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Vet - notes > Suture material > Flashcards

Suture material Flashcards

1
Q

functions of suture material

A

Wound closure
Attachment of tubes
Ligation
Stay sutures

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2
Q

ideal interaction with the tissue

A

Maintains strength until wound strength develops
Rapid resorption when no longer required
Encapsulated without post-operative complications
Easily removed
Minimal tissue reaction
Does not favour bacterial growth
Minimal drag through tissues
Suitable for all wounds

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3
Q

ideal interaction with the surgeon

A

easy to handle

good knot security

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4
Q

ideal material properties

A 
Easy to sterilise 
Non-capillary (fluid doesn't stick to them) 
Non-electrolytic 
Non-corrosive 
Non-allergenic 
Non-carcinogenic
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5
Q

classification of suture material

A

natural vs synthetic
absorbable vs non
multi vs monofilament

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6
Q

Natural fibre - properties

A

Tissue inflammatory reaction

Variable absorption

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7
Q

Synthetic fibre - properties

A

Less reaction

Predictable absorption

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8
Q

Multifilament - properties

A

Easier to handle
Better knot security
 Capillarity

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9
Q

Monofilament - properties

A

Less tissue drag

Can weaken when crushed

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10
Q

coating effects

A

improves handling

reduces tissue drag

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11
Q

Synthetic Absorbable Multifilament - materials

A

Vicryl - Polyglactin 910
Dexon - Polyglycolic acid
Polysorb - Lactomer 9-1
Panacryl - Poly(L-lactide/glycolide)

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12
Q

Synthetic Absorbable Multifilament - Interaction with tissue

A

Absorption complete at 60-90d

Speed: Polysorb>Vicryl>Dexon

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13
Q

Synthetic Absorbable Multifilament - Tensile strength & loss

A

Loss 33% (7d), 80% (14d), 100% (21d)

Strength: Polysorb>Vicryl>Dexon

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14
Q

Synthetic Absorbable Multifilament - Handling & knotting

A

Good handling/knotting

Tissue drag - improved by coating

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15
Q

Synthetic Absorbable Multifilament - use

A

Vessel ligation

General soft tissue closure (skin, mouth)

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16
Q

Synthetic Absorbable Monofilament - short duration - Materials

A

Monocryl - Polyglecaprone

Caprosyn – Polyglytone

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17
Q

Synthetic Absorbable Monofilament - short duration - Interaction with tissue

A

Absorption complete @ 90-120d

Speed: Caprosyn>Monocryl

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18
Q

Synthetic Absorbable Monofilament - short duration - Tensile strength & loss

A

High tensile strength

Loss: 50%(7d),60%(14d), 100%(21d)

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19
Q

Synthetic Absorbable Monofilament - short duration - Handling & knotting

A

Monocryl - soft & pliable, low memory

Caprosyn - more sticky

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20
Q

Synthetic Absorbable Monofilament - short duration - use

A

General soft tissue closure

Visceral closure - Monocryl

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21
Q

Synthetic Absorbable Monofilament - long duration - Materials

A

PDS II - Polydioxanone
Maxon - Polyglyconate
Biosyn - Glycomer 631

22
Q

Synthetic Absorbable Monofilament - long duration - Interaction with tissue

A

Absorption complete @ 110-210d

23
Q

Synthetic Absorbable Monofilament - long duration - Tensile strength & loss

A

Strong materials (>Nylon, Prolene)
Loss: 26% (14d), 40% (28d), 75% (42d)
Strength: PDS II>Maxon>Biosyn

24
Q

Synthetic Absorbable Monofilament - long duration - Handling & knotting

A

PDS - memory, tendency to coil, 7 knots

25
Q

Synthetic Absorbable Monofilament - long duration - use

A

Soft tissues needing long support

Muscle, fascia, linea alba, viscera

26
Q

Synthetic Non-absorbable Monofilament - Materials

A

Prolene/SurgiPro - Polypropylene
Ethilon/Monosof – Polyamide
Flexon – Steel

27
Q

Synthetic Non-absorbable Monofilament - Interaction with tissue

A

Minimal reaction – inert

28
Q

Synthetic Non-absorbable Monofilament - Tensile strength

A

Strong

25% loss at 2 years - nylon

29
Q

Synthetic Non-absorbable Monofilament - Handling & knotting

A

Memory - Prolene>Nylon

Knot security - Prolene>Nylon

30
Q

Synthetic Non-absorbable Monofilament - Use

A

Inert - skin, stoma, vessels

Prolonged support-hernia, tendon

31
Q

Synthetic Non-absorbable Multifilament - Materials

A

Mersilene, Ethibond - Polyester
Novafil - Polybutester
Supramid - Caprolactam

32
Q

Synthetic Non-absorbable Multifilament - Interaction with tissue

A

Moderate inflammation

33
Q

Synthetic Non-absorbable Multifilament - Tensile strength

A

stronger than nylon

Very little loss of strength

34
Q

Synthetic Non-absorbable Multifilament - Handling & knotting

A

Fair handling, slight elasticity

Sheath cracks on knotting

35
Q

Synthetic Non-absorbable Multifilament - Use

A

Ligament prosthesis

? Skin closure

36
Q

Natural Absorbable Multifilament - Materials

A

Catgut – plain or chromic

Collagen – ophthalmic surgery

37
Q

Natural Absorbable Multifilament - Interaction with tissue

A

Absorption complete @ 60-70d
Tissue reaction marked
Faster in infected, vascular or acidic wounds
UNPREDICTABLE: absorption via phagocytosis cf hydrolysis

38
Q

Natural Absorbable Multifilament - Tensile strength & loss

A

33% loss (7d), 67% loss (14d)

39
Q

Natural Absorbable Multifilament - Handling & knotting

A

Knots weaker when wet
Poor knot security so leave ends long
Good handling

40
Q

Natural Absorbable Multifilament - Use

A

Vessel ligation, ophthalmic surgery

41
Q

Natural Non-absorbable Multifilament - Materials

A

Mersilk, PermaHand – Silk

42
Q

Natural Non-absorbable Multifilament - Tissue interaction

A

Moderate-marked inflammation

Encapsulated in fibrous tissue

43
Q

Natural Non-absorbable Multifilament - Tensile strength

A

Weak - will break

Very slow absorption - 2yr

44
Q

Natural Non-absorbable Multifilament - Handling & knotting

A

Handling good (silk)

45
Q

Natural Non-absorbable Multifilament - use

A

Large vessel ligation

NOT in viscera – ulcers and calculi

46
Q

General rules to avoid complications

A

Avoid multifilament material in contaminated wounds
Avoid non-absorbable sutures in hollow organs
Use inert material in the skin
Avoid reactive material for stoma creation
Use slowly/non-absorbable material in fascia/tendons
Avoid burying any suture from a multi-use cassette
Avoid catgut in inflamed, infected or acidic wounds

47
Q

Choice of suture size

A

Use the smallest size possible
Less tissue trauma – tissue tract
Smaller knots – reduced bulk

48
Q

Advantages of swaged-on needles

A 
Available for use immediately 
Unlikely to detach suture material 
Less handling of suture material 
Less fraying of suture material 
Less tissue trauma 
Likely to be sharper 
Guaranteed sterile 
Greater range of needles available
49
Q

advantages of reverse cutting needles

A

stronger
Danger of tissue cutout is greatly reduced
Hole left by the needle leaves a wide wall of tissue against which the suture is to be tied

50
Q

needle requirements

A

Sharp enough to pass through tissue
No change to tissue architecture
Needle resists bending/breakage
Needle hole just big enough for suture

Vet - notes (32 decks)

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