tag:blogger.com,1999:blog-30499448.post1197833348103869427..comments2024-02-18T13:53:30.168-08:00Comments on Surgeonsblog: Knot ReallySid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-30499448.post-57016261660060195782007-04-09T05:44:00.000-07:002007-04-09T05:44:00.000-07:00Hmm. I always thought of dexon and vicryl as inter...Hmm. I always thought of dexon and vicryl as interchangeable: both polyglycolic acid. Our hospital bought vicryl. I used #1 vicryl for running closure, and had no problems with it.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-52006245014975321392007-04-08T21:16:00.000-07:002007-04-08T21:16:00.000-07:00Sorry Sid, but Vicryl & other short-acting absorba...Sorry Sid, but <B>Vicryl</B> & other short-acting absorbables for closing laparotomy incisions have substancially higher hernia rates then PDS, Dexon, or the permanent sutures (steel, nylon, polyester). Your other comments I agree with 100%.Dr. Rob Oliver Jr.https://www.blogger.com/profile/09059882318849767896noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-5311931427296428392007-03-23T10:40:00.000-07:002007-03-23T10:40:00.000-07:00My ortho surgeon used staples to close the wound. ...My ortho surgeon used staples to close the wound. Because of a planned trip I had to ask him to remove them several days before it was scheduled. Have to say each snip (fourteen) smarted but was not unbearable! Now, nine months later, there's hardly a visible scar. <BR/><BR/>I finished your book in one setting, also! It was great. Love your blog and hope you write another book!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-79602188510419294912007-03-21T13:48:00.000-07:002007-03-21T13:48:00.000-07:00It must be a surgeon thing: English speaking surge...It must be a surgeon thing: <BR/>English speaking surgeons using the French pronunciation for "centimeter"; <BR/>another favourite, of course, is "debridement".Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-26952734874257478242007-03-21T11:30:00.000-07:002007-03-21T11:30:00.000-07:00Yep, been there, done those!Yep, been there, done those!Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-55517872864645572372007-03-21T11:23:00.000-07:002007-03-21T11:23:00.000-07:00I myself am a big fan of the double-stranded #1 PD...I myself am a big fan of the double-stranded #1 PDS. The loop eliminates the need to tie in the corners and you can start one from either end and tie in the middle.<BR/>Of course if all else fails there is the old retention closure with the "dead man's stitch" of #2 nylon with cut up red rubber catheters.Bard-Parkerhttps://www.blogger.com/profile/07529042060117023381noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-5777780831166664072007-03-20T07:35:00.000-07:002007-03-20T07:35:00.000-07:00one thing i've learned in the blogosphere is that ...one thing i've learned in the blogosphere is that the surgical world is small. our old (very old) professor used to say centimeter in that same way, "sahnnimeeter". i just thought he was old and perculiar. once again i see there is nothing unique to us but rather a constant thread that binds us all together. <BR/><BR/>i feel a tear welling up in my eye...Bongihttps://www.blogger.com/profile/12918640034313468627noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-5329079457955033272007-03-19T18:55:00.000-07:002007-03-19T18:55:00.000-07:00Don't know what specialty the student ended up in....Don't know what specialty the student ended up in.<BR/><BR/>Malpractice attorney.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-24323188033216771702007-03-19T18:08:00.000-07:002007-03-19T18:08:00.000-07:00I was told that there were two ways that the medic...I was told that there were two ways that the medical student can cut a suture: too long and too short. This is true.<BR/><BR/>One fellow student was set on getting things exactly right and was allowed by an attending doc to close. True to form, Dr. Attending yelled, "Too short! Too long! I want them one centimeter [pronounced the bizarro-surgeon way as "sahnnimeeter"], exactly!" He called for a sterile ruler. Still, the sutures ran 1.2cm, 0.9cm, 1.1cm... Student sees his surgical career fading incrementally with each millimeter (the sutures were plentiful, as Dr. Schwab notes, and the running commentary was interminable). At the end, the surgeon said "Good job!" and walked out laughing. Don't know what specialty the student ended up in.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-26727356028011392482007-03-19T14:56:00.000-07:002007-03-19T14:56:00.000-07:00on suturing: approximate, don't strangulateon suturing: approximate, don't strangulateAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-62150607178439744102007-03-19T13:48:00.000-07:002007-03-19T13:48:00.000-07:00"Here's a hint: right click on the image and then ..."Here's a hint: right click on the image and then go to [save image as]..."<BR/><BR/>I got that when I clicked directly on the photo. I figured the guy was a rapper named Too Short. Being an old broad, I don't do rap, so I can only guess.<BR/><BR/>Thanks for the explanations, Sid. I've heard that term "throwing down" from any number of places.<BR/><BR/>Still loving your book. Wish I could just sit and eat it up in one sitting like Anon did. Lucky stiff!Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-28184427302561717602007-03-19T12:00:00.000-07:002007-03-19T12:00:00.000-07:00Here's a hint: right click on the image and then g...Here's a hint: right click on the image and then go to [save image as]...<BR/><BR/>ps Dr. Schwab, I loved your book (I think I read it all in one sitting - couldn't put it down)... please keep your illuminating posts coming.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-30499448.post-18640230128251563642007-03-19T10:37:00.000-07:002007-03-19T10:37:00.000-07:00lynn: the suture material I used for running closu...lynn: the suture material I used for running closure was big and strong. #1 vicryl, to be specific. It's absorbable, meaning it entirely disappears, but only after at least a couple of months, by which time it's all healed. It's impossible to break the stuff, and it's quite thick so it won't pull through. Barring manufacturing defect (which I've never seen or heard of), and assumint the initial and final knots are well-tied, ain't no way it'll come loose. <BR/><BR/>"Throwing down" (not a universally used phrase, I'd say) refers, I think, to the act of tying each knot, as opposed to place the stitch in the first place. When tying one-handed, the loop is made and sort of thrown down to the knot with the index (or sometimes the middle) finger. Sling, push, pop.<BR/><BR/>And I'm waiting until I see if anyone gets it before explaining the pun.Sid Schwabhttps://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-30499448.post-36183056335558174102007-03-19T10:00:00.000-07:002007-03-19T10:00:00.000-07:00As always, you throw out an interesting post. I'm ...As always, you throw out an interesting post. I'm in the middle of writing a chapter where the doc is teaching med students how to do stitches on chicken legs - really happened when we were in the Amazon jungle - and find your comments helpful in giving me added reality. <BR/><BR/>As an old seamstress from another age, I always feared the running stitch because if one end came undone, bango, my daughter's prom dress could be in a heap on the dance floor. A lovely sight for her date, agonizing hell for Daughter. Even more agonizing hell for Mother. I assume that the surgeon's running stitch is far stronger and less likely to unravel than a seamstress', yes? If so, how?<BR/><BR/>Another question: Why do docs call it "throwing down" a stitch? Makes it sound like you have a bag of them and you reach in and toss one into an organ.<BR/><BR/>"(Only the very hip will get the photo-pun. And I'm nothing, if not hip.)"<BR/><BR/>God, I'm so uhip. I give. What's the pun?Lynn Pricehttps://www.blogger.com/profile/02958402288888144904noreply@blogger.com