3. Surgical Instruments and Suture Materials

Question 1

9. Ideal suture material

Answer 1

-MUST NOT: 1. irritate tissues 2. allergenic 3. cancerogenic 4. electrolytic properties: not pass (ex. orthopedic vire with metallic vire-eli ei johtaa sähköä) 5. expensive

-MUST HAVE: 1. low capillarity 2. minimal know slippage 3. good handling 4. stable diameter

-MUST BE: 1. sterile 2. contrasting

Question 2

10. Suture material characteristics (including size)

Answer 2

-USP most commonly used
> 5-0 (0,1mm) bigger than 7-0 (0,05mm)
> without zero, bigger the number is
> zero (0,35mm) is between 1 (0,4mm) and 2-0 (0,3mm)

-MATERIALS:
>flexibility; torsion stiffness and diameter
>surface characteristics and coating: influence moving through tissues
>capillarity (capability of suture material to absorb fluids) high -> increase risk of infections
> Monofilament / Multifilament:
monofilament preferred
>absorbable / non-absorbable (non-absorbable stay always there if not removed).
>relative know security : knot holding capability

Question 3

Monofilament

Answer 3

-low capillarity
-less tissue damage
-fever infection risk
-lesser tissue damage when pulled out
>should be preferred unless indicated otherwise

Question 4

Multifilament

Answer 4

-know security
-handling more easy
-flexibility more
-strength
-have to use more strength when pulling out

Question 5

Absorbable suture material

Answer 5

-short term: natural=enzymatic, synthetic=hydrolysis
-medium: braided multifilament, monofilament
-long term: braided multifilament, monofilament

Question 6

Non-absorbable suture materials

Answer 6

-natural: silk
-synthetic: braided multifilament, monofilament

> will be encapsulated within tissues
tensile strength lost in several years, never absorbed ex. Nylon in 2 years loose 30% of tensile strength, silk 30% in 2 weeks and 50% in 1 year

Question 7

10. Different needle types

Answer 7

-Atraumatic:
1. TAPERPOINT: thin, round tip, no cutting edges, spreads tissues NOT CUT, suturing soft tissues
6. BLUNTPOINT: spreads NOT CUT, soft parenchymal tissue (liver, kidneys), tip blunt as well (cause minimal trauma)

-Traumatic:
2. TAPERCUT: reverse cutting sharp tip and taper point body, dense and tough fibrous tissue; fascia, ligaments, used in cardiocvascular procedures
3. REGULAR CUTTING; 3 cutting edges, 1 on inside,, very sharp, cuts NOT spread, promotes ‘‘cut out’’ of tissue
4. REVERSE CUTTING: 3 cutting edges, 1 on outside, stronger than regular cutting needle, reduced amount of tissue cut out
5. SPATULA POINT: flat on top and bottom, cutting sides, opthamalogy procedures

Question 8

NEEDLE PACKAGE information that it includes

Answer 8

-USP size
-length of suture
-shape of needle: conventional cutting needle
-date of expiring
-braided multi- or monofilament
suture material used ex. coated vicryl