Suturing

Re: Suturing

Siobhan Steven — Sat, 22 May 2010 09:15:52 GMT

The Australian Aborigines use ants as 'sutures', it wouldn't be a painless procedure though! We get these ants in the gardens and bush over here and if one crawls up your trouser leg and bites you, you know all about it!!

Funny about this topic, I was suturing a cadaver yesterday for practice. We do purse string sutures in our anal gland ablations etc & head soft tissue surgeon allows us nurses to do it.

Sometimes there are workshops conducted at conferences for nurses to learn suturing, I think its great for us to have as many skills as possible, though can understand some peoples reluctance or that their interests lie in other areas of the field.

Re: Suturing

Polly P — Sat, 22 May 2010 00:01:55 GMT

Wow, really? I didn't know that. I have been wondering how they get the ant to bite just in the place that they want them to!

Tonight I have been looking up the 'pull through method of wound healing' (I found it in the veterinary dictionary in work) but there is not much info on it online!

Fascinating idea- if you put an item/ substance etc. into the wound that then shrinks in size/ retracts, it pulls the two sides together gradually to heal...

I would love more info on this!

Re: Suturing

A Little TLC — Fri, 21 May 2010 20:36:25 GMT

Still do in some tribal communities :)

Re: Suturing

Polly P — Fri, 21 May 2010 20:25:33 GMT

[quote user="Polly Player SVN"]I learnt last week that army ants used to be used to suture! They;d get the ant to bit on the two edges of the sound thne twist it's head off to make the hold...[/quote]

D'oh let me translate myself...

"I learnt last week that army ants used to be used to suture... They'd get the ant to bite on the two edges of the wound then twist it's head off to make it hold."

Re: Suturing

Polly P — Fri, 21 May 2010 20:23:46 GMT

I just found this thread... I am a very new SVN and nurses (of any level) don;t suture in the company I work for, so not something I will ever do in the medium term future... But I have become fascinated with suturing and types of stitches, needles, thread, techniques, history etc... All of it...

I learnt last week that army ants used to be used to suture! They;d get the ant to bit on the two edges of the sound thne twist it's head off to make the hold...

The link above about schedule III/ CPD isn't working for me, would you mindl inking it again please?

Re: Suturing

Maisy — Mon, 19 Apr 2010 21:27:59 GMT

http://www.caw.ac.uk/sc/scourse.asp?scc=SN this is a good one run by CAW and I think Improve CPD/CPD Solutions have courses on schedule 3. Some of the colleges and universities also run them, there's a lot around at the moment

Re: Suturing

LoveCat — Mon, 19 Apr 2010 21:20:46 GMT

[quote user="Vicky VN"]There are a few good courses around to help VNs learn schedule 3 though.[/quote]

Just noticed this comment! Does anyone have any more info?

Re: Suturing

LoveCat — Mon, 19 Apr 2010 21:19:59 GMT

Are there any 'formal' courses that you can take to learn about placing sutures? We had an RCVS inspection a while ago and our vet told the inspector he felt our head nurse was competant to perform skin sutures. The inspector asked what further training she had had in the area on top of her VN course....

Re: Suturing

Maisy — Mon, 19 Apr 2010 09:26:45 GMT

[quote user="Kim Blowing RVN"]

Think I'll stick to the nursing and let the vets do the surgery for now.

[/quote]

Agree! Personally I don't have the interest (if that's the right word) to carry out surgical procedures like tail/digit amps or stitch ups and would rather focus on nursing instead. A practice I worked at wasn't really willing to let nurses to do stitch ups except when the vet didn't have time so it meant that nurses weren't really being properly trained in this. There are a few good courses around to help VNs learn schedule 3 though.

Re: Suturing

Kim Buckley — Mon, 19 Apr 2010 07:09:28 GMT

What worries me about things like tail amputation and bigger stitch ups is that nurses don't get any formal training and so are only taught by vets in practice. Seems a bit silly to me that you are trained and tested on things like placing cannulas and taking bloods but you can be expected to do extensive stitch ups with no proper training.

Think I'll stick to the nursing and let the vets do the surgery for now.

