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what's up you guys it's doctor buck thanks for watching this video and this video is how to suture

from a surgeon

so this video is actually going to be

a quick and dirty guide

to how i suture

this is the first video in a series of videos that we're going to teach you about suturing

suture material

instruments

and all that good stuff i'd like to thank the folks at medical creations for supporting my channel by sponsoring this video as well as sending me this suture kit i'll be using today

so

what the what you get here

is a nice little kit

like that

so what do you get in this kit is

a pair of forceps these are adsense

a needle driver

scalpel

hemostats

and scissors

perfect right

you also get

a bunch of suture

and one of these pads to suture on

this is actually the old

style pad this is the new path

it's a great little kit

if you

want to learn and practice at home and the company is called medical creations

so

let's get to it

i'm going to pull out my needle driver here

and my

four step

and

some scissors

and i've already opened a pack

of

actually a four oh

silk suture we're going to go over the types of sutures and the needles and all that stuff later

but this one i want to get to

the fun stuff which is suturing real quick let's talk about how to put the needle on the needle driver you want it out

about a ninety degree angle

i

i sometimes do a little bit of an angle

forward

and that's just because

my

arms are triangulating the spot that i want to be

it provides a ninety degree angle to the

actual

incision site

so i do that sometimes second thing is how to hold

the

needle driver you want to put your thumb

and your ring

finger in the

needle driver not the index

here not the index or the middle finger the other way you can do it is the way i do it is

you palm the needle driver like that and then that gives you more kind of like degrees of freedom

because you can actually twist it like this

but when you're starting out if you want to

do those two that's just fine now this is a pick up this is an add some pickup

because it's got teeth this is specifically for skin

so you do want to use the tooth pick up with skin

so if i'm going to try and close this incision right here

i'm going to take this

needle driver

and i want to put my

finger as close to the tip

of the needle driver as possible

that actually

makes the tip of the needle

driver more steady and thus the needle more steady

and the more things that you can rest your

hands or elbows or wrists on

the more steady you're going to be

i turn

twist my wrist like this

and i get the needle so it's going in about

ninety degrees to the skin

once it's in the depth that i

like

i twist

my wrist

OK

and i

see the needle come out you can close incisions with one or two bites

and this one i'm going to do two bytes and notice what i'm going to do here

is pull the needle out just a little bit

and then i'm going to grab the needle

exactly where i want

to

grab it

for the next bite

and that is about

two thirds back

and at the tip of the needle driver two thirds of the way back

on the needle and now what i do

is since i have this exactly where i want it

and this is what's good about palming

is i pull it up slowly

right i twist

and i'm actually ready for the next bite

there it is

and

notice

i am palming

which is why i can make this move

once i put that in the second side

i can go ahead and pull this out now i don't have to really hold the needle

with

my

forceps the reason is because once you put the needle in the tissue

the tissue should stay stable

unless the patient is moving all around

and second

will stay stable

if you hold it with the

forcep so you want to hold the tissue actually with the forcep and not the kneel with the forcep and if you hold the tissue in place and let go of the needle the needle should stay

right in place and so then you can

pick it up again now i can pull it out a little bit again

i'm going to grab it right where i want the needle driver to go for the next bite

but i'm not going to

actually do next bike because we're going to tie this

and so here's another tip here a lot of students i see

we have this long suture here

a lot of people

like pull this way high right you're going to touch your face you're going to hit somebody else 's face

if you're seeing it real

procedure you're gonna

make it unsterile you're gonna lay this

suture way out somewhere else that's not sterile

so here's a little tip here what you can do is you just put your four step

right in here

OK and you pull this

along

and you want to pull this

suture down

until you got a few centimeters out there and the suture is sticking straight up that's going to help later

so then i'm going to let go of the needle with this hand

now the needle is not really that dangerous when it's not attached to something

if it's attached to this

you know you can poke somebody so

as long as the needle is like dangling

then typically it doesn't really

cause any damage and won't poke

through anything

so what i do here is i grab

usually a couple

palm links

or so

and i'm

also palming

the four step with my left hand

OK this is for right handers

and

all i do is just

put the needle driver in between

the tail

and the length of the suture

and the first one i usually do two wraps

so this is pretty typical

notice how much length i have a lot of students they make a mistake they go like this

and then they don't have anything it's tight and it's going to get caught in these jaws when you open it up it gets caught or gets caught in these back here

pick

a big nice loop

and then when you bring it in

OK i kind of

brought around the back

i start to make that loop

and then

look how big that loop is

and then i make another loop and this nice and big and then i grab this tip here which is sticking straight up

