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Complications - Suturing and Knotting Technique

general and visceral surgery
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Anatomy Perioperative management Technique Complications Evidence Total Video

  1. Complications and their Avoidance

    • Tissue traumatization → smooth surface of the thread, atraumatic needle-thread combination
    • bacterial invasion → as much as possible absent capillarity of the thread
    • Tissue ischemia with consecutive necrosis and thus increased infection risk
      → layer-appropriate fascia closure without grasping the musculature (“small bites” technique), avoiding a subcutaneous suture (controversially discussed)
    • Wound rupture, suture dehiscence → suture technique according to the wound tension, sufficiently tear-resistant suture material
    • Knot coming undone → smooth surface and stiffness of the suture material worsen the knot hold, which must be compensated by a higher number of knots (approx. 6 to 8).
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