What material around the home can I use to practice my suturing technique?

Question

Calling all fellow medical students, nurses, doctors, surgeons, dentists, and anyone else handy with a needle holder, forceps, and some Ethilon!

Any tips for what material I can use to practice suturing at home? I have the equipment and suture packs, but I'm in need of something that feels kinda fleshy!

I've been told banana skins and orange peel, but first one seems too soft, and second too hard. My gf suggests suturing our Thanksgiving turkey after we stuff it good - which sounds like a great idea to me.

Any other suggestions for less festive times of the year? :)

Answer 1

The quality of the material is completely inconsequential in regard to the practice of suturing. The most important aspect of placing sutures is proper tissue handling, instrument and tying technique, relative to the situation at hand. If one is suturing into strong tissue such as abdominal muscle fascia with a #1 vicryl, then a completely different amount of force is applied than if one is using a 5-0 prolene to close an opening in the vena cava. The placement of the needle through the tissue, however, and the attention paid to avoiding lateral stresses to the tissue by "following the curve of the needle" is key. When you tie down the knot, whether using instrument tying technique or hand tying, make certain that you snug the knot firmly but without over-cinching. "Approximate, don't strangulate!" is a slogan of wisdom now, just as it has always been. Bring the knot TO the tissue, and do not tension the tissue by pulling on the suture as the knot is tightened.

Here are some illustrative exercises:

(I'm assuming you've been properly instructed in how to hand-tie suture using two-handed and one-handed technique, as well as instrument tie.)

1) Using a rubber exam glove, place a finger of the glove under a small weight on the table top. Use a small book, or for more challenge, use less weight such as a cell phone or even just a pen. With foreceps and a needle driver, gently place a stitch into the glove. For glove material, I recommend a 3-0 silk. Now, tie the suture down firmly without pulling the glove out from under the weight. Once you have 3 or 4 knot throws, pick up the glove and look at your knot very closely. Did it cinch tight? Is it an "air knot" ? Use a tine of your foreceps and worm it into the suture below the knot, if you can. Can you pull the suture open, showing that your knot can slide? If you do this exercise correctly, you can show that your throws are "going down square" because the knot won't slide.

2) Take a styrofoam coffee cup and poke a hole in the side, near the bottom. Worm the finger of a rubber exam glove from the outside into the cup so that as you look down into the cup, you see the finger protruding into the space. Grasp the tip of the glove finger with a pick-up and clamp across it with a right-angle Mixter clamp. Now, tie off around the finger using a free (silk) tie. Use whatever size you want, but again I recommend 3-0. When you're done, remove the glove from the cup and blow it up like a balloon. Can you prevent air from travelling distally into the finger tip? Is your tie-off "air tight"?

3) For giggles, peel an orange in one piece. Start at one end, gently tearing a large circle around the stem insertion point, but then continue down the orange as a spiral till you can lift off the far end as another circle. Now, sew the peel back together with a running subcuticular stitch. I recommend 3-0 vicryl on the SH needle. Don't use a pop-off needle. The secret is that you don't need to knot the suture at the beginning, just anchor the start by doing a couple of needle passes through the white underside, then when you run out of suture, cut off the needle and just start a new one. No need to knot! If you do this well, you can make the orange look PERFECTLY intact, but it's tougher than it sounds. The orange peel will show off any step-offs from asymmetric suture placements from one side of the gap to the other, and if your exits and entries aren't close to perfectly aligned across the gap, then when you gently cinch it down, the gap will gape. If you over-cinch in order to try to crush the flaws out of your suture line, the tissue will tear.

4) With a sharp knife (perhaps a scalpel), cut a grape in half. Now sew it back together with at least 4 interrupted sutures. I don't care how you hold the grape to do this, and the suture choice is an exercise left to you. There are two modes of failure. One is if your suture rips through. The other is if you tie so losely that when you pick up the grape by one half, the other half sags or shifts.

The bottom line is that any practice is good practice as long as you practice good technique! If you start developing bad habits now, then you're going to be fighting to rid yourself of ingrained error. Work with surgeons to critique your skills, and remember, do as they SAY, not as they do... many surgeons will bend the rules a bit here and there when they know that the situation isn't critical. You, on the other hand, are in training. As such, rule bending isn't something you're priveleged to do!

I hope that helps.

Feel free to contact me if you have questions.

Answer 2

Practice Suture Kit

Answer 3

Suture Practice Kit

Answer 4

For an ideal home made kit for practicing suturing technique, the age old method of thread and needles can be taken, the tread can be passed through the eye of the needle and a sponge/ eraser can be taken, with the help of blade a slit can be made and the needle along with the suture can be passed through the slit. After passing through the slit a simple knot can be applied, a simple knot over two simple knot is known as a surgical knot. After practicing for a few times with bare hands, a pair of tweezers can be used for grasping the needle.

Answer 5

In the superstore, fruits are usually chosen much too soon. Some are rocks, many are bad. Some of the fresh vegetables are generally right (zucchini, onions, garlic, lettuce, greens, and a few others) so I'd have to go with vegetables.

Answer 6

Suture Kit Medical Student

Answer 7

Leaving out the behavioral jokes, pigs and people have remarkably similar tissues. Pickled pigs feet are not as popular as they once were, and you may be able to bum some feet or other cast-off parts from the local butcher. I've found them useful for teaching purposes. Your turkey is now like everybody else's leftovers, but raw, the drumsticks are a great way to practice intraosseous cannulations, with the added thrill of turkey-associated microbiology.

Answer 8

Pork flesh is very similar to human flesh. Buy an untrimmed loin, slice it into pieces, then sew it back together. I know that oranges are used in nursing school to teach nurses how to use hypodermic needles.....haven't heard about using them th suture, but it wouldn't surprise me

Answer 9

Oranges. They have about he same thickness as human skin and are used to practice tattooing.

Answer 10

I would suggest some sort of meat. Whether it be pork, chicken or whatever. Maybe something with the skin on it so you have to do the underlayers and then the outer portion of the skin.