for me

and then i bring this across

and i pull this through

OK

and then i lay this down

and you pull it a little bit tight not too tight

just

approximating the tissue you don't want to strangulate the tissue

to set this suture

so it doesn't come out

for my next

throw

i pull it like this

snap it like that

and even you can set it U in the air a little bit so that way it's not laying on the skin

and then what i'm going to do is i'm going to put my

needle driver between

the long end and the

tail again

and i'm going to make this big old loop

i don't care if it's

too big

but i don't want it too small

and then i'm going to pull it through

and this will then

secure that

now going back and forth and i'm going to make a

the square knot

so now i'm gonna go

this way

i didn't pull it up in the air

right

bang

but umm

them

back and forth

OK i got a little maybe too much there

but that is essentially

simple

suturing

now this is

what we call

a simple interrupted

suture

or not

stitch i guess and there are lots of different types of

sutures

that knots

and

stitches

and we're going to go over those

in my other videos

but i'm just going to do a couple more for you to watch

and i'll point out a few other things

so

i palm it

i can get more

rotation

while palma

that's why i do that

the your attendings might not like that at the beginning and so you might have to

put your

thumb and

ring finger

in there

but

practice palming at home OK and now i'm going to do just one bite across here

i'm going to turn it up

there we go

OK it didn't come out very much there and i don't have to hold this tissue with with this thing but you might have to hold the tissue to keep the needle in the same spot so if i hold the tissue with this

i pull this across

i

study this

side of the tissue

this needle is not going anywhere then i'm going to pull it out of justice a tab so i'm going to go

and right about there

because two thirds of the way back is where i want to grab it

right there

OK and then i'm going to pull it through

and this

is what happens when you call sometimes

trying to be fancy

and i can do this maneuver

this is a long suture typically you don't use suture this long

but it's good

that comes in this kit because you can practice more

so

the other thing

that you want to do is

really you don't want to touch the needle

too much because

the more you touch it the more

chance you have to

poke yourself so

what you can do is actually grab this suture here

or by your finger

and raise it up

and then set the needle

in a place that you think

you can pick it up

in fact you can just

grasp it a little bit not

clamp it all the way down

OK

and then

turn it a little bit if you want to

and so this is going to be a figure eight suture

stitch

we're going to two of them right next to each other this is used for

a lot of time

or

ligating a blood vessel

put the blood vessel right in the middle there

i also use this for

my abdominal incisions

the port sites

for like a twelve millimeter port for a laparoscope so

it's called the figure eight because

we're going to make an eight out of it see what it looks like an eight

almost

more like an ex but you know what i'm talking about snap this there pull it up in the air

put the

needle driving in between the two

i already did

i did

two right

OK

right snap it down

with silk

you don't necessarily need to do a lot of

throws

typically most people say

three

for silk

and four for vicryl

i do

usually four and five

extra safety i'm doing just some more just to walk so you can watch and you don't have to go back and forth with silk because

it's a poly filament

suture which i'm going to talk about in the other videos as well

you can if you want

so

OK

that's

a lot

you don't need that many

for reals

OK

OK

that is the basics

of suturing

now you know how to do it i'm going to talk about hand tying

and different types of sutures and things like that and the other videos so go check out those videos

and i'll see you in the next one anyway that is how to suture

from a surgeon

that's the quick and dirty

and i'll see you in the next video don't forget to subscribe like share

comment below

thank you guys so much for watching i'll see you in the next one

hey guys welcome back to the channel so in today's video we are talking about

chapter three of REM beauty so they were kind enough to send this to me

and in in the collection we have new

lip oils

liquid lipsticks classic lipstick lip balm and lip liner pencils OK

so

i was sent chapter two of REM beauty i wasn't sent chapter one so i don't know anything from chapter one

chapter two

i will say

i wasn't incredibly impressed by the only product i really loved was

the

REM cheek and lipsticks and these were

phenomenal like the

formula for the blush

even doubling as a lipstick these were amazing these i felt like it

added to the beauty space that being said i have some

feelings about REM beauty i think i

just find it very difficult to get behind brands that the

creator is not from the makeup space they're not a makeup artist they

are just

someone that has had makeup put

on them so they make a make up line

and

for the price point

of these products

i think

i take issue with the fact that you

kind of

are

going into it knowing you're only buying these products because you're an ariana grande fan

