Lec.5 Principle Of Sutures

Question 1

What is the purpose of stabilizing tissue during suture placement?

Question 2

To allow for proper suture placement.

Question 3

What types of forceps can be used to grasp tissue for suturing?

Answer 3

Toothed or untoothed forceps.

Question 4

What is the advantage of grasping the needle near the eye or swage during suturing?

Answer 4

Grasping the needle near the eye or swage allows maximum needle length for suturing and reduces the risk of needle slippage.

Question 5

What is the risk associated with grasping the needle near the eye or swage?

Answer 5

The risk is that the needle is more likely to bend or break unless delicate tissue is being sutured.

Question 6

What is a disadvantage of extracting the needle when it is held near the pointed end during suturing?

Answer 6

Extracting the needle is difficult when it is held near the pointed end.

Question 7

What is the benefit of holding the needle near the pointed end when suturing tough tissue?

Answer 7

Holding the needle near the pointed end allows for the greatest driving force when suturing tough tissue.

Question 8

Why should needles generally be placed perpendicular to the needle holder?

Answer 8

Placing needles perpendicular to the needle holder allows for the greatest maneuverability.

Question 9

Where should a needle be grasped to allow for greater force and less risk of breakage during suturing?

Answer 9

A needle should generally be grasped near its center to allow it to be advanced through tissue with greater force and less risk of breakage.

Question 10

What is the importance of grasping and stabilizing the needle before removing the needle holder?

Answer 10

Grasping and stabilizing the needle before removing the needle holder is important to decrease the risk of losing the needle in the dermis or subcutaneous fat, especially when small needles are used.

Question 11

What type of needle is recommended for the Ford interlocking suture to expedite the suturing process?

Answer 11

A large serpentine needle is recommended for the Ford interlocking suture to expedite the suturing process.

Question 12

What angle should the needle penetrate the skin to minimize the size of the entry wound?

Answer 12

The needle should penetrate the skin at a 90° angle.

Question 13

How far from the wound edge should the needle be inserted when suturing?

Answer 13

The needle should be inserted 1 - 3 mm from the wound edge, depending on the thickness of the tissue.

Question 14

What is the importance of equal bites when suturing a wound?

Answer 14

The ‘bite’ taken on one side of the wound must be equal to the bite taken on the second side to ensure even tension and proper healing.

Question 15

What general guideline should be followed regarding the entry and exit points of sutures?

Answer 15

In general, sutures should enter and exit at an equal distance from the wound margin.

Question 16

What is the typical spacing between sutures in relation to the wound margin?

Answer 16

Spacing between sutures is typically equal to the distance from needle entry to the wound margin.

Question 17

What is the basic component that all suture patterns start with?

Answer 17

The square knot.

Question 18

What is the primary use of the square knot in suturing?

Answer 18

To start and finish all suture patterns, whether continuous or interrupted.

Question 19

What is a surgeon’s knot and when is it used?

Answer 19

A surgeon’s knot is produced by passing one strand through the loop twice on the first throw of a square knot. It is occasionally used for closure of tissues where tension on the tissues makes it difficult to apply a regular square knot.

Question 20

What is the correct method for pulling the suture strand out?

Answer 20

Gently pull the suture strand out through the side opposite the knot with the forceps, ensuring not to pull any portion that has been outside the skin back through the skin.

Question 21

How should the suture be cut during the removal process?

Answer 21

Pick up one end of the suture with thumb forceps or thumb and index finger, and cut as close to the skin as possible where the suture enters the skin.

Question 22

What factors influence the choice of suture technique?

Answer 22

The choice of suture technique depends on the type and anatomic location of the wound, the thickness of the tissue, and the degree of tension.

Question 23

How are suture patterns typically categorized?

Answer 23

Suture patterns are typically categorized as continuous or interrupted, inverting, appositional, or everting, and tension suture.

Question 24

What is a disadvantage of interrupted suture patterns?

Answer 24

Interrupted suture patterns require more time to tie individual knots, have poor suture economy, and increase the amount of foreign material in the wound.

Question 25

What is an advantage of continuous suture patterns?

Answer 25

Continuous suture patterns are faster and involve less foreign material in the wound.

Question 26

What is a disadvantage of continuous suture patterns?

Answer 26

Continuous suture patterns provide less precise control of wound approximation and tension, and failure of a knot may lead to disruption of the suture line.

Question 27

What is an advantage of interrupted suture patterns?

Answer 27

Interrupted suture patterns allow adjustment of tension throughout the suture line, and the failure of one knot is often inconsequential.

Question 28

What is the technique for placing a simple interrupted suture?

Answer 28

The needle is inserted 1 - 3 mm into one side, advanced to the bottom of the wound, then traversed into the other side, exiting on the opposite side of the wound.

Question 29

What is the importance of proper tension in suturing?

Answer 29

Proper tension is important to ensure precise wound approximation while preventing tissue strangulation.

Question 30

Why are large bites used in suturing?

Answer 30

Large bites can be used to reduce wound tension.

Question 31

What is the purpose of using small bites in suturing?

Answer 31

Small bites can be used to precisely coapt wound edges.

Question 32

What types of tissues can be sutured?

Answer 32

Sutures can be used on skin, subcutaneous tissue, vessels, nerves, gastrointestinal, respiratory, and urinary tracts.

Question 33

What is a simple continuous suture?

Answer 33

A simple continuous suture is an uninterrupted series of simple interrupted sutures, started by placing a simple interrupted stitch that is tied but not cut, followed by a series of simple sutures placed without tying or cutting the suture material after each pass.

Question 34

What are some uses of sutures?

Answer 34

Sutures are used in subcutaneous tissue, fascia, muscles, gastrointestinal, and urinary tract.

Question 35

Where is the knot tied when completing a suture line?

Answer 35

The knot is tied between the tail end of the suture material where it exits the wound and the loop of the last suture placed.

Question 36

What is the final step in completing a line of stitches?

Answer 36

The line of stitches is completed by tying a knot after the last pass at the end of the suture line.

Question 37

What should be ensured regarding the spacing and tension of sutures along the suture line?

Answer 37

Sutures should be evenly spaced, and tension should be evenly distributed along the suture line.

Question 38

What is a disadvantage of the Ford interlocking suture pattern?

Answer 38

The Ford interlocking suture pattern is more difficult to remove.

Question 39

What is a key advantage of the Ford interlocking suture pattern compared to simple continuous sutures?

Answer 39

The Ford interlocking suture pattern is more secure than simple continuous sutures if the knot fails.

Question 40

How is the first knot of a running locked suture tied in the Ford interlocking pattern?

Answer 40

The first knot of a running locked suture in the Ford interlocking pattern is tied as in a traditional running suture and may be locked by passing the needle through the loop preceding it as each stitch is placed.

Question 41

How does the interrupted cruciate suture pattern compare to the simple interrupted pattern in terms of closure speed?

Answer 41

The interrupted cruciate suture pattern allows for faster closure than the simple interrupted pattern.

Question 42

What advantage does the interrupted cruciate suture pattern have regarding tension and eversion?

Answer 42

The interrupted cruciate suture pattern resists tension and prevents eversion.

Question 43

What is the interrupted cruciate suture pattern used for?

Answer 43

The interrupted cruciate suture pattern is used to suture the skin.

Question 44

In terms of strength, how does the interrupted cruciate suture pattern compare to the simple interrupted pattern?

Answer 44

The interrupted cruciate suture pattern provides a stronger closure than the simple interrupted pattern.