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

 

Principles of Microsurgery: 19

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

   
 

Grasping the needle
A useful method of easily grasping the needle (as demonstrated by Dr. Ackland) is to hold the suture with a platform forceps one needle length behind the needle and touch the tip of the needle to the background material. The needle can them be rotated to the proper orientation for grasping by the needle holder in the opposite hand.      

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Principles of Microsurgery: 20

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

   
 

The needle is grasped at its center and held a short distance from the tip of the needle holder. To make use of the mechanical advantage of the curved needle-holder, the needle is positioned so the tip is coming out of the convex side of the holder.       

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Principles of Microsurgery: 21

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

   
 

Practice suturing is done using silastic sheet of about 100-micron thickness simulating a microvascular wall (rubber exercise bands make excellent, cheap practice material). A slit is made and is oriented so that the needle can be comfortably passed from upper right to lower left (for a right-handed operator). Whenever possible in a clinical situation, the tissue should be oriented for efficiency of movement and comfort. Quick, efficient surgery is not done by moving fast, but by avoiding wasted, inefficient motions. Under high (20X) power, a platform forceps is placed under the right lip of the slit to support the edge with the tips slightly separated.    

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This page was last modified on 4/15/2000.