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- Presentation
Gloves, Germs, and Steel: Easy Tips to Improve Your Procedural Practice
Description
In this presentation, Melissa Scheibe shares valuable surgical tips aimed at improving procedural practices. She emphasizes the importance of effective surgical planning, suggesting the use of the back of the glove to imprint wound designs for patient visualization. Incorporating orienting lines when closing elliptical wounds can greatly enhance the process, while micro-dosing Clindamycin in local anesthetics may lower infection rates. Scheibe advises checking syringes for rubber stoppers to prevent accidental injection into patients and highlights the significance of patient comfort during procedures, using techniques like cold sprays and vibratory devices. She introduces practical suturing methods, such as pinching sutures instead of pushing them together for tension, and demonstrates a special knot-tying technique effective under tension. Utilizing longer-lasting sutures like PDS or Maxon for optimal scar healing is recommended, along with advanced techniques like setback sutures and running subcuticular stitches to improve cosmetic outcomes. Finally, she introduces the use of running horizontal mattress stitches for areas under tension to obtain better healing results. Overall, her strategies focus on elevating patient care and surgical performance.
View moreConclusions
- Using the back of the hand for surgical planning enhances patient counseling and surgical accuracy.
- Orienting lines on the skin can help maintain the shape of surgical closures during the procedure.
- Microdosing clindamycin in local anesthetic significantly lowers the infection rate in surgical wounds.
- Checking syringes for rubber stoppers can prevent accidental injections of foreign materials.
- Creating a pain-free experience for patients improves their perception of the surgeon's skills.
- Pinching sutures rather than pushing them together offers a more effective technique for closing tense wounds.
- Employing specific knot-tying techniques helps manage sutures under tension more effectively.
- Using PDS or Maxon sutures in areas of tension leads to superior long-term scar outcomes compared to Vicryl.
- The set-back suture technique can enhance wound closure outcomes by reducing tension on epidermal edges.
- Running subcuticular stitches eliminate the need for follow-up suture removal, improving patient satisfaction.
- Flipping forceps can provide better control and precision when suturing delicate tissues.
- Running horizontal mattress stitches are effective for cosmetic outcomes, especially in areas of tension.
- Huether, M. J., Griego, R. D., Brodland, D. G., Goh, M., Hollewand, C., McBride, S., Ryan, N., van der Werf, B., & Mathy, J. A. (2023). Effect of Microdoses of Incisional Antibiotics on the Rate of Surgical Site Infections in Skin Cancer Surgery: A Randomized Clinical Trial. Dermatologic Surgery.
- Kantor, J. (2010). The set-back buried dermal suture: An alternative to the buried vertical mattress for layered wound closure.
- Alikhan, A. & Hocker, H. (2016). Review of Dermatology.