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Surgical biology and methods > Suture material > Flashcards

Suture material Flashcards

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1
Q

Label the parts of a surgical needle.

A
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2
Q

What are the different needle point and body configurations?

A
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3
Q

How much does knot placement typically reduce suture strength?

A

10 - 40%

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4
Q

What are the suture pull out values of the following materials; fat, muscle, skin and fascia?

A

Fat: 0.2 kg
Muscle: 1.27 kg
Skin: 1.82 kg
Fascia: 3.77 kg

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5
Q

What are the main differences between monofilament and multifilament sutures?

A

Less tissue drag, decreased capillarity and tendency for bacterial colonization and decreased pliability of monofilament sutures

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6
Q

Are barbed sutures more or less stiff than their smooth counterparts?

A

Stiffer and have less elongation

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7
Q

What smooth polypropylene suture size was comparable in breaking strength to 2-0 barbed polypropylene suture?

A

3-0

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8
Q

What affect does triclosan suture coating have on bacteria?

A

Inhibits bacterial fatty acid synthesis

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9
Q

Describe the general characteristics of common absorbable sutures.

A
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10
Q

What is the definition of an absorbable suture?

A

A suture that loses most of its tensile strength in 60-90 days

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11
Q

What are the two major mechanisms of suture absorption?

A
  1. Proteolytic/enzymatic: natural sutures are absorbed through the action of cellular proteases and collagenases
  2. Hydrolysis: synthetic sutures are absorbed in this fashion
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12
Q

What factors can effect the rate of suture absorption?

A

Environmental, pH, bodily fluids, temperature, application and amount of strain

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13
Q

What is catgut made from?

A

Twisted suture material from small intestinal submucosa of sheep or intestinal serosa of cattle

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14
Q

How long does silk take to deteriorate in vivo?

A

Complete deterioration by 12-months with significant loss of strength in the first 12-weeks. This is caused by hydration.

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15
Q

What effect does steam sterilization have on nylon leader line?

A

Increased elongation (2-4 fold)

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16
Q

Is nylon susceptible to degradation in vivo?

A

Yes, begins as a result of hydration. In an acid environment 50% loss of tensile strength expected in 12 weeks

17
Q

Do sutures with a glycolide component degrade more or less rapidly in an alkaline environment?

A

More rapidly

18
Q

Do sutures with a dioxanone component degrade more or less rapidly in an acid environment?

A

More rapidly

19
Q

Describe the general characteristics of common non-absorbable sutures?

A
20
Q

What is the composition of FiberWire?

A

Multifilament ultra high molecular weight polyethylene core surrounded by a braided polyester and polyethylene exterior

21
Q

Is FiberWire or stainless steel stronger?

A

FiberWire - greater strength and maintenance of stiffness under 3-point bending

22
Q

What is the bias direction of a woven material?

A

45 degrees to the warp and weft

23
Q

What accounts for the strength of a knitted mesh?

A

The wale. Elongation along the course if greater than elongation along the wale (anisotrophy)

24
Q

What is the downside of a small pore size in a mesh?

A

Ingrowth of capillaries and fibroblasts are prevented resulting in encapsulation rather than incorporation

25
Q

How long does porcine small intestinal submucosa take to be replaced by native connective tissue?

A

3-months

26
Q

What is the effect of porcine small intestinal submucosa on the local wound environment?

A

Modulatory effect on local cytokines evoking an intense initial leukocyte infiltration

27
Q

Is porcine small intestinal submucosa suitable for use in high strain environments?

A

No (particularly single layer)

28
Q

How much overlap of a mesh with the native tissue is recommended?

A

1cm if under tension, 0.6 cm if not under tension

29
Q

What are the dimensions of regular and wide skin staples?

A
30
Q

What are the dimensions of ligate-divide-staple (LDS) staples, both regular and wide?

A

Regular: 5.79mm wide, 5.23mm tall, closure width 5.33mm
Wide: 8mm wide, 7.2mm tall, closure width 7.3mm

31
Q

What are the basic principles of vascular clip application?

A
  1. Vessel is skeletonized
  2. Diameter of the vessel to be occluded is not more than 2/3 and no less than 1/3 the length of the clip
  3. Clip is applied several mm from the vessel edge
  4. Arteries and veins are clipped separately
32
Q

What are the staple sizes for use in the TA stapler?

A
33
Q

What are the staple sizes for use in the GIA stapler?

A
34
Q

What is the combined tissue thickness limitation for use of a circular stapling device?

A

Should not be used if combined tissue thickness is less than 1mm or greater than 2.5mm

35
Q

What causes tissue bonding when using cyanoacrylate glue?

A

Polymerization when the flue encounters anions associated with moisture on the surface of the skin or wound edge

36
Q

What are the byproducts of cyanoacrylate polymerization?

A

Formaldehyde and cyanoacetate

37
Q

Are short or long alkyl cyanoacrylate derivative glues preferred for medical use?

A

Long alkyl derivatives as they have slowly conversion to toxic byproducts allowing tissue to clear and leading to less toxicity. Bonding is also less brittle and has higher wound bursting strength

Surgical biology and methods (11 decks)

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