History of Suturing Over the Centuries

追加: 2026-05-10

[00:00:00]Merit Ptah was an ancient Egyptian doctor in 2700 BC who probably didn't exist. Medical historian Kate Campbell Hurd Mead might have accidentally invented Merit Ptah through her 1937 book on ancient female doctors. Ancient Egypt held women in high esteem. They had equal rights to men and could hold powerful social positions. An inscription left by her son says Merit Ptah was the chief physician, meaning she probably trained other doctors and may have even worked with the ruler at the time. Her picture is even on one of the pyramids in the Valley of the Kings.

[00:00:28]Although there is no other record a person being a doctor. If she really did exist, she is the first female doctor to be mentioned by name in all of human history and even the first woman in STEM. But even if Merit Ptah's life was a myth, her popularity reflects the very real hunger of women to be seen as equals in science and medicine. So in a way it doesn't matter that maybe that exact person never existed. If nothing else, she is a very real symbol of the 20th century struggle to write women back into the medical history books and still stands as an inspiration for women in STEM and medicine around the world.

[00:00:58]What do you think? Did Merit Ptah really exist? In 1809, future surgeon Margaret Ann Bulkley had to change her name to that of her deceased uncle and live life as James Barry to go to medical school.

[00:01:08]After graduating from medical school with her MD, Barry joined the British Army and was sent to Cape Town, South Africa. In 1826, she performed the first recorded C-section using modern Western surgical technique where both the mother and baby survived, something unheard of at the time. As without anesthesia or antisepsis, the surgery had always been fatal for the mother. In 1828, Barry transferred to Malta where she helped contain the cholera outbreak. After her long career as an army surgeon revolutionizing health care in British outposts around the globe, in 1865, Barry passed away in England. When it was finally discovered that she was a woman, newspapers in Britain reported the news, noting that a woman had received an MD, become a renowned surgeon, and served in the military for 40 years, all under the disguise of being a man. Of course, the British Army denied the fact and sealed all records relating to Barry for over a hundred years until historian Isabel Rae obtained permission to examine them in 1950. Would you be prepared to hide your real identity to pursue your passions in life? In magnetic surgery, instead of slicing the patient open with gigantic incisions, surgeons inject tiny tools into the body through a little hole.

[00:02:08]Then strong magnets are slid over the skin to control these instruments. It all started in the 1990s when Texan Dr. Jeffrey Cadeddu was watching a show on TV about teens using magnetic studs to avoid piercings in their lips. The kids could even move these fake lip piercings around by using their tongues to move the magnets. This gave him an idea.

[00:02:26]Maybe we can use magnets to avoid incisions in surgery, he thought.

[00:02:29]Because every hole created in the patient has associated risks like pain, bleeding, and infection. So, avoiding holes where possible is as much a priority for surgeons as it is for teens. In magnetic surgery, you only need a single little hole to insert all the instruments. By contrast, conventional laparoscopic or robotic surgery requires a separate incision for each tool. Unfortunately, Dr. Cadeddu's idea of magnetic surgery was ahead of his time and didn't end up getting approved by the FDA until a company called Levita Magnetics had it approved 15 years later. Now, even robotic surgeons have started performing magnetic surgery. But magnetic surgery is still new and limited as magnetic surgical instruments are in the early phases of development. In 1809, future surgeon Margaret Ann Bulkley had to change her name to that of her deceased uncle and live life as James Barry to go to medical school. After graduating from medical school with her MD, Barry joined the British Army and was sent to Cape Town, South Africa. In 1826, she performed the first recorded C-section using modern Western surgical technique where both the mother and baby survived.

[00:03:25]Something unheard of at the time. As without anesthesia or antisepsis, the surgery had always been fatal for the mother. In 1828, Barry transferred to Malta where she helped contain the cholera outbreak. After her long career as an army surgeon revolutionizing healthcare in British outposts around the globe, in 1865, Barry passed away in England when it was finally discovered that she was a woman. Newspapers in Britain reported the news, noting that a woman had received an MD, become a renowned surgeon, and served in the military for 40 years, all under the disguise of being a man. Of course, the British Army denied the fact and sealed all records relating to Barry for over 100 years until historian Isabelle Rae obtained permission to examine them in 1950. Would you be prepared to hide your real identity to pursue your passions in life? The future of vaccines is kombucha, bananas, and mosquito bites.

[00:04:09]Forget needles, let me explain why.

[00:04:11]Scientists are genetically modifying parasites so that a mosquito bite can be protective rather than pathogenic. So, it's possible that future mosquito bites will vaccinate you against malaria, dengue, and Zika. Not into getting a bitten for science, but consider yourself a foodie? Edible vaccines might be for you. They are GMO crops that immunize you just by eating the genetically modified banana or sipping on GMO tomato soup. Then there are the mRNA patches that are just dissolvable stickers you slap on your skin. It's supposed to be virtually painless.

