Principles of Closure Flashcards
ideal suture material
- maintains tensile strength
- absorbed predictably
- bio-insert
- sterilized
- monofilament
- economical
absorbable suture
- absorbable
- rapid loss of tensile strength < 60days
- phagocytosis by macrophage
- enzymatic hydrolysis
- may remain for >60 days but have 0 tensile strength
non-absorbable suture retains tensile strength for __
> 60 days
natural suture
animal or plant by product
less predictable!
synthetic suture
increase predictability of tensile strength loss and have memory
multifilament suture is softer and has a __ to improve handling but is a __ for infection
coating, nidus
monofiliament suture has little to no__ action while multifilament has __ action absorbing and wicking fluid in suture (transports bacti)
capillary, capillary
is 2-0 or 2 a larger suture?
2 is larger
2-0, 3-0, 4-0 get smaller as the first number increases
surgical gut (catgut)
- natural, monofilament, absorbable
- severe foreign body reaction
chromic gut
chromium salts added to sx gut
- decreases tissue reaction
- increases tensile strength
- increases resistance to degradation
advantages of chromic gut
good handling
minimal capillary action
good knot security when dry
inexpensive (reel)
disadvantages of chromic gut
reactive
poor knot security when wet
not autoclavable
irritation from packing liquids
loss of tensile strength in infected wounds
vicryl has __ loss of tensile strength in 14 days
50%
vicryl
synthetic, multifilament, absorbable suture
- minimal reactivity
- good handling and knot security
- stable in contaminated wounds
- absorbed predictably
- soft, easy to bury
monocryl has __ tensile loss in 7 days and no tensile strength by day __
40-50%, 21
PDS has __ tensile strength loss at 4 weeks
42%
advantages of PDS
- monofilament, synthetic, absorbable
- minimally reactive
- no capillarity or drag
- good handling and know security
- predicatable absorption
- good in contaminate sites
PDS disadvantages
- expensive
- tendency to kink
- clear product is difficult to see
- can be more reactive intradermal
silk is __, natural and multifilament
non-absorbable
silk suture has __ tensile loss at 1 year and __ loss at 2 years
50%, 100%
swaged needle
suture directly attached to the needle
- less traumatic than eyed needles
-1/2 circle needle most useful
reverse cutting
- flat concave surface
- minimizes cutting through tissue
- skin, SQ, intradermal
elliptical Incision closure
closure by halves to reduce tension
feline mammary neoplasia is one of the __ common neoplasias of cat but if found is __ malignant
less, 90%
monocryl
synthetic, monofilament, absorbable suture
- high initial tensile strength
- absorbed predictably in 90-120 days by hydrolysis
- most pliable monofilament
- good strength
- minimal reactivity
- can use in contaminated wounds
silk disadvantages
- moderate tissue reaction and capillarity
- potentiate infection
- poor to fair know security
- loses tensile strength when wet
nylon is __, synthetic, monofilament with memory and poor __ and __
non-absorbable, knot security and handling
polypropylene is __, synthetic, monofilament that is minimally reactive and the least __ suture
non-absorbable, thrombogenic
braunamid is polymerized caprolactum that is non-absorbable. It has good handling, __ strength and is __. It has poor tissue __ and is not __
tensile, inexpensive, reactivity, not sterile
taper point needle
sharp, non-cutting point, cylindrical body
- for visceral, muscle, SQ
cutting needle
triangular point with 3 cutting edges
reverse cutting
flat concave surface that minimizes cutting through tissue
- for skin, SQ, intradermal
how can you provide tension relief when closing an eliptical incision?
- positional
- undermining
- tension relieving sutures
- simple flaps
- axial pattern flaps
