To end continuous suture, either a square knot, surgeon’s knot or an Aberdeen knot is required. The Aberdeen knot has been shown to be superior to a surgeon’s knot. Recommendations on number of throws: Technique/Steps:
Tag: General Surgery
Surgical Skills 
Running subcuticular suturing
1. Start with a buried knot at distal apex of the wound. 2. Take a bite deep to the epidermis that should curve parallel to the skin surface and exit in the same plane approximately 5-10mm along the wound, taking care to stay at the same level. 3. Continue step…
Surgical Skills 
DIY Vac Dressing for Wounds
Pre-requisites for Vac Dressing Components of Vac Dressing 1. Pump for Negative Pressure: In a study, 3 closed suction drainage systems were studied – Davol Reliavac 400 Evacuator, Jackson-Pratt Closed Wound Suction Drainage System, and Snyder Hemovac 400. In all three systems, maximal negative pressures (-71 to -175 mm Hg)…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
ECG Guide for Surgeons
There is an old saying that two surgeons and an ECG form a double-blind-study. Then, there’s a protocol for surgeons intended for humor: All spikes up: Operate All spikes down: Call Medics All spikes missing: Recently: Call Anesthetist A long time ago: Complete death certificate So, let’s think of heart…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Perioperative Management of Venous thromboembolism (VTE)
Recommended duration of anticoagulant prophylaxis The recommendations are as follows: 1. Provoked DVT (with reversible surgical or nonsurgical provoking factor): 3 months 2. Unprovoked isolated distal DVT (has low risk of recurrence): 3 months 3. Unprovoked proximal DVT or PE: Indefinite therapy if D-dimer positive after 1 month after 3 months of therapy or second VTE…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Mnemonic based management of Acute Pancreatitis
Acute pancreatitis along with case based discussion has been already covered earlier here: To remember the initial management of acute pancreatitis, one can remember the mnemonics given below: iPA-NCREAS (Ye et.al.) Investigations: Imaging (CT, MRI or Ultrasonography) Prognostic screen to identify severe pancreatitis Amylase and lipase levels Initial treatment: Nutritional…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Stages of Skin Graft take : Mnemonic
Mnemonic: AIIRR I – Adherence Formation of fibrin bonds between graft and it’s recipient wound bed II – Imbibition (1st 2-4 days) Donor tissue receives nutrition from absorption from the recipient site wound bed via capillary action (graft drinks from recipient bed) Graft increases in weight and volume and appears…
Surgical Skills 
Techniques of Securing Surgical Drain to Skin (Drain Fixation)
Choice of Suture: Non-absorbable (braided suture provides slightly superior grip on tubing than monofilament sutures) Technique 1: Create a series of knots around the drain. The long end of the thread (attached to the needle) is passed through the skin directly next to the drain exit site, to create a…