Flash Notes Miscellaneous - Suture Knots & Patterns

Question 1

what is the difference between a swaged needle & eyed needle?

Answer 1

swaged: suture is already fixed to the needle, so less traumatic, eyed: have to thread the needle, so more traumatic

Question 2

what are the differences in needle points of taperpoint, tapercut, cutting/reversed cutting, & blunt?

Answer 2

taperpoint: tapered piercing tip, tapercut: tapered cutting tip, cutting (regular/reverse): 2 or 3 cutting edges, & blunt: rounded point

Question 3

when are eyed needles not used?

Answer 3

not used on easily damaged tissues (make a bigger hole)

Question 4

when are straight keith needles used?

Answer 4

used for accessible areas that allow the needle to be manipulated directly by the fingers - purse string suture at the anus

Question 5

when are curved needles used?

Answer 5

deeper/inaccessible areas

Question 6

when are taper point needles used?

Answer 6

used on easily penetrated tissue such as subcutaneous fat, muscle, & intestine

Question 7

when are tapercut needles used?

Answer 7

used on tough fibrous tissue like tendons

Question 8

why are they called cutting needles?

Answer 8

they have 2 or 3 cutting edges to penetrate tough tissues such as skin

Question 9

what is a conventional/regular cutting needle?

Answer 9

3rd cutting edge is located on the inside/concave side of the curve

Question 10

when is a reverse cutting needle used?

Answer 10

3rd cutting edge is located on the outside/convex side of the curve - when closing incisions as there is no tendency for it to tear out

Question 11

why are blunt point needles rarely used? what are the exceptions for when they are used?

Answer 11

rounded points that don’t cut friable tissues - used on the parenchyma of the liver & kidney

Question 12

T/F: swaged needles are preferred for all surgeries

Answer 12

TRUE

Question 13

what is the most common suture knot used?

Answer 13

square knot

Question 14

what suture type is known to have a low coefficient of friction?

Answer 14

monofilament sutures

Question 15

when is a surgeons knot used?

Answer 15

only used if tissue opposition is not possible with a square knot or done to prevent the knot from slipping before placing the 2nd throw

Question 16

T/F: inversion & eversion of skin sutures both delay healing

Answer 16

TRUE

Question 17

what is the most common closure used on skin?

Answer 17

simple continuous

Question 18

what is the rough estimate when placing sutures from skin edges?

Answer 18

3-5mm from the skin edge

Question 19

what is the proper spacing that should be used between suture bites?

Answer 19

5-8mm

Question 20

what is the rule for placing the first & last sutures on a skin incision?

Answer 20

10mm from the end of the incision & start of the incision line

Question 21

why not include fat in an incision when closing skin?

Answer 21

prevents healing & may lead to dehiscience

Question 22

what is the purpose of eliminating dead space when suturing skin closed?

Answer 22

the body will eliminate it by filling it with fluid

Question 23

what is the benefit of using a simple interrupted suture pattern?

Answer 23

if one suture breaks, rest of incision is not affected & allows for precise adjustment of tension at each point of the incision

Question 24

when are inverting suture patterns used? what are some examples of patterns?

Answer 24

used to close or seal incisions/wounds of hollow internal organs like the stomach, intestine, bladder, & uterus - cushing, connell, halsted, lambert, or purse string

Question 25

what are appositional suture patterns? when are they used? what are some examples of patterns?

Answer 25

brings the edges of a wound together so they just touch - simple interrupted, simple continuous

Question 26

what are everting suture patterns? when are they used? what are some examples of patterns?

Answer 26

turn the edges of a wound outward - usually used when tension tends to pull the incision edges apart (tension sutures) mattress sutures

Question 27

what are tension suture patterns? what are some examples of patterns?

Answer 27

usued to relieve tension on the closure (vertical & horizontal mattress)

Question 28

why are inverting suture patterns no longer recommended for use on the gi tract?

Answer 28

they help prevent leakage but lead to stenosis (narrowing of the lumen)

Question 29

what is the holding layer of the abdomen?

Answer 29

submucosa - external rectus sheath

Question 30

what is the benefit of using a vertical mattress suture pattern?

Answer 30

stronger tension pattern with less eversion problems than the horizontal mattress

Question 31

what is another name for the subcuticular suture pattern?

Answer 31

intradermal

Question 32

what is the purpose of burying knots in suture patterns?

Answer 32

reduces irritation in some patterns - need to bury in subcutaneous closure to prevent necrosis of the skin due to pressure

Question 33

what is a stent suture pattern?

Answer 33

modified simple interrupted stitch that incorporates a sterile gauze sponge to take tension off of an incision or wound

Question 34

what is a quilled stitch?

Answer 34

incorporation of a rubber/plastic/salastic/gauze tube in the external loops of a vertical mattress suture on each side of the incision so like stent sutures it can take tension off of an incision so it can be sutured closed

Question 35

when are near & far stitches used?

Answer 35

used when tension doesn’t allow normal sutures to close an incision - stronger than quilled & relieve tension on the incision without applying tension to the incision edge - used on skin & fascia

Question 36

what is a purse string stitch?

Answer 36

special stitch used to close the anus, other openings, or tubular viscus to close a defect or stoma (new opening)