Suture and Suture Patterns Flashcards
Two broad Classification of Suture Pattern
Interrupted and Continuous
6 Categories of Sutures
- Apposition Suture
- Inversion
- Eversion
- Purse-string Suture
- Relaxation/ Tension Sutures
- Miscellaneous Sutures
Each suture is a separate entity, and can be individually positioned and tightened as needed
Interrupted Suture
Knots only at the beginning and end of pattern, and is better at providing an air, and water tight closure.
Continuous suture
Anatomically opposes the edges of the incision. This also enables to have the fastest healing and gives the most cosmetic result
Appositional
Turns incision edges inward, away from surgeon. Desirable when closing hollow organs
Inverting
Turns incision edges outwards, towards surgeon. This results in delayed healing and is rarely indicated
Everting Suture pattern
Examples of Apposition Sutures
Simple continuous
Simple Interrupted
Continuous lock-stitch (Ford-interlocking)
Subcuticular
Cross mattress or Interrupted cruciate
Example of Inversion Suture
- Lambert Suture
- Jobert;s Suture
- Cushing Suture
- Connel Suture
Suture Passes through serous and muscular layers not the mucosal layer. Needle bites are at right angles/ perpendicular to suture line
Lambert suture
Same Like lambert Suture but it penetrates mucosal Also.
Jobert’s Suture
Similar to Lambert except that bite is parallel to incision line
Cushing suture
Same as cushing but needle penetrates all layers including mucosa
Connel suture
Examples for Eversion Sutures
Horizontal Mattress Suture
Vertical Mattress Suture
Suture: Applied on the hernial ring where one side of the tissue overlaps on the other side. Combination of Lambert and horizontal mattress sutures
Overlapping (Vest over Pant) suture
Description: Short term, Multifilament, Absorbable
Has wound support of 14 days
Vicryl Rapide, Velosorb Fast, Nevolactine Rapid
Description: Medium Term, Multifilament, Absorbable
Wound support: 30 days
Vicryl, Polysorb, Nevolactine
Description: Short term, monofilament, Absorbable
Wound support: 21 days
Monocryl, Biosyn, Nevocaprone
Description: Long Term, Monofilament, absorbable
Wound support: 60 days
PDS, Maxon, Nevodiox
Suture for the Abdominal Wall: Linea Alba
- Sizes
PDS, Maxon : 3-0 ; 2-0 ; 0 in larger dogs
- Simple continuous 6-7 knots
Long term, Absorbable, monofilament: Simple interrupted 4-5 knots
- <5kg = 3-0 | 5-20 kg = 2-0 | 20-40 = 0 | > 45kg = 1
Suture for subcutaneous (how many layers)
-Pattern
-Size
-Type
Suture: PDS, Maxon (long tern absorbable monofilament)
size: 3-0 or 2-0
Pattern: Simple continuous knot (6-7 knots)
One to two layers
Suture for skin
-type
-Size
- Pattern
Layer: one
Suture: non-absorbable or absorbable
Size: small dogs and cats 4-0
Most dogs: 3-0
Pattern: Intradermal (absorbable)
Simple interrupted ford interlocking
Uterus Suture
-layer
-size
-Pattern
Layer: 2
Suture: Monocryl or PDS
Short or long term absorbable monofilament
Size: 3-0 / 2-0
Pattern: Simple continuous pattern
What drug can help with uterine involution
Oxytocin
Ovarian Pedicle
Layer: 2
Suture: PDS, Maxon, Biosyn, Monocryl
Short or long term absorbable monofilament
Size: 3-0 to 2-0 | Large breed: 0
Pattern: Two Ligatures
Circumferential and transfixational
Two Circumferential
Stomach Wall
Layer: one or two
Suture: PDS, Maxon, long term absorbable monofilament
Size: 3-0 or 2-0
Pattern: Full thickness simple continuous pattern or simple interrupted
Second layer: inverting (cushing, lembert, utrect)
Intestine
1 layer
Suture: PDS, Maxon | ,Long term, absorbable monpfilament
Size: 4-0 3-0
Pattern: Full thickness
Simple continuous pattern of simple interrupted
-taper point needle
Bladder
Layer: one or two
Suture: Biosyn or Monocryl | Short term absorbable monofilament
Size: 3-0 or 2-0
Pattern: Full thickness
Simple continuous or simple interrupted
Thick wall- one
Thin wall- two
