuous Vicryl suture intestinal submucosa, mucosa without seam, excess mucous membrane should be trimmed to avoid mucosal eversion. Mesangial seam to the other edge of traction with the knotted end of the line, then turned to the other side of the small intestine, the same continuous suture continuous suture closed the final hole of mesangial
Double-layer anastomosis Albert-Lembert anastomosis
- With two needles were 3-0 silk suture at both ends of the anastomosis of the remnant stomach and jejunum lined with fixed corners, cut the posterior wall of residual stomach and jejunum wall, using 3-0 absorbable suture line of gastric remnant jejunal anastomosis with the posterior wall lined with suture, and then still use the lock side of the above full-thickness suture continuous suture anastomosis posterior to the anterior wall changed to full-thickness continuous inverted suture anastomosis pockets reinforced bottom corners and a half , then the same interrupted suture to complete the anterior wall lined with inverted sutures.