[00:04:37]Meanwhile, self-spreading vaccines are being designed to pass from person to person like a mild cold, potentially ending pandemics before they even start.

[00:04:44]This would make it feel wrong to cover your mouth when sneezing in public. AI personalized vaccines are custom made for your body based on your genes. No more one-size-fits-all. Even cancer vaccines are evolving that train your immune system to hunt down cancer cells.

[00:04:57]And for probiotic lovers, your daily yogurt or kombucha might soon deliver vaccine-infused bacteria for built-in immunity. Finally, sonic vaccines use sound waves to push vaccines through the skin. So, yeah. During the apocalypse, you have to administer 75 mg of miracle drug X diluted in 50 ml of normal saline while also ensuring the final concentration does not exceed 0.5% deadly side effects. But you, all you have available is 10 ml of a 5% solution. How the heck do you figure out how much drug X to draw up? Well, a 5% solution means 5 g of drug X per every 100 ml. 5 g is 5,000 mg, and 5,000 mg in 100 ml is 50 mg per ml. And since your vial contains 10 ml, it has a total of 500 mg of the drug. Your patient needs 75 mg of it, so you only need to give them 1 and 1/2 ml of the stock solution.

[00:05:47]Since you'll be adding this 1 and 1/2 ml to 50 ml of saline, the total volume after dilution will be 51 and 1/2 ml, but the amount of drug doesn't change with dilution, so it remains 75 mg. So, your final concentration will be 1.46 mg per ml. This is the equivalent of a 0.146% solution, so you won't have exceeded the 0.5% deadly concentration.

[00:06:08]Wounds are usually sutured from one end to the other, which can result in the center of the wound gaping open. The bootlace suture is a rare invisible suture technique that solves this problem. Start by taking a bite of tissue on either side of the center of the wound, going from deep to superficial on one side and superficial to deep on the other. Repeat these bites in one direction until the end is reached, resulting in a bootlace appearance to the suture. Make sure to maintain some slack as next the needle holder is passed under the bootlace to grab the needle and pull it back to the starting point at the center of the wound. Pull the loose end to close the side of the wound. Now, the same process is repeated, but this time starting from the opposite side of the wound until the center is reached. Pull the needle to fully close the wound. Once you're happy with the opposition of wound edges, tie a surgeon's knot between the two ends in the center of the wound, tightening each throw by pulling the ends parallel to the wound to bury the knot. But, this hybrid technique is not rare for no reason. It's much more complicated, increasing the chances of error, and the running nature of the technique means compromise at any point in the course of the suture may result in wound dehiscence. So, it should not be utilized as a solitary technique for the closure of most wounds. In surgery, dog ears aren't the cute floppy kind.

[00:07:12]They're little bunches of skin that pop up at the ends of a wound closure.

[00:07:15]Imagine stitching up an incision, and instead of laying flat, the skin at each end sticks out like a dog's ears perking up. Often complicated biometry, like east to west flaps and Z-plasties, are needed to strategically prevent dog ear formation, or you're stuck needing to trim them out. The dog ear tacking suture is a slick, no-fuss fix that doesn't allow dog ears to form in the first place. First, just take a bite of the under surface of the dermis at each apex of the wound. Then, reload the needle and snag a deep bite of the underlying fascia or periosteum. Now, just tie off the suture with a surgeon's knot. If you did everything right, you will see a little dimple forming in the skin at the apex of the wound as the excess skin that would otherwise stick out like a sore thumb is pulled downward. Then, you're in the clear to stitch up the wound like normal without any fears of dog-ear formation. Patients with thin atrophic skin need special sutures to prevent cheese-wiring of their skin. To place a running oblique mattress suture, start with an anchoring stitch at one end of the wound, securing it into place with a surgeon's knot.

[00:08:07]Reload the needle in forehand and take near-near bites on either side of the wound. Pull the suture through, then reload the needle in backhand. Now, take far-far bites going in the opposite direction. These broader anchoring bites of the oblique mattress suture are what limit the suture from tearing through the skin. It also helps to evert wound edges to allow better dermis-to-dermis contact, which is essential for ideal results when healing. Although I'm using thick suture material for demonstration purposes to make it easier for you to see, it is best to use the thinnest suture possible in order to minimize the risk of track marks left by the suture and foreign body reactions. The only exception to this is if the wound is under a lot of tension. Then, a thicker suture material might be needed. Other sutures that might be appropriate for thin atrophic skin include the ladder stitch and sometimes the steri-strip combo technique may also work. Use Code Adventure to get 10% off the most affordable high-quality suture body pad and start practicing.