Implanted Materials Flashcards
What is the definition of an implanted material?
Anything put in the body that remains for a prolonged period
Name 4 uses for suture material
- Closing tissues
- Ligation
- Anchoring drains and tubes
- Atraumatic tissue manipulation
What is a round-bodied needle?
Smaller hole in tissue, harder to pass through fascia
* Used in tissues easy to penetrate
* Blunt ended
* Used in parenchymatous organs, fat and muscle
What is a cutting needle?
Cutting edge concave side
* Larger hole in tissue, easier to pass through fascia/skin
What is a reverse cutting needle?
Cutting edge on convex side
* Less risk of pulling needle though tissue bite
* Smaller hole in tissues
What is a tapercut needle?
- Sharp Cutting Point
- Used for fascia and pericardium
What is the characteristic of an absorbable suture?
Loses most tensile strength within 90 days
* Use for tissues inaccessible after implantation
* Short duration <21 days
* Long duration >21 days
* Influenced by environment (urine . . .)
What is the characteristic of a non-absorbable suture?
Does not lose tensile strength within 90 days
* 6 months (nylon) to years
* Use for slowly healing tissues, tissues requiring prolonged mechanical support Or where
easily accessible
* for removal
* Elicit tissue reaction resulting in encapsulation by fibrous tissue
* E.g.silk used for vascular surgery
What is chromic catgut impregnated with?
Chromium trioxide, stronger and lasts longer
How does catgut degrade?
It degrades via phagocytosis
* Unpredictable tensile strength
* marked FB reaction
* loses strength more rapidly
What is polydioxanone, and what is it used for?
Sites where slow healing but not permanent suture
needed
* Abdominal wall, ruptured diaphragm, muscle/fascia
* Removed by hydrolysis
When might you use monocryl?
Fast-healing structures with not a lot of forces
applied
* Subcutaneous, intradermal, mucosa
* Loses strength quickly
When might you use vicryl?
Fast-healing structures with not a lot of forces
applied
* Subcutaneous, intradermal, mucosa
* Where safe knots needed – ligatures
* Where soft sutures needed (oral cavity
When might you use nylon?
Skin sutures, securing tubes and drains
* Permanent sutures in the body (tendon repair, hernia repair)
* Ethilon (monofilament Nylon) and Supramid (multifilament Nylon)
When might you use prolene?
skin sutures
* Permanent sutures in the body (tendon repair, hernia
repair)
* Used for vascular sutures
How might you choose the tensile strength of a suture?
Suture should be as strong as the normal strength of tissue in which it is
being used
* Rate of loss of tensile strength should be parallel to the increase in wound
strength with healing
* Forces exerted on the tissue (and sutures)
How might you choose the knot security of a suture?
Improves as diameter decreases
* Too small diameter less strong in larger patients
* Too large diameter = excessive tissue reaction
* Number of throws required to make a secure knot varies with material and
pattern
When should sutures generally be removed?
Generally removed ~10 days
» Skin bursting strength only ~20% normal
» Minimises inflammation/infection risk
» Rarely problem as stress taken up by underlying
fascial closure
» If tension then leave in for 14-21 days
» Tension relieving sutures interspersed can be
removed in 3-5 days
What makes up tissue glue?
Cyanoacrylates
* Instant water tight seal
* Will not resist tension
* Reduce infections? (limit contamination before fibrin seal)
* Do not use in deep tissues
* place over apposed wound not in between wound edges
* FB
* Sloughs in 5-10 days
What is a sub-ureteral bypass?
- Treating a blocked bladder
- tube carries urine from the kidneys to the bladder
What is an ameroid constricter used for?
Used to gradually close a blood vessel or shunt
