suture material Flashcards

1
Q

how is the choice of suture material made

A

preference of the surgeon

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2
Q

to hold wound edges in apposition until the wound can endure normal stress without the suture support

A

purpose of suturing

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3
Q

digested and assimilated by the body during normal healing

A

absorbable

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4
Q

do all absorbable sutures cause tissue reaction

A

yes

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5
Q

what does absorption time depend on

A

location, composition of suture, presence of infection

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6
Q

should suture material be autoclaved

A

no it weakens it

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7
Q

produced from sub-mucosal layers of sheep or hog intestines

A

surgical gut (catgut)

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8
Q

what are the 2 types of catgut

A

plain and chromic

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9
Q

treated with chromic acid salts to prolong absorption time

A

chromic catgut

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10
Q

how long does it take plain catgut to absorb

A

3-5 days

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11
Q

how long does it take chromic catgut to absorb

A

10-15 days

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12
Q

synthetic material made from hydroxyacetic acid

A

polyglycolic acid

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13
Q

how long does polyglycolic acid last

A

14-21 days

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14
Q

degrades rapidly in an alkaline environment, dissolves faster in infected urine

A

dexon and vicryl

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15
Q

made from lactic and glycolic acids

A

polyglactin 910

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16
Q

how long does polyglactin 910 last

A

14-21 days

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17
Q

made from glycoside and lactide copolymers; multifilament

A

polysorb

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18
Q

how long does polysorb last

A

14-42 days; gone by 70 days

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19
Q

has potential for bacterial wicking

A

polysorb

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20
Q

newer synthetic polyester with less tissue drag and memory. requires multiple throws and better for slow healing wounds

A

polydioxanone/polyglyconate

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21
Q

how long does polydioxanone/polyglyconate last

A

180 days to absorb

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22
Q

monofilament used for fast healing in place of gut

A

pliglecaprone and gllycomer 631

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23
Q

how long do pliglecaprone and gllycomer 631 last

A

7-14 days; gone by 90-120 days

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24
Q

how long do non-absorbable keep their strength

A

at least 60 days

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25
Q

what happens if non absorbable are left in skin

A

may get encysted

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26
Q

when should non absorbable be removed

A

7-14 days post op

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27
Q

forms due to a pocket of dead space or unrestricted exercise with sutures

A

seroma

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28
Q

splitting open of part of surgical wound due to licking or chewing

A

dehiscence

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29
Q

licking or chewing completely through body wall

A

complete dehiscence

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30
Q

non-absorbable: excellent handeling, commonly used in cardiovascular surgery, can induce severe soft-tissue reaction, can serve as point of origin for infection

A

silk

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31
Q

non-absorbable: natural fibers, strengthen when wet, behaves like silk, limited use

A

cotton and linen

32
Q

non-absorbable: synthetic, no tissue reaction, strength lasts 7 years, stiff and slippery, significant memory, excellent handling

A

polyamide

33
Q

non-absorbable: synthetic plastic, similar to nylon, does not weaken over time, permenent suture support

A

polypropylene

34
Q

non-absorbable: elastic, useful for ligament repair and structures under weighted motion

A

polybutester

35
Q

non-absorbable: multifilament, requires 5-6 knot throws, significant tissue drag and reaction, may have teflon or silicone coating, may cause chronic infection and draining fistuale

A

polyester fiber

36
Q

non-absorbable: coated with plastic-like material, high tensile strength, minimal tissue reaction, outer sheath can break, should never be used below skin level, can predispose fistulas

A

polymerized caprolactum

37
Q

what can polymerized caprolactum cause if left in too long

A

stitch granuloma

38
Q

useful in infected wounds or tissue that will be stressed in a slow healing process, also active and chewing pts

A

wire

39
Q

5 string

A

ordinary

40
Q

0 string

A

ought

41
Q

10-0

A

very delicate sx

42
Q

what do needles vary in

A

shape, point design, attatchment, size

43
Q

needle frequently used and reusable with any type of point, but must thread through eye and causes possible tissue damage

A

eyed needles

44
Q

needle will not unthread itself, less bulky, always sharp, material attached, but more expensive and one time use

A

swaged or swedged

45
Q

what needle is most atraumatic

A

swaged or swedged

46
Q

stapler has squeeze trigger, holds 25-35 staples, places single row, used for skin and fascia closure, cannot refill

A

surgical skin stapler

47
Q

stapler one time use, GI resection and anastomosis, 4 rows of staples and cuts between middle 2 rows, pre packaged

A

gastrointestinal stapler

48
Q

stapler comes pre packaged, used in lung resection, places double or triple row of staples

A

thoracoabdominal stapler

49
Q

stapler used for blood vessel ligation, places 2 staples on a vessel and cuts between them

A

ligate-and-divide stapler

50
Q

needle driven through by hand, resembles regular sewing needle; aka keith needle

A

straight

51
Q

special needle with the eye in the point, requires a special braided tubular suture, used for retaining prolapsed vaginas in large animals

A

buhner needle

52
Q

needle with double curve design, goes through skin without wrist pivot, only used in large animal; aka bovine needle

A

s curve

53
Q

needle uses holders to drive through tissue, many different curvatures, hundreds of types

A

curved

54
Q

when is a curved 1/4 circle used

A

opthalmic sx

55
Q

when is a curved 3/8 & 1/2 circle used

A

general sx (most popular)

56
Q

needle round all the way to the tip with taper, used for soft tissue, internal tissues, and SQ, atraumatic to tissues

A

non-cutting or tapered

57
Q

needle produces “cut out” effect, should not be used with an airtight or watertight suture line, used for skin and tough tissue, triangular shapped point

A

cutting

58
Q

needle where triangle is reversed, has less cut out, does not bend as easily most preferred

A

reverse cutting

59
Q

K needle aka

A

reverse cutting

60
Q

how are suture patterns categorized

A

continuous or interrupted

61
Q

how are suture pattern catagories divided

A

simple and mattress

62
Q

suture pattern designed to withstand added tension

A

mattress

63
Q

turning tissue outward toward surgon; will not close

A

everting

64
Q

turning tissue inward toward patient

A

inverting

65
Q

brings tissue in direct apposition

A

apposing

66
Q

how many throws are used for suturing

A

2-4

67
Q

where are needle holders held

A

inside of sutures

68
Q

suture pattern used in skin, SQ, fascia, blood vessels, GI, causes puckering and strangulation

A

simple continuous

69
Q

suture pattern used in skin, SQ, fascia, blood vessels, nerves, GI

A

simple interrupted

70
Q

suture pattern used in skin and fascia, stronger closure, resists tension, faster to apply

A

interrupted cruciate

71
Q

suture pattern used on skin and diaphragm, mainly used in large animal

A

ford interlocking

72
Q

suture pattern used in skin, SQ, fascia, muscle, tendon, continuous is common in cattle following rumenotomy, potential for strangulation

A

horizontal mattress

73
Q

suture pattern used for inversion of visceral stumps or tubes

A

purse string

74
Q

suture pattern used for manipulation or retraction of tissue, usually 2 or more are used

A

stay sutures

75
Q

suture pattern where suture material is passed through the stump to ligate, tied around half the stump, then around entire stump

A

transfixation ligature

76
Q

suture pattern for closing gut, needle penetrates serosa and musculans but not mucosa, continuous or interupted

A

lembert