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These sticks (Steri-Strip buy generic sildenafil line what causes erectile dysfunction yahoo, Proxi-Strip ) are suitable for closing short superficial wound without need for suturing purchase sildenafil erectile dysfunction protocol + 60 days, and for securing intracutaneous suture buy sildenafil 50 mg otc garlic pills erectile dysfunction. Tissue glues are mostly made from fibrin bases buy 20mg apcalis sx amex, causing consistent fibrin mesh (using last steps of the haemostatic cascade) (Beriplast P Combi-Set) cheap cialis sublingual 20 mg mastercard. Volkmans bone curette: this spoon-shaped instrument is sharp generic kamagra 100 mg, it is used for removing tissue particles, and to refresh infected wounds base. Probe: end is dull, thats why extent of fistulas can be revealed without making tissue damage. Payrs stomach and bowel crushing forceps: inner side is finely fluted, atraumatic. It is suitable for crushing wall of the bowel, avoiding rupturing the serosa during ligation of the bowel. After opening the layer of the crushing can be seen, in this line the ligation must be performed. There are linear (some of them include also cutting edge) and circular sewing machines. Suction system, hand part is going on towards a plastic tube, which is connected through a reservoir towards the central suction system. For the drainage of the operating area using a scalpel a puncture must be performed. Abdominal Pan must be drawn through the abdominal wall, and plastic tube should be drawn from inside out. Lamp set: because it is sterile, operator can set the position of the operating lamp during operation. Practice Knotting technique and type of knots During practice two types of knots will be introduced: Wiener knot and surgical knot must be learnt using both hands. For better visibility on knotting table thick threads in various colours will be used. Other hand surgical knot is strong and safe, thats why it is appropriate in case of tension. At first Wiener knot made by right and left hand will be demonstrated, after this surgical knot will be shown performed by right and left hand. Wiener knot made by right hand: threads end is positioned in right hand between first and second finger ~ palm side is facing upwards ~ third, fourth and fifth fingers are lying side by side stretched ~ second finger is flexed maximally ~ the other end of the thread (held in left hand) must be laid on third finger ~ right third finger must be flexed and must reach the thread held by right first and second finger ~ this end must be grabbed by right hand third and fourth finger, while releasing it with first and second finger ~ thread must be drawn through the loop ~ knot must be pushed down by right hand second finger. Wiener knot made by left hand: threads end is positioned in left hand between first and second finger ~ palm side is facing upwards ~ third, fourth and fifth fingers are lying side by side stretched ~ second finger is flexed maximally ~ the other end of the thread (held in right hand) must be laid on third finger ~ left third finger must be flexed and must reach the thread held by left first and second finger ~ this end must be grabbed by left hand third and fourth finger, while releasing it with first and second finger ~ thread must be drawn through the loop ~ knot must be pushed down by left hand second finger. As repeating Wiener knot made by right and left hand, after it surgical knot made by right and left hand will be shown.

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