Quick Fire Surgical Pearls to Optimize Patient Outcomes - High Tension Closure Tips

Dr. Rick Drew, a surgeon from Kansas with dual fellowships, shares valuable tips on handling high tension wounds, particularly in challenging areas like the back. He stresses the importance of selecting appropriate surgical tools, recommending the RB-1 needle for 3-0 sutures due to its smaller size and durability compared to the commonly used PS2 needle, which is also significantly more expensive. Dr. Drew emphasizes using larger needle drivers and forceps specifically designed for 3-0 sutures to facilitate handling without damaging smaller instruments. Another critical technique he discusses is the creation of a Slipknot, which helps maintain wound approximation while minimizing tissue loss during suturing. This can be done with or without an assistant, although teamwork can reduce the wastage of suture material. Lastly, he advises using skin hooks to draw the edges of the wound together, improving visibility for suture placement and allowing for a cleaner closure. Overall, these insights aim to enhance surgical efficiency and patient outcomes in high tension wound closures.