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Eq ACVS Phase 1 > Ch.16 Suture Materials and Patterns > Flashcards

Ch.16 Suture Materials and Patterns Flashcards

1
Q

Relative knot security

A

RKS% = (KHC/TS) X 100

KHC - Knot holding capacity TS = Tensile strength

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2
Q

Absorbable suture materials

A
  1. Surgical gut - Cat gut, Chromic gut
  2. Polyglactin 910 - Vicryl
  3. Polyglycolic acid - Dexon
  4. Braided Lactomer - Polysorb
  5. Glycomer 631 - Biosyn
  6. Polyglytone 6211 - Caprosyn
  7. Polydioxanone - PDS II
  8. Polyglyconate - Maxon, Monosyn
  9. Poliglecaprone - Monocryl
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3
Q

Longest absorption time

A

Polydiaxone - PDS II
or
Polyglyconate - Maxon

Both 180 days

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4
Q

Fastest absorption time

A

Polyglytone 6211 - Caprosyn
56 days

Polyglactin 910 (Vicryl)
&
Braided lactomer (Polysorb)
both 56-70 days

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5
Q

Greatest tensile strength loss at 14 days

A

Polglytone 6211 - Caprosyn
<100% at day 21 so assuming a lot at 14 days

Poliglecaprone - Monocryl
80% lost

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6
Q

Trade name, composition, structure, abs, tensile strength, adv and dis adv of Poliglecaprone

A

Name: Monocryl
Comp: Glycolide + Caprolactone
Structure: Mono
Absorption: 90-120 days

TS:
50% day 7
80% lost day 14
100% lost day 21

Advantages:
Low tissue drag
Initial high tensile strength

Disadvantages:
Rapid loss of TS

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7
Q

Trade name, composition, structure, abs, tensile strength, adv and dis adv of Polyglyconate - Monosyn

A

Name: Monosyn
Comp: Glycolide, Caprolactone + Trimethylene carbonate

Structure: Mono
Absorption: 60 - 90 days

TS:
30% day 7
50% lost day 14
80% lost day 21

Advantages:
Good handling
Good knot security

Disadvantages:

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8
Q

Trade name, composition, structure, abs, tensile strength, adv and dis adv of Polyglyconate - Maxon

A

Name: Maxon
Comp: Glycolide + Trimethylene carbonate
Structure: Mono
Absorption: 180 days

TS:
25% lost day 14
50% lost day 28
75% lost day 42

Advantages:
Slow resorption & loss of TS
3 Times stronger than vicryl at day 21

Disadvantages:
High memory
Limited pliability

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9
Q

Trade name, composition, structure, abs, tensile strength, adv and dis adv of Polydioxanone

A

Name: PDS II
Comp: Polymer of poly-p-dioxanone

Structure: Mono
Absorption: 180 days

TS:
25% day 14
30% lost day 28
50% lost day 42

Advantages:
Maintains ts over prolonged period of time

Disadvantages:
Moderate knot security
Moderate handling

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10
Q

Trade name, composition, structure, abs, tensile strength, adv and dis adv of
Polyglytone 6211

A

Name: Caprosyn
Comp: Glycolide, Caprolactone, Trimethylene carbonate + lactide

Structure: Mono
Absorption: 56 days

TS:
Almost 100% lost day 21

Advantages:
Rapid abs

Disadvantages:
Rapid abs

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11
Q

Trade name, composition, structure, abs, tensile strength, adv and dis adv of
Glycomer 631

A

Name: Biosyn
Comp: Glycolide, dioxanone, Trimethylene carbonate

Structure: Mono
Absorption: 90-110 days

TS:
25% lost day 14
60% lost day 21

Advantages:
Excellent handling

Disadvantages:
NA

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12
Q

Trade name, composition, structure, abs, tensile strength, adv and dis adv of
Braided lactomer

A

Name: Polysorb
Comp: Glycolide + lactide
coating - caprolactone/glycolide/calcium stearoyl lactylate

Structure: Braided, multi, coated
Absorption: 56 - 70 days

TS:
60% lost day 14

Advantages:
High TS
Good handling

Disadvantages:
Rapid loss of strength when exposed to serum or inflamed peritoneal fluid

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13
Q

Trade name, composition, structure, abs, tensile strength, adv and dis adv of
Polyglactin 910

