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What's up you guys? He' Dr. 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 they are gonna 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 you get here is a nice little kit like that. So what you get in this kit is a pair of forceps. These are Adsensse a needle driver, scalpel, chemostats 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 pad. 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 gona pull out my needle driver here and my.

Force set and some scissors and i've already opened a pack of actually have a fourhoto silk suture. We're gonna 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 need driver. You want it at about a 90 degree angle. 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 90 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 wanna do those two, that's just fine. Now this is a pickup. This is an add some pickup because it's got teeth. This is specifically for skin, so you do want to use the tooth pickup with skin. So if i'm go to try and close this incision right here, i'm gonna 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 gona be. I turn twist my wrist like this, and I get the needle, so it's going in about 90 degrees to the skin. Once it's in the depth that I like. I twist my wrist, okay, and I see the needle come out. You can close incissions with one or two bites, and this one i'm gonna do two bites and notice what i'm gonna do here is pull the needle out just a little bit, and then i'm gona grab a needle exactly where I want to grab it for the next bite. And that is about twothirs back and at the tip of the needle. Driver two-irds of the way back on the needle. And now what I do is since I have this exactly where I want it, 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's moving all around. And second, it'll stay stable if you hold it with the.

Force so you want to hold the tissue actually with the force and not the needle with the force. And if you hold the tissue in place and let go 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 gonna grab it right where I want the needle driver to go for the next bite. But i'm not gonna actually do next bite because we're gonna 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 gona touch your face, you're gonna hit somebody else's face. If you're in a real procedure, you're gonna make it unsterile. You're goingna 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 force right in here? Okay, 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 gonna help later. So then i'm gonna 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. It 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 force.

Do you prefer late nights or early mornings? One of those choices could be bad for your health. This is news review from BBC Learning English. I'm Neil and i'm Shan make sure you watch to the end to learn vocabul about today's story and don't forget to subscribe to our channel like this video and try the quiz on our website. Now our story staying up late into the night. For some people, it's just the way they prefer to live, but it may be affecting their health. New research from the US found that night owls may be more likely to develop heart disease and diabetes. It's because people who get up early burn fat for energy more easily. You've been looking at the headlines. Sean, what's the vocabulary? Okay, we have Night Owl Chronic and Prone too. This is news review from BBC Learning English.

Let's have a look at our first headline. Okay. This one is from Sky News.

Early birds or Night Owl how your sleep cycle puts you at risk of heart disease and diabetes, so the headline asks. What kind of sleep pattern you have? Do you prefer to stay up late or do you like getting up early? And there are two expressions in there for those two situations, what are they okay? So the one we're going to look at is night Owl? What can you tell me about owls? Neil Well owls are a type of bird and they stay up late. They stay up all night and they are very active at night. That's when they do their work which is hunting in this case exactly. And so we call people who stay up late. Night owls. It means they stay up late, but also they are mentally or physically active at night. What about the opposite nail well we can also see in the headline the expression early bird which comes from the saying the early bird catches the worm and it describes someone who likes to get up early. There are other ways of saying that as well. You can call someone an early riser or a morning person.

Which one are you shan? I used to be a night owl, and I think naturally i'm a night owl, but I want to be a morning person. So i've made myself become one. How About you? Well, theyre saying Yeah. I like staying up late, but it's never a good idea. Let's have a look at that again.

Let's have our next headline. This one is from CNN.

Night Owls at High Risk of Certain Chronic Diseases study says the headline is saying that Night owls, that's the expression we just looked at are at a higher risk of developing chronic diseases. And that's the word we're looking at chronic. And if we use chronic to describe an illness, it means it's longlating, so it doesn't go away. For example, if I hurt my back in an accident and the pain lasts forever. I can say I have chronic pain or a chronic backache. Yeah, and in a medical sense, the opposite of that is acute. So if you hurt your back, but you get better after a couple of weeks, that is not chronic pain. That is acute pain.

We use this word though chronic for more than just illnesses. Don't we shn, that's right. We can use it to describe situations which are longlasting and bad. So for example, we can talk about chronic unemployment or we can say there's a chronic shortage of doctors. Yeah, and as you said, that's for bad situations. And in fact, in slang, you can use the word chronic on its own just to mean bad. So for example, did you see that new detective drama on TV? It was chronic. Actin was terrible and one more thing to note about the pronunciation. So the spelling and pronunciation are a bit tricky. Normally when we see ch, it's pronounced chck like cheese, but here it's ka. So chronic. Let's take a look at that one more time.

Our next headline please this one's from The Guardian Night Owls may be more prone to heart disease.