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  • 1. SURGICAL Sutures & Knots/ Operation Theater *Mansoor Khan26 May, 2010

2. 1650 BC 2000s AD Through the ages, Practitioners have used a wide range of materials and techniques for closing tissue The origins of surgery can betraced back many centuries 3. In the 10 thcentury BC,ANTSwas held over the wound until it seized the wound edges in its jaws. It was then decapitated. 4. Thethorn , used by Africantribes to close tissue,was passed through the skin on either side of the wound.A strip of vegetable fibrewas then tiedaround the edge in a figure eight. 5. The tough membrane ofsheep intestinewas providedto the surgeon pre-sterilised and required threadingthrough the eye of the needle before use. 6. Post World War IIbrought theswaged-on needle . The thread fits into the hollow end of the needle, allowing it to pass through tissue without the double loop of thread that exists with a conventional needle, reducing tissue trauma. 7. SuturesAbsorbableNon-absorbable NaturalSynthetic Natural Synthetic Mono-filament Multi-filament Mono-filament Multi-filament Mono-filament Multi-filament Mono-filament Multi-filament 8. Multifilament (braided) Monofilament 9. Sterility Low tissue reactivity Easy handling

    • knot
    • security

Tensilestrength QUALITIES 10. ABSORBABLE ! Usually lose their tensile strength within60 days. ABSORBED by Hydrolysis or enzymatic degradation 11. Derived from the small intestine of healthy sheep. Loses 50% of tensile strength by 5-7 days. Used on mucosal surfaces. P L A I N G U T 12. Treated with chromic acid to delay tissue absorption time. 50% tensile strength by 10-14 days. Used in episiotomy repairs. C H R O M I C G U T 13. Monofilament 50% tensile strength = 30+ days Sites = need for prolonged strength,POLYDIOXANONE (PDS ) 14. Braided, synthetic polymer 50% tensile strength for 30 days Used: subcutaneous Polyglycane 910 (vicyle ) 15. NON-ABSORBABLE ! Permanent, used for long term strength 16. Appears to be stronger then nylon and has better overall wound security.Polypropylene (Prolene) 17. Braided Before the advent of synthetic fibers,silk was the mainstay of wound closure. Easy handling, excellent knot security. High reactivity and infection due to the absorption of body fluidsby the braided fibers.S I L K 18. 5..4..3..2..1..0..2/0..3/0..4/0..5/0..6/0..7/0..8/0..9/0..10/0..11/0 Thick Thin Suture size USP (United States Pharmacopoeia) General 19. Bowel: 2/0 - 3/0 Fascia: 1 - 0 Ligatures: 0 - 3/0 Pedicles: 2 - 0 Skin: 2/0 - 5/0 Arteries: 2/0 - 8/0 Micro surgery 9/0 - 10/0 Corneal closure: 9/0 - 10/0 SUTURE SELECTION 20. 21. Operation Theatres 22. Place where life saving or life improving invasive procedures are performed on human body under strict aseptic measures!!!!!! 23. History of Hygiene

  • Aristotle Greek Philosopherrecommends
  • Boiling water to armies. Advises the Alexander.
  • Recommends hygiene for healthy living

24. HAND WASHING-Semmelweis Practices, emphasizes the importance of washing hands with chlorinated water in Obstetricsto reduce maternal mortality 25. Florence Nightingale creates fundamentals in Nursing care The Very First Requirement in hospitals that should do the sick no harm Florence Nightingale 1860 26.

  • 1867 Dr.JosephLister first identifies airborne bacteria and uses Carbolic acid spray in surgical areas
  • 1880 Johnson and Johnsonintroduce antiseptic surgical dressings.

Beginning of Safe Operation Theatre Practices 27. Soap ,WaterandCommon SenseYetthe bestAntiseptic William Osler Factors which influence Safety in Hospital Environment 28. H A N D S W A S H I N G WET HANDS & APPLY SOAP RIGHT PALM OVER LEFT, LEFT OVER RIGHT PALM TO PALM FINGER INTERLACED ROTATIONAL RUBBING ROTATIONAL RUBBING OF RIGHT THUMB IN LEFT PALM & VICE VERSA BACK FINGERS TO OPPOSING FINGERS INTERLOCKED 1 3 2 5 4 6 29.

  • Which suits the Circumstances.
  • Availability of Resources.
  • Economical.
  • Safe to you.
  • Some chemical containing compounds can cause sensitization and Allergic reactions.

BEST HAND WASH IS. 30. Good Hand Washing PracticesSave many Lives 31. Cleaning more Important than Disinfection and Sterilization 32. Sterilization! is absolute, removes microbes and spores too . To achieve Sterilization is Expensive, not sustainable, many times not needed. Disinfection! reduces the infections drastically. 33.

  • Paying great attention toFloorsUsing unnecessary, too many chemical not necessary
  • Keep the floor Clean and Dry- Bacteria are reduced,
  • Most Important component of Bacteria is water a dry areas causes natural death except spores


  • Do not disturb unnecessarily,
  • Do not use ceiling fans they cause aerosol spread
  • Clean only when remodeling or accumulated ,good amount of dust.

Do not disturb the Roof 35. Who/What is Important in prevention of Infections 36. Remember we are More important than many 37. Operation Theatre Safety is Responsibility Of.???????? 38. Everyone.. 39. THANKS QUESTIONS PLEASE