Ch.16 Suture Materials and Patterns Flashcards
Relative knot security
RKS% = (KHC/TS) X 100
KHC - Knot holding capacity TS = Tensile strength
Absorbable suture materials
- Surgical gut - Cat gut, Chromic gut
- Polyglactin 910 - Vicryl
- Polyglycolic acid - Dexon
- Braided Lactomer - Polysorb
- Glycomer 631 - Biosyn
- Polyglytone 6211 - Caprosyn
- Polydioxanone - PDS II
- Polyglyconate - Maxon, Monosyn
- Poliglecaprone - Monocryl
Longest absorption time
Polydiaxone - PDS II
or
Polyglyconate - Maxon
Both 180 days
Fastest absorption time
Polyglytone 6211 - Caprosyn
56 days
Polyglactin 910 (Vicryl)
&
Braided lactomer (Polysorb)
both 56-70 days
Greatest tensile strength loss at 14 days
Polglytone 6211 - Caprosyn
<100% at day 21 so assuming a lot at 14 days
Poliglecaprone - Monocryl
80% lost
Trade name, composition, structure, abs, tensile strength, adv and dis adv of Poliglecaprone
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
Trade name, composition, structure, abs, tensile strength, adv and dis adv of Polyglyconate - Monosyn
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:
Trade name, composition, structure, abs, tensile strength, adv and dis adv of Polyglyconate - Maxon
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
Trade name, composition, structure, abs, tensile strength, adv and dis adv of Polydioxanone
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
Trade name, composition, structure, abs, tensile strength, adv and dis adv of
Polyglytone 6211
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
Trade name, composition, structure, abs, tensile strength, adv and dis adv of
Glycomer 631
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
Trade name, composition, structure, abs, tensile strength, adv and dis adv of
Braided lactomer
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
Trade name, composition, structure, abs, tensile strength, adv and dis adv of
Polyglactin 910
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
TS of Nylon - Dafilon/Monosof
Monofilament: Loses 30% by 2 years
Multifilament: Losses 100% by 6 months
Advantages of Nylon - Dafilon/Monosof
Degredation products act as antibacterial agents
Needle shapes
1/4
3/8
5/8
1/2
Use for 1/4 shape needle
Opthalmic sx
Needle shape for suturing in confined/deep spaces
5/8
Cutting vs reverse cutting vs tapercut
Cutting - Cutting surface inside
Reverse cutting - Cutting surface outside
Tapercut - Triangle point, round body
Use of Dechamps needle
Ligate vessels in deep poorly accessible areas
Clamping the first throw - effects on suture
No effect on multifilament
Reduces breaking strength of monofilament by 10% if clamped with a hemostat instead of needle driver
Characteristics of suture material affecting knot security
Memory
Coefficient of friction
Bodily fluids coming into contact with suture will affect frictional behaviour
How many throws req for a secure square knot using 2-0 USP Polyglycolic acid, polyglactin 910 and polypropylene
3
If larger suture diameter use 5
Intrinsic suture tension
Tension on tissue within the suture loop
