تقنية الربط بالأدوات في طب الأسنان

Study Notes

Instrument Tie Suturing Technique

Used to stop bleeding from soft tissues when visible vessels aren't available to tie.
Dental applications: Maintaining the integrity of the socket after tooth extraction.
Advantages: Fewer knots, less likely to slip from regular sutures.
Two methods:
- First Method:
  - Needle enters the buccal papilla, exits the corresponding palatal papilla.
  - Needle enters the adjacent buccal papilla, exits the second palatal papilla.
  - Tie the thread on the buccal side at the initial needle entry point.
- Second Method:
  - Needle enters the lingual buccal papilla, exits the adjacent buccal papilla.
  - Needle enters the lingual palatal papilla, exits the distal palatal papilla.
  - Tie the thread on the buccal side at the initial needle entry point.

Knot Tying Methods

Instrument aided
Hand tied
Single handed tie

Instrument Tie Technique

Pull the thread through the tissue leaving a free end approximately 2 cm long.
Create the first knot by placing the needle holder over the thread and forming a loop with the hanging thread segment around the instrument, counterclockwise (3 turns).
Hold the free end of the thread and pull it through the loop, while sliding the left thumb the loop away from the needle holder downward around the free end of the thread.
Apply tension to both ends in opposite directions to form a stable knot fixed to the side of the wound.
Repeat the process wrapping the thread around the needle holder clockwise (opposite direction of the first knot).
Secure the free end and pull through the looped thread.
Apply tension in opposite direction to the first knot.

Additional Knots

Additional knots can be added on top of the first knot using the same method.

Wound Cleaning Before Removing Sutures

Clean any debris gathered on sutures with antiseptic cotton (e.g. peroxide, chlorhexidine).
Grasp the knot with forceps and slightly pull to reveal a section of the thread within the tissue.
Trim the thread entirely below the knot part inside tissue.
Pull the cut thread along the wound line to prevent the wound opening.
This avoids contamination of the tissue by the thread.

Description

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