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Ch 1-21 > 17 > Flashcards

17 Flashcards

1
Q

how are needles define

A

fraction of a circlecord length (bite width)needle lengthneedle diameterneedle radius

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2
Q

channel vs laser drilled swaged needles

A

channel: suture is crimped in a depression in the body of the needlelaser: suture is crimped in a hole drilled in the body of the needle (less drag, better grip with needle holders)

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3
Q

breaking strength of suture

A

the stress value on a stress-strain curve at which the suture acutely fails

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4
Q

capillarity of suture

A

degree to which absorbed fluid is transferred along the suture linemultifilament > monofilament

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5
Q

creep of suture

A

tendency of suture to slowly and permanently deform under constant stress

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6
Q

elasticity of suture

A

degree to which suture will deform with load applied and return to normal shape when load is removed

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7
Q

knot pull out strength of suture

A

load required to break a suture deformed by a knotknots generally decr suture strength by 10-40%

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8
Q

knot strength of suture

A

force necessary to cause a knot to slip

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9
Q

memory of suture

A

tendency for a suture to return to its original shape after deformation

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10
Q

plasticity of suture

A

degree to which a suture will deform without breaking and will maintain shape after removal of the deforming force

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11
Q

pliability of suture

A

the ease of handling and the ability to change shape of suture

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12
Q

stress relaxation of suture

A

the ability of suture to reduce stress under constant strain

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13
Q

suture pull out value

A

the weight required to full a suture loop from tissuedepends on type of tissue fat < muscle< skin < fascia

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14
Q

tensile strength of suture

A

measure of a sutures ability to resist deformation and breakage and the stress at which it deforms (yield strength) or rupture (breaking/ultimate strength) occurs

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15
Q

general characteristics of monofilament vs multifilament suture

A

monofilament =less pliable, more susceptible to catastrophic damage from crushing/nicking, lower tissue drag and is smoothermultifilament =greater strength & pliability, more tissue drag, greater capillarity and tendency for bacT colonization

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16
Q

T/FCatgut is monofilament

A

FALSECatgut is multifilament suture with TWISTED not braided filaments

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17
Q

newer types of sutures

A

polyblend suture (core polymer and braided exterior): extremely strong and resistant to failureSelf anchoring, barbed suture: surface barbs, decrease bulky knots, monofilament

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18
Q

water soluble vs insoluble suture coating in terms of knot security

A

water soluble coatings improve knot securitywater insoluble coatings reduce knot security

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19
Q

antibiotic coating for suture

A

+PLUStriclosan: inhibitor of bacT fatty acid synthesis

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20
Q

study of PDS PLUS with % percent of wound infections

A

PDS PLUS (polydiaxone w triclosan)11% wound infection PDS5% wound infection PDS PLUS

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21
Q

two major mechanisms of suture absorption

A
  1. hydrolytic: synthetics2. enzymatic: Catgut (acid phosphatase, leucine amino peptidase)
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22
Q

PDS in sterile urine vs infected urine

A

PDS polydioxanonesterile urine: lost all strength 3 daysinfected urine: lost all strength 1 day (Proteus)

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23
Q

Dexon in sterile urine vs infected urine

A

Dexon polyglycolic acidsterile urine: lost 64% strength in 10 daysinfected urine: lost all strength 1 day (Proteus)

