Principles of Closure

Question 1

ideal suture material

Answer 1

• maintains tensile strength
• absorbed predictably
• bio-insert
• sterilized
• monofilament
• economical

Question 2

absorbable suture

Answer 2

• absorbable
• rapid loss of tensile strength < 60days
• phagocytosis by macrophage
• enzymatic hydrolysis
• may remain for >60 days but have 0 tensile strength

Question 3

non-absorbable suture retains tensile strength for __

Answer 3

> 60 days

Question 4

natural suture

Answer 4

animal or plant by product
less predictable!

Question 5

synthetic suture

Answer 5

increase predictability of tensile strength loss and have memory

Question 6

multifilament suture is softer and has a __ to improve handling but is a __ for infection

Answer 6

coating, nidus

Question 7

monofiliament suture has little to no__ action while multifilament has __ action absorbing and wicking fluid in suture (transports bacti)

Answer 7

capillary, capillary

Question 8

is 2-0 or 2 a larger suture?

Answer 8

2 is larger

2-0, 3-0, 4-0 get smaller as the first number increases

Question 9

surgical gut (catgut)

Answer 9

• natural, monofilament, absorbable
• severe foreign body reaction

Question 10

chromic gut

Answer 10

chromium salts added to sx gut
- decreases tissue reaction
- increases tensile strength
- increases resistance to degradation

Question 11

advantages of chromic gut

Answer 11

good handling
minimal capillary action
good knot security when dry
inexpensive (reel)

Question 12

disadvantages of chromic gut

Answer 12

reactive
poor knot security when wet
not autoclavable
irritation from packing liquids
loss of tensile strength in infected wounds

Question 13

vicryl has __ loss of tensile strength in 14 days

Answer 13

50%

Question 14

vicryl

Answer 14

synthetic, multifilament, absorbable suture

• minimal reactivity
• good handling and knot security
• stable in contaminated wounds
• absorbed predictably
• soft, easy to bury

Question 15

monocryl has __ tensile loss in 7 days and no tensile strength by day __

Answer 15

40-50%, 21

Question 16

PDS has __ tensile strength loss at 4 weeks

Answer 16

42%

Question 17

advantages of PDS

Answer 17

• monofilament, synthetic, absorbable
• minimally reactive
• no capillarity or drag
• good handling and know security
• predicatable absorption
• good in contaminate sites

Question 18

PDS disadvantages

Answer 18

• expensive
• tendency to kink
• clear product is difficult to see
• can be more reactive intradermal

Question 19

silk is __, natural and multifilament

Answer 19

non-absorbable

Question 20

silk suture has __ tensile loss at 1 year and __ loss at 2 years

Answer 20

50%, 100%

Question 21

swaged needle

Answer 21

suture directly attached to the needle
- less traumatic than eyed needles
-1/2 circle needle most useful

Question 22

reverse cutting

Answer 22

• flat concave surface
• minimizes cutting through tissue
• skin, SQ, intradermal

Question 23

elliptical Incision closure

Answer 23

closure by halves to reduce tension

Question 24

feline mammary neoplasia is one of the __ common neoplasias of cat but if found is __ malignant

Answer 24

less, 90%

Question 25

monocryl

Answer 25

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

Question 26

silk disadvantages

Answer 26

- moderate tissue reaction and capillarity - potentiate infection - poor to fair know security - loses tensile strength when wet

Question 27

nylon is __, synthetic, monofilament with memory and poor __ and __

Answer 27

non-absorbable, knot security and handling

Question 28

polypropylene is __, synthetic, monofilament that is minimally reactive and the least __ suture

Answer 28

non-absorbable, thrombogenic

Question 29

braunamid is polymerized caprolactum that is non-absorbable. It has good handling, __ strength and is __. It has poor tissue __ and is not __

Answer 29

tensile, inexpensive, reactivity, not sterile

Question 30

taper point needle

Answer 30

sharp, non-cutting point, cylindrical body - for visceral, muscle, SQ

Question 31

cutting needle

Answer 31

triangular point with 3 cutting edges

Question 32

reverse cutting

Answer 32

flat concave surface that minimizes cutting through tissue - for skin, SQ, intradermal

Question 33

how can you provide tension relief when closing an eliptical incision?

Answer 33

- positional - undermining - tension relieving sutures - simple flaps - axial pattern flaps