c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Lipoma: 19

A D V E R T I S E M E N T

   

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The skin was closed with a running subcuticular. The toothed Adson forceps gently holds the skin one centimeter from the intended bite, and is held in place as the exposed needle tip is grasped with the needle holder. The forceps is then released and assists in positioning the needle for the next bite. Current practice avoids manually manipulating sharps because of the dangers of hepatitis and HIV. Manipulation is facilitated with the use of platform forceps which have parallel elevations behind the tips for grasping needles.   

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Lipoma: 20

A D V E R T I S E M E N T

   

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There are several ways of ending a subcuticular stitch. One can create several slip loops, then bury the resulting knot by passing the needle beneath the knot and out through the skin at the end of the incision. A deep bite of subcutaneous tissue was taken on either side with the last two bites in this case, leaving a loop on one side and the needle end on the other.    

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Lipoma: 21

A D V E R T I S E M E N T

   

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With the loop hooked with the ring finger of the left hand, a true buried knot was made. Note that the loop is brought down round and equal just as it is with single strands (see two-handed tie animation) to create a flat square knot. Skin strips were placed across the wound.    

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This page was last modified on 6/25/2004.