When many of us first started medical school, skills were exciting and new, and we were eager to practise them. I was no exception and I remember going to a conference meant for first year medical students, where I snuck into a suturing workshop. I was that determined to learn how to suture, knowing that I would be aiming for Obstetrics and Gynaecology and would require a good handle on the skill.
I was addicted from the start. I went home that day and hopped online and ordered a suture kit so I could practise at home. With no one in my circles who practised medicine, its not like I could borrow tools from friends or family and practise on bananas, so I went ahead and got my first set of tools and a practise suture pad. In fact when my dog tore his favourite toy, I actually did some “stuffed animal surgery” and practised on it! You can see my dog in the photo below was quite worried, and apparently didn’t trust my skills yet. In the years since, I’ve had a lot more practise, and have developed a much broader range of skills. From different mattress stitches, to practising perineal repairs (photo below), I’ve expanded my horizon.
I’ve also stumbled across a few suture kits in this time. With more experience and a variety of suture kits behind me, I feel like its time I share a bit more about which suture kits I’ve tried and why you might prefer one over the other. Read on and find out what might suit you best!
For the First Time Suturer
When you first start suturing, it is a whole learning curve that takes time and patience. Whereas I’m currently practising new grasping techniques and hand tying, I didn’t get here without a lot of practise. The first couple stitches I threw were hardly beautiful. In fact they were awkward, slow, and felt unnatural. The skills quickly came to me (thank you Girl Guides for the knot tying experience!) but I had to do so. much. repetition.
If you’re on a similar page and just learning, I would recommend getting your hands on a SimVivo kit. These kits are brilliant! I was sent one a few months ago, and was thoroughly impressed by the entire kit. (Contents pictured below).
As you’ll see from the pictures, your kit comes with a training guide, a suture pad with templates on it, a few sets of sutures, and three tools: suture scissors, a needle holder, and toothed forceps, as well as a #10 blade. According to the SimVivo website, “The Sim*Suture Module will help the learner practice skills of simple interrupted and running suture, instrument tying, vertical mattress sutures, and running subcuticular sutures.” The website also has a bunch of videos to teach you the sutures that are in the training manual.
The tools are pretty hefty and have a nice solid feel to them. They’re branded with the SimVivo logo on them, but seem to work well for their purpose. I used to hate toothed forceps but I’ve gotten a lot better at using them, so this is a good way to get that comfort level. The sutures come with 10 in a back in a variety of sizes which is good because you might be using sutures for a variety of reasons. I also really like the training module and videos because you can really teach yourself – this would make it the perfect gift for even a premed or someone who just got into medical school/pa school/nursing!
Like I mentioned above, I would recommend this kit to a beginner because it goes right from the start to teach you some very basic skills. That being said, it is pretty limited beyond that. For anyone who is looking to get a realistic feel, the suture pad doesn’t stretch or gape the same way you might get in real tissue, nor does it have many layers. I’ve definitely seen better suture pads for mimicking this (keep reading below). Furthermore, the lines on the template pad are very simple. All that being said, I think the idea is that its meant to be simple. To that effect, SimVivo is a perfect kit for a first year learner or someone just looking to practise their basic foundational skills a little more
For the Experienced Suturer
Fast forward three years, to clerkship. This is a huge part of medical school, and many people say it is the most formative year. I would say it has the biggest learning curve. You go from merely reading and listening to didactic lectures, to being hands on, seeing patients, and practising under doctors who teach you live and in person. There is a lot of nerves that comes with this, but I personally found it very exciting. In fact I had the most ideal first day at the start of my clerkship year – I got to deliver a baby, and excise a lesion all within the first morning. As someone going for Obstetrics and Gynaecology, it was perfect! I got to see a delivery then practise some valuable suturing skills. Even better was the fact that my preceptor was really impressed with my excision and suturing skills, and wrote a review on my first day about how my suturing was above my expected skill level… thank you to all my suturing practise!
It was also really nice to have the affirmation that I’ve learned a lot and have a lot of great skills that I’m working on. The key word here is “working on”, because the learning process never ends. While I may have been capable of doing suturing for a simple excision, I might not be ready to do all the different sutures a surgeon would expect, and that’s where this next kit comes in.
If you’re looking for a kit that will challenge you, that is realistic, and that has all the components you could ever need, look no further than the Simulab BOSS Platform. Simulab offers a huge range of products for learners and simulations. The BOSS platform, which stands for Basic Open Surgical Skills, is probably what I would most recommend off their website for anyone learning to suture and wanting the full experience.
As you can see from the stock photo above and left, it comes with a lot of materials, which I have more specific photos of below from my own personal kit. What I love about this the most is how realistic some of it felt. The simulation tissues were slippery, they had layers to them, and most importantly, the board was designed to provide tension and shape like you might find in a real situation. There are clips on the bottom half of the board to clip samples into place, or you can put one of the three pads that it comes with into the curved tension piece on the top right.
The variety of practise simulation tissue you get is also pretty amazing. There is subcuticular tissue, complex tissue, injectable tissue, large intestine tissue, and a multi tissue structure with lots of shapes (all simulation of course).
If I haven’t stressed it enough, the diversity in this kit is fantastic. You can practise hand tying, tying under tension, there are a variety of ways you can clip things, you can add a cup to practise tying in depth… you can see from my photos that I just was loving this kit and did as much as I could with it.
Like the SimVivo kit, it comes with a worksheet type page. This one is laminated which I think makes it a bit more sustainable long term. I would say this is more for the experienced sutures however because the challenges require some pretty solid knowledge of the skills. For example, there are time limits and “penalties” that make you restart if you mess up a set of skills you’re practising on. I actually really liked this because it was realistic to me, you can’t break sutures over and over, or drop them, or take your sweet time (at least not always!).
Overall, this is my favourite kit out of the mix because it comes with so much, it challenges me in all the right ways, and you really get your bang for your buck. Speaking of which, it is a fairly expensive kit, but I have gotten hours of practise out of it and would recommend it anyways – the value is there, and you can’t put a price on practising skills! Oh how I wish I could afford the perineal training tool, but knowing how much I’ve loved the BOSS kit, I would absolutely consider it.
For the Discerning Suturer or to Restock
The last set I’m going to recommend isn’t really a set but rather a great website to stock up on tools and supplies. Wether you’re a first time sutures looking for the basics, a discerning sutures with a preference for tools that you want to pick yourself, or you just need a few extra sutures to practise with, Faux Medical is the place for you.
I actually got myself a full set of supplies from here pretty early on in medical school. It’s a nice small set that is easy to tote around, and because you can order supplies individually, I was able to get flat nosed forceps (before I graduated to toothed forceps), which allowed me to get a feel for the tools and really decide what I liked. They’re also a really nice quality. The price range of these supplies are really reasonable, so its a good starting point for anyone not really sure where they fit in this post based on skill.
I hope this post has provided some guidance on suture kits for anyone out there looking for them. For a quick recap, here’s my final thoughts:
- Pro: Perfect for the beginner. Simple and easy to learn.
- Con: Not very realistic, limited
- Pro: Their BOSS kit is fantastic for the aspiring surgeon, and really high quality
- Con: The price is pretty steep
- Pro: Good quality at a reasonable price
- Con: You have to know what you’re shopping for