RU2621426C1 - Method to perform surgical suture - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: surgical suture is performed. A needle with a ligature is injected into the skin at a distance of 1.5 cm from the wound edge. The ligature is directed over one wound edge capturing its bottom. The needle with the ligature is directed over another wound edge from the bottom to the skin surface without pricking out. Next, the needle is directed intradermally and pricked out into the space between the wound edges in the middle layers of dermis. The needle is injected into the first wound edge at the same level and directed intradermally. It is pricked out of the epithelium in the place of the original injection. The surgical wound is pulled together with suture material.

EFFECT: method allows to increase the cosmetic effect of suturing by accurate approximation of the dermis and epithelial layers of both wound edges.

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Description

The present invention relates to medicine, in particular to surgery, and can be used for suturing wounds in patients with various surgical pathologies in compliance with the principles of cosmetic surgery.

The invention relates to surgery and may be applicable to perform intermittent cutaneous surgical suture. The essence of the method is that they inject the needle into the skin, with a ligature, at a distance of up to 1.5 cm from the edge of the wound through the subcutaneous fat with the capture of the bottom of the surgical wound, then the needle is carried out intradermally, without puncture, in the opposite edge of the wound and excreted into the space between the edges of the wound in the middle of the dermis layer. Then, at the same level, the needle is pierced into the wound edge and carried out intradermally, performing a puncture from the epithelium at the site of the initial injection. After that, the operating cavity is compressed and tightened with suture material, while the dermis and epithelial layer are precisely matched, the latter is fixed over the epithelium with a surgical unit.

Using this method allows to increase the cosmetic effect of suturing.

Known vertical mattress nodal surgical suture Donati used for suturing extensive wounds (Topographic anatomy and surgical surgery. / Under the editorship of the academician of RAMS Yu.M. Lopukhin. In 2 vols. M .: GEOTAR - MED, 2002 T. 1. S. 64-67). A suture is performed as follows: injection of a needle into the skin through subcutaneous fat with capture of the bottom of the wound, puncture through all these layers on the skin of the opposite side of the wound. The needle is again injected into the skin, departing from the puncture site a few millimeters, punctured from the side of the wound cavity, punctured into the skin from the opposite side of the wound, also from the side of the wound cavity, and again punctured on the skin, stepping back a few millimeters from the previous injection site.

The main disadvantage of the seam is a cosmetic defect in the form of transverse traces on the skin remaining after the removal of the seam due to thread cutting. And this seam due to the small capture of tissues is not applicable for extensive purulent wounds.

A known method of performing a cosmetic surgical suture, including injecting a needle with suture material into the skin, after the needle is carried out intradermally parallel to the skin at a distance of 2 ÷ 5 cm from the edge of the wound, is turned and brought to the bottom of the wound, then it is passed through the subcutaneous fat with the capture of the bottom of the wound and the puncture is carried out through all layers to the middle of the dermis from the opposite side 2 ÷ 5 cm from the wound edge, then the needle is rotated and withdrawn intradermally to the injection site (Patent RU No. 2360624 C1. Method for performing cosmetic surgical suture. - M By 7: A61V 17/04 - 10.07.2009)..

The disadvantage of this method is the inversion of the edges of the operating cavity, causing an unsatisfactory cosmetic effect, especially in obese patients with various surgical pathologies, as well as the possibility of the formation of pockets and spaces in them.

A known method of performing a cosmetic surgical suture, in which, when injected into the epidermis, the needle is rotated in the direction of the operating cavity and carried out in the thickness of the dermis with the bottom of the operating cavity being grasped on its opposite side, behind which the needle is deployed in the opposite direction with the dermis grasping and brought into the operating cavity on the level of a third of the wall from the epithelium. Then, at the same level, the needle is injected into the opposite wall of the operating cavity and a puncture from the epithelium is carried out through the dermis and epidermis, indented from the injection site in the direction of the edge of the operating cavity. After that, the operating cavity is compressed and pulled together with suture material. The latter is fixed over the epithelium with a surgical unit. Then, the upper third of the operating cavity is closed with the epidermis by applying a suture material with a continuous linear suture. It is possible to inject the needle into the epidermis at a distance of 2-3 cm from the edge of the operating cavity (Patent RU No. 2408301. Method for performing cosmetic surgical suture). This method is adopted as a prototype.

The main disadvantage of the seam is a cosmetic defect in the form of transverse traces on the skin remaining after the removal of the seam due to tissue capture. Additional suture overlay is required with a continuous linear seam, which lengthens suture time and requires additional suture material.

Tasks: increasing the effect of the surgical suture, eliminating the possibility of the formation of pockets and spaces in the surgical wound, achieving a cosmetic effect.

A positive result achieved by the claimed invention is a good cosmetic effect due to the adaptation of the edges of the epidermis and the walls of the dermis in the surgical wound.

The presence of an intradermal element during the suture completely eliminates the indicated negative effect in the form of transverse traces of the applied threads on the skin, including purulent surgery. For a better understanding, the seam is schematically shown in FIG. 1, FIG. 2, where:

1 - ligature,

2 - epidermis and dermis,

3 - subcutaneous fat,

4 - the space between the edges of the wound,

5 - the bottom of the wound,

6 - surgical nodes (final view).

The essence of the method is that they inject the needle into the skin, with a ligature (1), at a distance of 1.5 cm from the edge of the wound through the subcutaneous fat (3) with the capture of the bottom (5), then the needle is carried out intradermally (2) , without a puncture, in the opposite edge of the wound, and the point of entry into the dermis is symmetrical to the point of the initial injection into the skin (a = b), and lead to the wound (4) in the middle of the dermis layer. Then, at the same level, the needle is pierced into the edge of the wound, i.e. the place of appearance of the needle in the dermis, on both sides equally (c = d), is carried out intradermally, by puncture from the epithelium at the site of the initial injection. After that, the operating cavity is compressed and pulled together with suture material, while the dermis and epithelial layer are precisely matched, the latter is fixed over the epithelium with a surgical unit (6).

Using this method allows to increase the cosmetic effect of suturing.

Claims (1)

A method of performing a surgical suture, including injecting a needle into the skin, with a ligature, through subcutaneous fat with grabbing the bottom of the surgical wound, then performing a puncture, characterized in that the needle is injected with a ligature at a distance of up to 1.5 cm from the edge of the wound with a grip the bottom of the operating cavity, conduct the needle intradermally in the opposite edge of the wound and lead into the space between the edges of the wound in the middle of the dermis layer, at the same level, the needle is pierced into the edge of the wound and is carried out intradermally, performing a puncture from the epithelium in the place of initial puncture ceiling elements, whereupon the operating cavity tightening the suture material, the latter is fixed on the surgical unit epithelium, dermis, and wherein the epithelial layer is accurately mapped.

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