Re: Suturing

Phrin Vernon RVN — Fri, 16 Apr 2010 22:24:03 GMT

As you say Paula, the HN is asked to do the heamatoma because the vets know she or he is competant to do so - this means a vet must have spent the time training her or him, as it is not part of the syllabus - YET VN's are able to do these things, without any further formal training if the vet deems them competant!

I have worked in 2 referral centres - in one the VNs (ond only QVNs) did the uncomplicated stitch ups, heamatomas etc, and in the other, the HN and DHN were allowed and able to to do stitch ups. In the first of those practices (many many moons ago - before they stopped VNs being allowed to do extractions and cat casts) I even monitered a GA while an AVN nurse did a dog cast! Eeek!

I do NOT think that castrations are appropriate, but I do think we should be able to do simple stitch ups and post op skin sutures, and that those at least should be part of the syllabus!

Anything more than that, and I think we are straying into 'mini-vet' territory, which I am not 100% comfortable with!

Re: Suturing

Saskia Quinn — Fri, 16 Apr 2010 22:10:26 GMT

[quote user="Phrin SVN"]

[quote user="bongo"]

We only get to stitch up after pms. Once we had an animal in, tiny cut, but needed 1 stitch, all vets were really busy and we could have easily put a quick stitch in using a 21g needle and some nylon, but nooooooo, dog had to wait for a vet who did exactly that!!! grrrrrr! we learn to do it so let us do it!!!

[/quote]

The practice I am in is mixed practice, so some of the vets have erm.. shall we say 'old school' expectations of their nurses!

However, we also have some vets who are happy to teach the VN's sch 3, and then expect them to be able to do it! Such as the vet doing the cruciate op!

If you have never been allowed to do stuff, have you tried asking? I say to the vets 'When I'm qualified I will be expected to be able to do this, even though we aren't taught it at college! Could you show/help me!?' Which is completely true! If once RVN I relocated to, for example a PDSA clinic, I believe they expect their RVNs to be competant at Sch 3 incl suturing, stitch ups, aural heamatomas etc. I have also worked in some referral places where the VNs did all of those, so feel I need to be at least on the road to being competant at it by the time I qualify!

Having said all that, don't think our vets would let us do stitch ups or aural heamatomas - or even tutor us in how to do them... but they do let us place skin sutures! Yay!

[/quote]

What you say about PDSA is correct, to an extent. The only nurse who will confidently repair an aural haematoma in our practice is the HN. Normally, its the vets who do it, however, if we have a very busy day with operations, then the HN is called to do the haematoma. I guess this is as a result of us nurses not having had the experience of doing one before.

Stitch up's etc are normally done by the vet, as more often than not, the patient needs a general anaesthetic, so it just seems so much easier to let the vet get on with it while we monitor the anaesthetic.

Re: Suturing

Phrin Vernon RVN — Fri, 16 Apr 2010 22:02:20 GMT

[quote user="bongo"]

[/quote]

The practice I am in is mixed practice, so some of the vets have erm.. shall we say 'old school' expectations of their nurses!

However, we also have some vets who are happy to teach the VN's sch 3, and then expect them to be able to do it! Such as the vet doing the cruciate op!

Having said all that, don't think our vets would let us do stitch ups or aural heamatomas - or even tutor us in how to do them... but they do let us place skin sutures! Yay!

Re: Suturing

bongo — Tue, 13 Apr 2010 22:16:54 GMT

Re: Suturing

miaoww — Tue, 13 Apr 2010 15:31:31 GMT

Allevyn pads are great for practicing suturing on their like the ones used on suturing courses but cheaper.

Re: Suturing

Claire Cameron — Mon, 12 Apr 2010 15:19:34 GMT

I've only ever really sutured up PTS'd animals on the table, post mortems and the like.

Re: Suturing

Nick Shackleton — Sat, 10 Apr 2010 18:46:15 GMT

[quote user="Kim Blowing RVN"]

When I was a student, I was on placement at the QMH at the RVC and I was scrubbed in and helping with a cruciate repair and was asked to suture the skin. I asked the surgeon if he was sure as I was a SVN and not a vet student (just in case he had got me muddled up) and he told me I had to learn some day! I was like ahhhhh! Did a good job though! lol Not done it since (except suturing animals who have been pts on table) but can't say I'm particularly fussed.