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24
Q

T/F rates of suture absorption are dramatically increased in infected urine

A

TRUE

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25
what sutures degrade more rapidly in alkaline pH
moncryl (polyglecaparone 25)maxon (polyglyconate)biosyn (glycomer 631)
26
what suture loses tensile strength rapidly in acidic pH
PDS polydioxanonenylon (even thought considered non absorbable)
27
T/Fprestraining suture material to reduce suture memory will enhance suture degredation
true
28
catgut characteristics
natural twisted multifilament intestinal submucosa/serosaabsorbable (variable) via enzymaticweak, not uniformhigh tissue reactioncompletely absorbed in 2-3 weeks
29
do NOT use catgut in
harsh environments (GI, urinary surgery)areas requiring prolonged strength (>5days)important structures (body wall closure, fascial repair)
30
list rapidly absorbing suture
Polyglycolic acid (dexon)polyglactin 901 (vicryl)--braided multifilamentpolyglecaparone 25 (monocryl)polyglytone 6211 (caprosyn)
31
list slowly absorbing suture
polydioxanone (PDS)polyglyconate (Maxon)glycomer 631 (Biosyn)
32
list nonabsorbable suture
SilkPolypropryleneNylonpolymerized caprolactampolyesterstainless steel
33
dexon
polyglycolic acidbraided multifilrapidly absorbabletensile strength 50% at 2-3 weeksabsorption 60-90 daysgreat knot security
34
vicryl
polyglactin 910braided multifilrapidly absorbabletensile strength 50 % at 2-3 weeks (0% at 2-3 weeks if rapide)absorption 56-70 days (42 days if rapide)
35
monocryl
polyglecaparone 25monofilrapidly absorbabletensile strength 50% at 1 week 70-80% at 2 weeksabsorption 119 days
36
caprosyn
polygytone 6211monofilrapidly absorbabletensile strength 0% at 2-3 weeksabsorption 56 days
37
PDS II
polydioxanonemonofilslowly absorbabletensile strength 50% at 5-6 weeksabsorption 180 days
38
Maxon
polyglyconatemonofilslowly absorbabletensile strength 50% at 4-5 (5-6) weeksabsorption 180 days
39
Biosyn
glycomer 631monofilslowly absorbabletensile strength 50% at 2-3 weeksabsorption 90-110 days
40
silk characteristics
silk-braided multifilament nonabsorbablefibroin and sericinactually slowly degraded by hydration (gone in 2 years)good for knots around large vesselshigh tissue reactivity
41
polypropylene
nonabsorbable monofilamentvery stronghighest energy to break pointgood handling
42
nylon
nonabsorbable monofilamentBUT susceptible to degradaton via hydrationwill elongate
43
steam sterilization and elongation of nylon leader line
steam sterilization resulted in 2-4x increase in elongationit did NOT effect ultimate strength
44
Vetafil
polymerized caprolactamtwisted multifilamentskin only
45
canine sternotomy closurestainless steel vs polybutester
20 g stainless steel wire had less displacement and appeared more stable than #2 polybutester suture
46
fiberwire vs orthocord polyblend suture
#2 suturefiberwire = greatest maximal failure load (263 N)orthocord = greatest elongation (50%)
47
knitted vs woven mesh
woven is stiffer, stronger and less porous than knittedknitted is anisotropic, more porous, flexible and less strong/stiff
48
types of knitted polypropylene mesh
prolene and marlex mesh
49
pore size of polypropylene meshes
macroporous0.6=0.9 mmporosity 28-32%MUCH bigger than expanded polytetrafluoroethylene 20-25 micrometers
50
type of collagen found in mesh with a large pore size
type I collagen ingrowth
51
name a synthetic mesh that prevents adhesions to viscera
expanded polytetrafluoroethylene ePTFE
52
biologic material used to cover defects
pericardiumfascia lataporcine small intestinal submucosa
53
characteristics of porcine small intestinal submucosa
SISmultilaminatebioscaffoldinflammatory (intense WBC infiltration; more than polypropylene mesh)not apparent histologically after 3 months
54
polypropylene Mesh, fascia lata, SIS multi and single in terms of best strength
fascia > Marlex polypropylene > multi SIS > single SIS
55
recommendations for overlapping mesh with or without the presence of tension
with tension 1 cm overlapwithout tension 0.6 cm overlap
56
complications of mesh
failure: migration, extrusion (fails at tissue-mesh interface)fistulainfectionadhesionreduce complications with use of muscle or mental pedicle and use the smallest amount of mesh possible
57
Frey et al 2010 compared stifle surgeries closed with nonmetallic vs metallic sutures and what % were infected
9.1% skin staples infected5.1% non metallic sutures infected
58
basic principles of vascular clip application
1. skeletonize the vessels2. diameter of vessel should be no more then 2/3 and no less than 1/3 the length of the clip3. clip is applied several mm away from the cut edge4. arteries and veins clipped separately
59
green TA
giant double rows4mm w x 4.8mm Hclose 2.0 mm
60
blue TA
middle double rows4 mm w x 3.5 mmm Hclose 1.5 mm
61
white TA
three rows ONLY 30 mm length3 mm w x 2.5 mm Hclose 1.0 mm
62
tissue thickness recommendations when using circular staplers
circular staplers should NOT be used if tissue is < 1 mm or greater than 2.5 mmdouble staggered circular rows

Ch 1-21 (19 decks)

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