unless

the formula or the product is

innovative in some way or of a certain quality level that you are adding to

the

well over saturated market in the second launch

like there was that essential oil spray there was her eye shadow formula i was beyond not impressed with they were actually very difficult to work with the colour story was a mess the shimmers were like not even shimmer it was just

it was actually hard to film a video because i was struggling to even come up with a look that i'd like to be able to even tell you guys about it this is not meaning to drag it it's just really my true opinions about this

so when it comes to this chapter three launch

i think i'm a little bit more

excited because

i don't really know how you could mess up lip products but

i'll stop ranting let's dive in and try these and see

if chapter three of a REM beauty is

a little bit more impressive

alright diving in this is what the PR package looks like

her PR packages are always stunning i will give her that this is pretty dope like i would keep this on my

table and like maybe store other lipsticks in it the reason i'm reviewing this with a bare face is because i'm starting to film but i know the eye look i'm doing is not going to go with any of these so i just kind of wanna

it's lip product so we'll just watch it that way OK so let's start with the

lip oil this is what the packaging looks like it is a twist off

and comes up just like this it is definitely like a light pinky clear

let's go ahead and put this

on

OK this is the

lip balm on

it

it's very pretty

it feels really nice on the lips

it has a little bit of a fragrance but nothing too strong yeah this feels really nice actually i feel like this is something i can tell right away that

using this for awhile like this actually will condition the lips there's no like plumping feeling which i like this is very nice and this retails for fourteen dollars which is a little

OK now we have four lip oils the packaging on this is really beautiful

we have the shades

picking petals

lavender kiss

raspberry drip and mint condition

let's go ahead and put these on the lips

let's start with picking petals

ooh the dough foot actually has

a little

metal

like ball on the

end which i imagine is going to make this like

cooling yeah oh wow

the metal ball definitely adds like a cooling effect

OK that is picking petals

wow it definitely added like a tint you definitely see that tint to it as far as the feeling of these

i don't know they don't feel overly hydrating it feels kind of watery if that makes sense obviously i don't know how like conditioning these are gonna be because obviously you'd have to wear it for a while to see if it's gonna condition the lips wearing it for a prolonged amount of time but it feels nice not sticky

or anything like that obviously it's a lip oil but umm

yeah

the color is pretty

OK now we have the shade raspberry drip alrighty this is what this looks like on

same exact feeling

this is the color

now we have the shade lavender kiss

i will say with these i almost feel like the

metal applicator actually like prevents a lot of product from coming out on the dofa and the doe foot is very hard

so it doesn't like absorb product like a spongy applicator to deposit and then or absorb it and then deposit it on the lips it's like actually kind of difficult to get a lot on this is the shade lavender kiss and it honestly looks

clear

and lastly we have the shade

mint

condition

OK this is the only one i notice has a different

dent it has a minty kind of pepperminty or more like toothpaste

smell

but this is this shade on the lips again this looks

clear

OK now moving on to the lip liners and these are called

at the borderline lip liner pencils and these retail for

eighteen dollars so again steeper price point for a lip liner there is ten shades and they sent me four

in

lyrics

harmony

reverb

and boss

the formula glides on really nice i will say that like you get good pay off like when you're going it's not like too dry or waxy

of a formula

obviously i just put them on but

as you're

like running your hand over them they don't smudge that easy so they tend they have a good grip to them

which i like

ohh wow really like smudging and they're barely smudging which i like because that really means they're going to grip onto the lips

OK this is the shade harmonies

this is probably like my favorite out of the lip liners this is really pretty

let's go ahead and pair this with one of the new lipsticks

another thing i forgot to mention is the lip liners are a twist of formula which is definitely not my favorite because it just

makes it harder after a while using them to get a sharp tip because they get a little bit rounded and it's just

you can't really sharpen it so that's another

con the first shade in the lipsticks we're going in with is lingerie this is what the packaging looks like it's like her astronaut theme which is really cute

it is very thin

don't let the packaging deceive you because at first i was like are you kidding me like this looks like no product

in this

lipstick i'll twist it all the way out so that's how much product you're getting

it is

point twelve

ounces and like

normal lipstick twist up is point fourteen

so it's not that far off even though it looks deceiving because of how small it is

alright so that's what lingerie looks like

it's a little brown for me i know it's also hard to tell on a bare face but another thing i'm noticing is that lip liner is a little lighter than the shade

so i wouldn't normally pair it with it maybe there's another shade in the collection that is like in the lip liner family that's a little bit lighter that would go with this but

