Flash Notes Miscellaneous - Suture Knots & Patterns Flashcards
what is the difference between a swaged needle & eyed needle?
swaged: suture is already fixed to the needle, so less traumatic, eyed: have to thread the needle, so more traumatic
what are the differences in needle points of taperpoint, tapercut, cutting/reversed cutting, & blunt?
taperpoint: tapered piercing tip, tapercut: tapered cutting tip, cutting (regular/reverse): 2 or 3 cutting edges, & blunt: rounded point
when are eyed needles not used?
not used on easily damaged tissues (make a bigger hole)
when are straight keith needles used?
used for accessible areas that allow the needle to be manipulated directly by the fingers - purse string suture at the anus
when are curved needles used?
deeper/inaccessible areas
when are taper point needles used?
used on easily penetrated tissue such as subcutaneous fat, muscle, & intestine
when are tapercut needles used?
used on tough fibrous tissue like tendons
why are they called cutting needles?
they have 2 or 3 cutting edges to penetrate tough tissues such as skin
what is a conventional/regular cutting needle?
3rd cutting edge is located on the inside/concave side of the curve
when is a reverse cutting needle used?
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
why are blunt point needles rarely used? what are the exceptions for when they are used?
rounded points that don’t cut friable tissues - used on the parenchyma of the liver & kidney
T/F: swaged needles are preferred for all surgeries
TRUE
what is the most common suture knot used?
square knot
what suture type is known to have a low coefficient of friction?
monofilament sutures
when is a surgeons knot used?
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
T/F: inversion & eversion of skin sutures both delay healing
TRUE
what is the most common closure used on skin?
simple continuous
what is the rough estimate when placing sutures from skin edges?
3-5mm from the skin edge
what is the proper spacing that should be used between suture bites?
5-8mm
what is the rule for placing the first & last sutures on a skin incision?
10mm from the end of the incision & start of the incision line
why not include fat in an incision when closing skin?
prevents healing & may lead to dehiscience
what is the purpose of eliminating dead space when suturing skin closed?
the body will eliminate it by filling it with fluid
what is the benefit of using a simple interrupted suture pattern?
if one suture breaks, rest of incision is not affected & allows for precise adjustment of tension at each point of the incision
when are inverting suture patterns used? what are some examples of patterns?
used to close or seal incisions/wounds of hollow internal organs like the stomach, intestine, bladder, & uterus - cushing, connell, halsted, lambert, or purse string
what are appositional suture patterns? when are they used? what are some examples of patterns?
brings the edges of a wound together so they just touch - simple interrupted, simple continuous
what are everting suture patterns? when are they used? what are some examples of patterns?
turn the edges of a wound outward - usually used when tension tends to pull the incision edges apart (tension sutures) mattress sutures
what are tension suture patterns? what are some examples of patterns?
usued to relieve tension on the closure (vertical & horizontal mattress)
why are inverting suture patterns no longer recommended for use on the gi tract?
they help prevent leakage but lead to stenosis (narrowing of the lumen)
what is the holding layer of the abdomen?
submucosa - external rectus sheath
what is the benefit of using a vertical mattress suture pattern?
stronger tension pattern with less eversion problems than the horizontal mattress
what is another name for the subcuticular suture pattern?
intradermal
what is the purpose of burying knots in suture patterns?
reduces irritation in some patterns - need to bury in subcutaneous closure to prevent necrosis of the skin due to pressure
what is a stent suture pattern?
modified simple interrupted stitch that incorporates a sterile gauze sponge to take tension off of an incision or wound
what is a quilled stitch?
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
when are near & far stitches used?
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
what is a purse string stitch?
special stitch used to close the anus, other openings, or tubular viscus to close a defect or stoma (new opening)
