Types of stitches to learn?

[Guest]

What are the highest yield stitches/techniques to learn for an incoming sub-I?

[Guest]

Neurosurgery doesn't typically get fancy with suturing. As a sub-i you will start out tying simple interrupted vicryls for the resident who is closing. For this you just need to be efficient tying one-handed. I personally bought a large role of fishing line and cut 20" pieces for an endless supply to practice with. At some point someone will let you throw your own facial/subq suture-- again these are just simple interrupted sutures. The most important thing here is to learn to palm your needle driver. Someone will inevitably point out how inefficient you are if you are constantly pulling your fingers in and out of the handle. I suggest grabbing a hemostat from a suture removal kit and practice palming with that-- I'm sure there are youtube videos demonstrating how to do this. Next, nearly all closures in neurosurgery are with simple running nylon or staples. The complex closure for a wound dehiscence requiring something more fancy like mattresses is not going to be given to the sub-i, so that is low yield. Finally, you may be given the opportunity to put in a drain stitch. Your resident may have their own preference, but most people use something like a simple purse or horizontal mattress-- don't tag the drain.

[Guest]

Thanks so much for your help!