Indications Contraindications Advantages Disadvantage Tension (maximum tension occurs in mid portion of the defect) especially with large defects Blood supply of flap Oblique terminal branches of the digital arteries arising from the trifurcation of distal interphalangeal joint (a subcutaneous pedicle flap) Technique References:
Tag: Surgical skills
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)…
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…
Surgical Skills 
How to make tourniquet for fingers using latex gloves?
Method 1: Digital block Painting with antiseptic solution Application of sterile latex gloves (slightly larger than the patient’s hand) on the patient’s hand A tiny piece of glove fingertip is snipped off to create a 1- to 2-mm hole With very gentle pulling—by either the forceps or the surgeon’s fingers—the…
Surgical Skills 
Zancolli-Lasso Procedure
Based on the preoperative clinical examination, the decision on which donor superficialis (FDS) tendon to use is made (commonly FDS middle finger is used). Transverse incision is made at the level of the distal palmer crease. Care should be taken to avoid the neurovascular bundles and the flexor tendons must…
Surgical Skills 
Corner Stitch
Synonym: Half-buried horizontal mattress suture Indications: V, Y or X-pattern laceration repair Risk: Dermal stitch may be placed too close to the tip of the flap and compromise the tenuous blood supply Suture: Non-absorbable Principle: When repairing, this stitch must be placed first Landmark sites (2 on each site of…
Surgical Skills 
Surgical Sutures – Basics
Monofilament Polyfilament Absorbable Caprosyn (Polyglytone 621)Monocryl (Polyglecaprone 25)Biosyn (Polyglecaprone CV-23)Maxon (Polytrimethylate carbon)PDS (Polydiaxonone) CatgutVicryl rapide (Polyglactin 910 rapide)Vicryl (Polyglactin 910)Dexon (Polyglycolic acid) Non-absorbable NylonEthilon (Monofilament polyamide)Prolene (Polypropylene) SilkDacronEthibond (Polyester)Braided nylon (Surgilon, Nurolon)Supramid Monofilament sutures: Polyfilament/Multifilament sutures: Natural sutures: Synthetic sutures: Absorbability: There are 2 principal methods, by which the sutures…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Timing of Wound Closure (Primary, Secondary, Tertiary)
Before moving to the concept of wound closure, it is necessary to understand the pathophysiology behind different types of healing. We have covered stages of wound healing in general previously. There are three types of wound healing: Primary intention Secondary intention Tertiary intention Healing by primary intention occurs when the…