Name: Kantor Atlas 2e- Video 4-37 - 18489969

Description: Kantor Atlas 2e- Video 4-37 - 18489969

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Duration: T00H04M14S

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Upload Date: 2022-04-01T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
The bootlace suture is a running buried technique. This is typically started at the center of the wound. The wound edge is reflected back and a bite is taken. This is classically done as a simple buried, or a buried vertical mattress, but it can also be done as a set-back dermal suture as well. On the contralateral side, wound edge is reflected back and, again, a small bite of suture is taken.
Suture material is pulled through, and this pattern continues moving away from the surgeon. The free end of the suture material is kept in place, it can be clamped if necessary with the hemostat or a needle driver. And, again, bites are taken on alternating sides, continuing to move away from the surgeon.
Once the apex of the wound is reached, a bite of suture material is taken. Needle is pulled through. At this point, the needle is grasped and is passed underneath all of the previously placed sutures. So the needle is going to go under all of these sutures. Can perform that technique this way by grasping and just gently pulling through.
Typically, this is very straightforward. Here, because I'm using a skin substitute, it's a little bit sticky as it moves through. At this point, you can already see that the wound edges are coming together nicely. So now the distal half of the wound has already been sutured, and the needle has been pulled underneath all the previously placed running sutures. We now start at the contralateral apex and we take symmetrical bites on one side and the other.
And what we're going to do is move distally in the direction of the center of the wound.
Once the center of the wound is reached and we're directly across from where we started, suture material can be pulled. You can see the nice eversion that we're seeing here along the edge of the wound. And an instrument tie may be performed. Suture material may be gently trimmed.
And this completes the closure. Notice that the wound edges are well everted with this continuous buried technique.

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