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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
Q

what sutures degrade more rapidly in alkaline pH

A

moncryl (polyglecaparone 25)maxon (polyglyconate)biosyn (glycomer 631)

26
Q

what suture loses tensile strength rapidly in acidic pH

A

PDS polydioxanonenylon (even thought considered non absorbable)

27
Q

T/Fprestraining suture material to reduce suture memory will enhance suture degredation

A

true

28
Q

catgut characteristics

A

natural twisted multifilament intestinal submucosa/serosaabsorbable (variable) via enzymaticweak, not uniformhigh tissue reactioncompletely absorbed in 2-3 weeks

29
Q

do NOT use catgut in

A

harsh environments (GI, urinary surgery)areas requiring prolonged strength (>5days)important structures (body wall closure, fascial repair)

30
Q

list rapidly absorbing suture

A

Polyglycolic acid (dexon)polyglactin 901 (vicryl)–braided multifilamentpolyglecaparone 25 (monocryl)polyglytone 6211 (caprosyn)

31
Q

list slowly absorbing suture

A

polydioxanone (PDS)polyglyconate (Maxon)glycomer 631 (Biosyn)

32
Q

list nonabsorbable suture

A

SilkPolypropryleneNylonpolymerized caprolactampolyesterstainless steel

33
Q

dexon

A

polyglycolic acidbraided multifilrapidly absorbabletensile strength 50% at 2-3 weeksabsorption 60-90 daysgreat knot security

34
Q

vicryl

A

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
Q

monocryl

A

polyglecaparone 25monofilrapidly absorbabletensile strength 50% at 1 week 70-80% at 2 weeksabsorption 119 days

36
Q

caprosyn

A

polygytone 6211monofilrapidly absorbabletensile strength 0% at 2-3 weeksabsorption 56 days

37
Q

PDS II

A

polydioxanonemonofilslowly absorbabletensile strength 50% at 5-6 weeksabsorption 180 days

38
Q

Maxon

A

polyglyconatemonofilslowly absorbabletensile strength 50% at 4-5 (5-6) weeksabsorption 180 days

39
Q

Biosyn

A

glycomer 631monofilslowly absorbabletensile strength 50% at 2-3 weeksabsorption 90-110 days

40
Q

silk characteristics

A

silk-braided multifilament nonabsorbablefibroin and sericinactually slowly degraded by hydration (gone in 2 years)good for knots around large vesselshigh tissue reactivity

41
Q

polypropylene

A

nonabsorbable monofilamentvery stronghighest energy to break pointgood handling

42
Q

nylon

A

nonabsorbable monofilamentBUT susceptible to degradaton via hydrationwill elongate

43
Q

steam sterilization and elongation of nylon leader line

A

steam sterilization resulted in 2-4x increase in elongationit did NOT effect ultimate strength

44
Q

Vetafil

A

polymerized caprolactamtwisted multifilamentskin only

45
Q

canine sternotomy closurestainless steel vs polybutester

A

20 g stainless steel wire had less displacement and appeared more stable than #2 polybutester suture

46
Q

fiberwire vs orthocord polyblend suture

A

2 suturefiberwire = greatest maximal failure load (263 N)orthocord = greatest elongation (50%)

47
Q

knitted vs woven mesh

A

woven is stiffer, stronger and less porous than knittedknitted is anisotropic, more porous, flexible and less strong/stiff

48
Q

types of knitted polypropylene mesh

A

prolene and marlex mesh

49
Q

pore size of polypropylene meshes

A

macroporous0.6=0.9 mmporosity 28-32%MUCH bigger than expanded polytetrafluoroethylene 20-25 micrometers

50
Q

type of collagen found in mesh with a large pore size

A

type I collagen ingrowth

51
Q

name a synthetic mesh that prevents adhesions to viscera

A

expanded polytetrafluoroethylene ePTFE

52
Q

biologic material used to cover defects

A

pericardiumfascia lataporcine small intestinal submucosa

53
Q

characteristics of porcine small intestinal submucosa

A

SISmultilaminatebioscaffoldinflammatory (intense WBC infiltration; more than polypropylene mesh)not apparent histologically after 3 months

54
Q

polypropylene Mesh, fascia lata, SIS multi and single in terms of best strength

A

fascia > Marlex polypropylene > multi SIS > single SIS

55
Q

recommendations for overlapping mesh with or without the presence of tension

A

with tension 1 cm overlapwithout tension 0.6 cm overlap

56
Q

complications of mesh

A

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
Q

Frey et al 2010 compared stifle surgeries closed with nonmetallic vs metallic sutures and what % were infected

A

9.1% skin staples infected5.1% non metallic sutures infected

58
Q

basic principles of vascular clip application

A
  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
Q

green TA

A

giant double rows4mm w x 4.8mm Hclose 2.0 mm

60
Q

blue TA

A

middle double rows4 mm w x 3.5 mmm Hclose 1.5 mm

61
Q

white TA

A

three rows ONLY 30 mm length3 mm w x 2.5 mm Hclose 1.0 mm

62
Q

tissue thickness recommendations when using circular staplers

A

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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