Technical Skills – Session 1
description
Transcript of Technical Skills – Session 1
Technical Skills – Session 1Technical Skills – Session 1
Prep date:Wednesday August 6Prep date:Wednesday August 6thth 2008 2008
Instruction/practice date: August 13Instruction/practice date: August 13thth, 2008, 2008Fontbonne Rm 3, St. Joseph HospitalFontbonne Rm 3, St. Joseph Hospital
McMaster UniversityMcMaster University
Open Basic Suturing Open Basic Suturing SkillsSkills
Important DetailsImportant Details
PGY1s, need to know where Fontbonne 3 PGY1s, need to know where Fontbonne 3 isis
Come in greensCome in greens
Practice knot tying before you come – we Practice knot tying before you come – we want to see slick, quick knotswant to see slick, quick knots
PGY2s, will be paired with PGY1s (same PGY2s, will be paired with PGY1s (same pairings as before) for help/supervision.pairings as before) for help/supervision.
Important DetailsImportant Details
PGY 2s – January presenters (you will be PGY 2s – January presenters (you will be identified and reminded soon):identified and reminded soon):
Need your topics by Sept 5Need your topics by Sept 5thth
If you don’t have a topic, let us knowIf you don’t have a topic, let us know
Goals and Objectives PGYI/IIGoals and Objectives PGYI/II
To learn:To learn:One handed and two handed tiesOne handed and two handed ties
Instrument tiesInstrument ties
Suturing techniqueSuturing technique
Basic stitchesBasic stitches SimpleSimple RunningRunning SubcuticularSubcuticular
Simple Flap constructionSimple Flap construction
Goals and Objectives PGYIGoals and Objectives PGYI
All residents:All residents: practice suturing and tying on turkey skinpractice suturing and tying on turkey skin Tasks:Tasks:
1.1. Single straight incision, wavy incisionSingle straight incision, wavy incisionSimple interrupted, running and subcuticularSimple interrupted, running and subcuticular
2.2. Circle anastomosisCircle anastomosisSimple interrupted suturesSimple interrupted sutures
3.3. Z-Plasty, V-Y advancement, LimbergZ-Plasty, V-Y advancement, LimbergSimple interruptedSimple interrupted
Ortho and Plastics residentsOrtho and Plastics residents Practice stitching tendons on Pig HocksPractice stitching tendons on Pig Hocks
advice-teaching from PGYIIsadvice-teaching from PGYIIs
Goals and ObjectivesGoals and Objectives PGYIIPGYII
To practice suturing and tyingTo practice suturing and tying
To teach and supervise PGYIsTo teach and supervise PGYIs
To try more difficult suturing tasksTo try more difficult suturing tasks
Goals and Objectives PGYIIGoals and Objectives PGYII
All residents:All residents: Practice suturing and tying on turkey skinPractice suturing and tying on turkey skin
Complex shapeComplex shape
Z-plastyZ-plasty
V-Y advancement flapV-Y advancement flap
Limberg FlapLimberg Flap
Plastics/Urology/Gen SurgPlastics/Urology/Gen Surg Vascular anastomosis if time permitsVascular anastomosis if time permits
Orthopaedics/PlasticsOrthopaedics/Plastics Tendon anastomosisTendon anastomosis
Session StationsSession Stations
Basic knot-tying stationBasic knot-tying stationPractice your one and two-handed tiesPractice your one and two-handed ties
Turkey SkinTurkey SkinSuturing on a simple surfaceSuturing on a simple surface
Can use this for the Flap sessionsCan use this for the Flap sessions
Sheep LungSheep LungModel for thick tissue (thanks to John Evans)Model for thick tissue (thanks to John Evans)
Practice deep sutures, follow the curve, don’t “hork”Practice deep sutures, follow the curve, don’t “hork”
Pig HocksPig HocksTendon suturing and thick skin suturingTendon suturing and thick skin suturing
EvaluationEvaluation
You will be evaluated by:You will be evaluated by:
How well you tie knots.How well you tie knots.Ensure that an evaluator observes you tying slick, quick Ensure that an evaluator observes you tying slick, quick
one and two-handed knotsone and two-handed knots
How well you sutureHow well you suture Technique Technique (holding the instrument, trajectory of needle, economy of (holding the instrument, trajectory of needle, economy of
movement and accuracy [placement, spacing etc])movement and accuracy [placement, spacing etc])
How much and how well you get stuff doneHow much and how well you get stuff done
PGYIIs, by your ability to supervise??PGYIIs, by your ability to supervise??
The One Handed Knot -Step 1The One Handed Knot -Step 1
The One Handed Knot -Step 2The One Handed Knot -Step 2
The One Handed Knot -Step 3The One Handed Knot -Step 3
The One Handed Knot -Step 4The One Handed Knot -Step 4
The One Handed Knot -Step 5The One Handed Knot -Step 5
The One Handed Knot -Step 6The One Handed Knot -Step 6
The One Handed Knot -Step 7The One Handed Knot -Step 7
The One Handed Knot -Step 8The One Handed Knot -Step 8
The One Handed Knot -Step 9The One Handed Knot -Step 9
The One Handed Knot -Step 10The One Handed Knot -Step 10
The Two-Handed Knot -Step 1The Two-Handed Knot -Step 1
The Two-Handed Knot -Step 2The Two-Handed Knot -Step 2
The Two-Handed Knot -Step 3The Two-Handed Knot -Step 3
The Two-Handed Knot -Step 4The Two-Handed Knot -Step 4
The Two-Handed Knot -Step 5The Two-Handed Knot -Step 5
The Two-Handed Knot -Step 6The Two-Handed Knot -Step 6
The Two-Handed Knot -Step 7The Two-Handed Knot -Step 7
The Two-Handed Knot -Step 8The Two-Handed Knot -Step 8
The Two-Handed Knot -Step 9The Two-Handed Knot -Step 9
The Two-Handed Knot -Step 10The Two-Handed Knot -Step 10
The Two-Handed Knot -Step 11The Two-Handed Knot -Step 11
The Two-Handed Knot -Step 12The Two-Handed Knot -Step 12
The Two-Handed Knot -Step 13The Two-Handed Knot -Step 13
The Two-Handed Knot -Step 14The Two-Handed Knot -Step 14
Z-PlastyZ-Plasty
Limberg FlapLimberg Flap
V-Y Advancement FlapV-Y Advancement Flap
Tendon Repair StitchTendon Repair Stitch
Resources for self-directed learningResources for self-directed learning
The webThe web Many videos already made on how to tie surgical Many videos already made on how to tie surgical
knots (one and two handed and instrument ties)knots (one and two handed and instrument ties) These slides will be available to you by email.These slides will be available to you by email.
URL:URL:
http://video.google.ca/videoplay?http://video.google.ca/videoplay?docid=8499774419188060835&q=surgical+knotdocid=8499774419188060835&q=surgical+knot+tying&ei=Vn-XSKTVEYXS-gHYru2gBg&hl=en+tying&ei=Vn-XSKTVEYXS-gHYru2gBg&hl=en