Ch 16 - Materials and Closure Flashcards

1
Q

List some reported used of barbed suture

A
  • Gastropexy
  • Gastrotomy
  • Enterotomy
  • Intestinal anastomosis
  • SDFT and gastrocnemius tendon repair

In GIT surgery, results in faster repair with equivalent or better bursting strength and leakage
However, significantly underperforms smooth knotted suture in tendon repair for ultimate tensile strength and gap formation

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2
Q

What are the 2 major methods of suture absorption?

A
  • Enzymatic (predominates in natural materials)
  • Hydrolytic (Predominates in synthetic sutures)
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3
Q

List the disadvantages of Catgut

A
  • Relatively weak
  • Not uniform
  • High tissue reaction
  • Absorption is extremely variable and unpredictable
  • very rapid absorption in gastric or intestinal surgery
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4
Q

What species of worms produce silk

A

Bombyx mori
Anaphe pernyi

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5
Q

What are the disadvantages of Nylon Leader Line

A

It was not designed as an implantable biomaterial. It will elongate under constant loads and its physical properties are significantly influenced by steam sterilisation

Steam sterilisation resulted in a 204x increase in elongation

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6
Q

What is the strongest form of suture?

A

Polyester composite sutures eg FiberWire (multifilament UHMW polyethylene core surrounded by braided polyester and polyethylene exterior)

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7
Q

What is meant by the warp, weft, and bias of woven mesh

A

Tend to be more elastic and fluid in the bias direction

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8
Q

What is meant by the course and wale of a knitted mesh?

A

They are anisotropic with more elongation along the course than the wale

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9
Q

What is meant by the pore size and porosity of mesh materials? How does this effect its properties?

A
  • The ratio of material to air
  • Polypropylene mesh - pore size 0.6-0.9mm with porpsity 28-32%
  • ePTFE pore size 20-25nm

Very small pore size will prevent capillary ingrowth causing encapsulation rather than incorporation

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10
Q

What biologic materials have been used as mesh?

A
  • Porcine SI submucosa
  • Bovine pericardium
  • Acellular dermal matrix
  • Canine fascia lata

3months after implantation, porcine SIS is histologically non apparent and has been replaced

Fascia lata consistently has shown the best biological properties followed by polypropylene

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11
Q

What are the recommendations for implantation of mesh?

A
  • Trimming with electrosurgery may seal edges and prevent fraying
  • Create a hem
  • Horizontal mattress sutures will engage more mesh
  • If under tension, should overlay 1cm of tissue
  • Little or no tension, 0.6cm overlap
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12
Q

What are the dimensions of regular and wide skin staples? Are skin staples appositional, inverting or everting?

A

Slightly everting

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13
Q

What are the principles of vascular clip application?

A
  • Vessel is skeletonised prior to application
  • Diameter of the vessel should be no more than 2/3 and no less than 1/3 the length of the clip
  • Clip applied several mm from cut edge
  • Arteries and veins clipped seperately
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14
Q

What sized staples are in the coloured cartridges of TA devices?

A

Green - 4.8mm to 2.0mm
Blue - 3.5mm to 1.5mm
White - 2.5mm to 1mm

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15
Q

What can linear staplers be used for?

A
  • Pulmonary Sx
  • Cardiac Sx
  • GI
  • hepatobiliary
  • reproductive
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16
Q

What are the rules regarding tissue thickness for circular stapling devices?

A

Should not be used when combined tissue thickness is less than 1mm or greater than 2.5mm

17
Q

What are the byproducts of cyanoacrylate glue?

A

Cyanoacetate and formaldehyde

18
Q

What are the benefits of using cyanoacrylate glue for wound closure?

A
  • Speed
  • No need for suture removal
  • Reduced cost
  • Barrier to microbial penetration
  • Antibacterial effects

In people, a study has shown that wounds closed with glue had significantly fewer post-op infections than sutures wounds