[/quote]

I'd agree with Kim there! In on of my previous jobs I used to work closely with one of the ortho surgeons and was often left to suture post op whilst he went off and did other 'vet' things. I did really enjoy and often did stitch ups when vets were busy etc.

When I moved to 100% referral I asked about doing more schedule III and they said would look into it...... Did a bit but not much, used to use surgical staples alot. Anyway, once I started my diploma got interested in other areas such as anaesthesia and radiography and actual surgical nursing of the patient per, peri and post op care. that sort of side of it.....

Re: Suturing

Kim Buckley — Sat, 10 Apr 2010 18:40:38 GMT

Re: Suturing

Lolita — Fri, 09 Apr 2010 19:48:02 GMT

mine either....never get to do anything...

Re: Suturing

Gillian Davidson — Fri, 09 Apr 2010 19:25:30 GMT

WOW.... what a fantastic opportunity. That would never be allowed in my practice.

Re: Suturing

Saskia Quinn — Thu, 08 Apr 2010 23:31:33 GMT

[quote user="Phrin SVN"]

But he would ask me all the awkward why? questions after!

Why is the doggy poorly? Can I cuddle it? Will a cuddle make it better? Why does mama have to help the vet? Why do you have to give funny medicine that make the doggy go to sleep? How is it asleep? Why is there a poorly? Why do poorlys have blood? How does blood make poorlys better? What is that dogs name? Ohh mama you just did an jection to that doggy - thats not nice mama!

Yay!

[/quote]

I know what you mean about the questions lol!! Once, I left my mobile phone in work and went on the saturday to pick it up - with both boys in tow!!

Had a hard job stopping them from opening kennels!!

There was a German Shepherd sedated that day - they STILL ask me about the police dog who was sleeping!!!

Re: Suturing

Phrin Vernon RVN — Thu, 08 Apr 2010 22:39:52 GMT

[quote user="Sue Cox"]

[quote user="Phrin SVN"]

I need to sort the closed gloving thing first! Gahhh!

Maybe we could be ladies that glove and suture! ;)

Or glove TO suture! Even better!

[/quote]

Ooo yes we do! You did good last time, so don't worry, just need to do it a few times until you don't need to think so much! When it gets closer to your practicals we will have to go to work at the weekend or something, bring Kirsty, bring little man (aw how cute if we get him to gown n glove?!) and just do everythin!!

[/quote]

Last time was first time! Have always done open gloving before - even in the referral places! says it all when i asked MC for advice, n he said ' well we don't do it properly anyway - we do it asepticaly, but not 'properly'

A gloving and suturing sunday sounds like fun!!

Lil man would LOVE to glove and gown! But he would ask me all the awkward why? questions after!

It never ends! BUT lil man really wants to be a vet nurse! (at this moment in time!) lol!

Yay!

Re: Suturing

Sue Cox — Thu, 08 Apr 2010 22:20:41 GMT

[quote user="Phrin SVN"]

I need to sort the closed gloving thing first! Gahhh!

Maybe we could be ladies that glove and suture! ;)

Or glove TO suture! Even better!

[/quote]

Re: Suturing

Phrin Vernon RVN — Thu, 08 Apr 2010 22:14:52 GMT

[quote user="Sue Cox"]

[quote user="Phrin SVN"]

I know it isn't part of the SVN course, but RVNs (and SVN's in our place!), are expected to be able to do it, and do it well, so I have decided to borrow some instruments and nylon, and practice at home! I believe banana skins are good to practice on!

[/quote]

Thats such a good idea Phrin! Maybe we should have a play on lunches or something? It could be a new trend! We would be like ladies that knit, but instead ladies that suture!

[/quote]

I need to sort the closed gloving thing first! Gahhh!

Maybe we could be ladies that glove and suture! ;)

Or glove TO suture! Even better!

Re: Suturing

Nick Shackleton — Thu, 08 Apr 2010 22:14:43 GMT

we used sheets of foam in a tube shape and then cut a slit in it and then ready for suturing!