A

Name: Vicryl
Comp: Glycolide, L-Lactide
Coating - polyglactin, calcium stearate

Structure: Braided, multi, coated
Absorption: 56- 70 days

TS:
25% lost day 14
50% lost day 21
100% lost by 35

Advantages:
Excellent handling
Strong

Disadvantages:
Cut through friable tisue

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14
Q

TS of Nylon - Dafilon/Monosof

A

Monofilament: Loses 30% by 2 years

Multifilament: Losses 100% by 6 months

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15
Q

Advantages of Nylon - Dafilon/Monosof

A

Degredation products act as antibacterial agents

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16
Q

Needle shapes

A

1/4
3/8
5/8
1/2

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17
Q

Use for 1/4 shape needle

A

Opthalmic sx

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18
Q

Needle shape for suturing in confined/deep spaces

A

5/8

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19
Q

Cutting vs reverse cutting vs tapercut

A

Cutting - Cutting surface inside

Reverse cutting - Cutting surface outside

Tapercut - Triangle point, round body

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20
Q

Use of Dechamps needle

A

Ligate vessels in deep poorly accessible areas

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21
Q

Clamping the first throw - effects on suture

A

No effect on multifilament

Reduces breaking strength of monofilament by 10% if clamped with a hemostat instead of needle driver

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22
Q

Characteristics of suture material affecting knot security

A

Memory
Coefficient of friction

Bodily fluids coming into contact with suture will affect frictional behaviour

23
Q

How many throws req for a secure square knot using 2-0 USP Polyglycolic acid, polyglactin 910 and polypropylene

A

3

If larger suture diameter use 5

24
Q

Intrinsic suture tension

A

Tension on tissue within the suture loop

25
Q

Benefit of monofilament for lap sx

A

Dont lose loop characteristics when wet

26
Q

Cons of barbed suture

A

Lower bursting pressure
Increased risk of wound infection

27
Q

How far from incison should needle enter skin

A

3-5mm as collagenaase activity remains high within 5mm

28
Q

How far apart to place skin sutures

A

5mm

29
Q

Ratio of suture length to incision length in linea alba

A

4:1

30
Q

Which sutures are extemely liable to lose yield stregth and knot security when exposed to inflammatory body fluids

A

Polyglactin 910
Braided lactomer

31
Q

Suture choice in urinary tract surgeries where the suture is exposed to urine

A

Polyglyconate
Polydiaxanone

Avoids premature loss of tensile strength

32
Q

Most common suture pattern for tendon

A

Three loop pulley - more resistant to gap formation under tensile loading

Locking loop

(Savage)

33
Q

Suture choice for nerves

A

Non absorbable

34
Q

Suture for vessels

A

Absorbable monfilament

35
Q

Abx for coating suture

A

Triclosan

36
Q

Size of green TA staples

A

Leg 4.8mm
Crown width 4mm
Closed height 2mm

These are what we most comonly use in equine sx but only blue are available as reloads

37
Q

Size of blue TA staples

A

Leg length 3.5mm
Crown width 4mm
Closed height 1.5mm

38
Q

Reusable TA stapler devices come in what sizes

A

30, 55, 90mm

39
Q

Single use TA staplers come in what sizes

A

35, 45, 60, 90mm

40
Q

Reusable GIA cartridge sizes

A

50, 90mm

41
Q

Disposable reloadabel GIA stapler sizes

A

60, 80, 100mm

42
Q

Reusable ILA stapler lengths

A

52, 100mm

43
Q

The incison cut by the knife blade of the GI stapler is how far short of the last staple

A

8mm

44
Q

Better apposition has been found with the 3.8mm vs thr 4.8mm staple in what procedure

A

Jejunocecostomy

45
Q

Interval between closure of GIA stapler jaws and insertion of staples

A

15 seconds

46
Q

Function of an LDS staples

A

2 staples on vessle and cuts between them

47
Q

LDS staple sizes

A

W:5.8mm x T:5.2mm = 5.3mm closed
6.35mm distance

or

8mm x 7.2mm = 7.3mm
9.5mm distance

48
Q

LDS should not be used on what tissues

A

Ones that cannot be compressed to 0.75mm

49
Q

Correct application of liga clip

A

Vessel should be 1/3 to 2/3 the size of the clip

2-3mm of the vessel should extend beyond the clip to avoid slipping

Dissect vessel free of surrounding tissue

50
Q

What material are absorbably staples made from

A

Lactomer

51
Q

What material are the tissue adhesives based on

A

2-Octylcyanoacrylate

52
Q

What are fibrin glues composed of

A

Concentrated fibrinogen, thrombin and calcium chloride

53
Q

Can fibrin glues be applied to wet surfaces

A

yes

54
Q

The incison cut by the knife blade of the TA stapler is how far short of the last staple

A

5mm

Eq ACVS Phase 1 (72 decks)

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