Surgery and Healing in the Developing World - Dartmouth-Hitchcock

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352 Surgery and Healing in the Developing World
Figure 5. A foot-powered
suction device.
Fishing Line for Skin Closure
Standard six-pound test nylon fishing line can replace 3-0 nylon or prolene suture
material (Fig. 6). It is cut into usable lengths and autoclaved. Prior to use, it is
threaded twice through a free curved cutting needle. This material is used to close
the skin and can also be reliably used to close fascia in abdominal closure or
herniorraphy.
Cotton Thread to Replace Silk Suture
Standard cotton sewing thread can be used in place of silk. It has been used for
the serosal closure in two layer bowel anastamoses and has also been used for skin
closure. Sterility is achieved through autoclaving.
A Note on Laparoscopy
Laparoscopy is used occasionally, but in our experience the benefits of this
technique have not been found to outweigh the associated difficulties and risks in
our patient population. Our patients do not request laparoscopy and do not place
much importance on minimizing the size of scars at incision sites. In addition, the
Figure 6. Sterilized six-pound-test nylon
fishing line used for skin closure.