they don't really go for me but

the formula is definitely a matte lipstick formula it's

very comfortable on the lips

it feels really nice

OK now i'm going in with the shade lyrics and

i'm kind of taking back what i said about the smoothness of it it's a little draggy

and

it's like

a patchy going on and

some lip liner formulas that aren't like

press this hard

you can put them on softer and get a lighter color if that makes sense like you can soften up the lip liner

you have to push so hard with these to get it on the lip

that you're gonna get the darkest possible color just to like even get it to adhere

to the skin

like i'm going back

after i do my lines and trying to fill

in

areas that are like patchy

and i think that's because of the waxiness like look as i put my lips together

it's like sticky when you go to put it on and i think that's maybe to get the lasting power

but it's not translating putting them on either which is disappointing the next lipstick color we're going to go in with is cuddly

don't mind the lip blinds we're not going for accuracy here

this is cuddly this is really pretty this is a beautiful chocolate brown i love colors like this like for bambi lips and

the formula of this is actually bomb like i'm not gonna lie this feels so good on the lips these

lipsticks

these rock

OK this is the next shade in the lip liner boss it's a really really pretty color but this is same as the other one it's just really hard to get on push very hard to get it it gives you clean lines which i appreciate but again

you know just using it but it already is like a mess just to get it

on and twist it up and same thing with like the

stickiness like

the next shade and lipstick we're going to put on it

is

attention

this looks gorgeous

OK this is attention

this is stunning this formula is bomb like i can't even explain how

like

hydrating and beautiful the lipstick formula is these are

gorgeous

OK i want to show you this on my phone because i feel like you can see it better i i literally can't even get this lip liner on like look how patchy

like and

getting it on and dragging it it's making it go outside my lip lines it is so waxy and

press so hard OK i'm giving up on the lip liner the last

lipstick we're going in with is CEO this is a really dark brown

it's a shame too because i feel like this lip liner would be so beautiful on dark skin tones

OK here we go do not mind the lip lines that lip liner made everything a mess but this

again is stunning these lipsticks to die for

this is a CEO

alrighty now on to the liquid lipsticks we have four shades here we have the shade diva

absolutely

yummy or yum

and

hottie

so let's go ahead and swatch these OK this is the shade hottie i let it dry down a little bit because i wanna see if it's sticky

yes it is

hi hi iphone me again so i wanted to show you doing that sticky test

it is

making it all come off in the center

OK honestly i'm not even gonna watch the rest on my lips i know i don't like this formula i'll just show you the colors swatched on my hand here so these are the four shades that they sent me they do have good coverage kind of right out of the gate but the red starting over here is

diva

and then we have yum

absolutely

and the one i swatched which was hottie

OK so final thoughts on everything from this

to be honest with you i think this went exactly how

the part chapter two when

i think out of this entire

launch the

only thing worth your money is

the

lipsticks like the

twist up matte lipsticks the lipsticks are nineteen dollars and i think they're like

OK they're worthy of that price point i would definitely be interested too to check out the other shades

as far as the liquid lipsticks go i think i'm not really a liquid lipstick person if you are you might like these a little bit more than me

but they feel sticky on the lips it was coming off in the center because of the stickiness

the lip oils are nothing special to me i just think like unless you're putting

easy good ingredients to hydrate the lips

i don't need a twenty dollar sheer like lip oil the lip liners were the biggest fail for me they

are so waxy and so hard pressed it is like impossible to get them on the lips

without them looking patchy you have to press really hard it's super hard to get a clean

lip line

so yeah this was not meant to like drag it this hard but to be honest with you this just kind of goes back to my initial thoughts

of

if you're gonna

go into a space

like beauty as

not a beauty person

i just have higher expectations you're putting a higher price points on all of these products

and

what are you bringing to the beauty space let alone for

nineteen twenty twenty one dollars a product

i just think it's very much

about the name when it comes to

anything i have personally tried from REM beauty and anything innovative that maybe they're taking a big swing with hasn't really landed for me

so

that's my real honest thoughts on

chapter three of REM beauty please feel free to buy whatever you want i'm not here to tell you what you should and should not buy if you love ariana grande if you love REM beauty power to you i'm just giving you my authentic thoughts

if you've tried anything from REM beauty or REM beauty chapter three in particular that you love please let me know in the comments i would love to try other things that doesn't mean

i'm not open to trying other things from the brand

but that is it for today's video make sure to subscribe to the channel if you are already hit the little notification bell next to the

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or wherever you guys are i hope you are happy

healthy and safe and i will see you on the next video