Suture Material and Needles Flashcards
What is suture?
Suture is a strand of material used to tie off blood vessels and approximate tissues
What should the ideal suture do?
The ideal suture should:
● Be easy to handle
● Minimally react in tissue
● Inhibit bacterial growth
● Secure hold when knotted
● Resist shrinking in tissue
● Absorb with minimal reaction
What is sutures role in wound repair?
Suturing plays an important role in wound repair
● Provides hemostasis
● Supports wound healing
How long does it take normally for skin to heal?
◦ Skin should take a couple days to a week to heal
How long does it take for Tendon and trachea to heal?
Tendons/ trachea can take weeks to months to heal
What is tensile strength? How does that relate to suture strength?
Tensile strength: measure time it takes for suture material to loose 70-80 % of its initial strength.
◦ Bigger suture more tensile strength.
What is being referenced about suture when pliability / flexibility is being discussed?
- Pliability/ Flexibility: used interchangeably to refer to ease of handling.
What is memory of suture? What suture type has more memory?
- Memory: Tendency of suture to return to its original shape
◦ Monofilament suture will have more memory then multifilament suture.
What is suture surface filament? What suture causes more damage natural or synthetic? Multifilament or Monofilament?
- Surface filament: roughness on outer surface of suture.
◦ Rough sutures will cause more damage than smooth sutures.
◦ Natural fibers»_space; synthetic
◦ Multifilament > monofilament
What is knot security? What is its relation to suture size?
Knot security: ability of suture to hold knot -> inversely related to size of suture
What is capillarity?
● Process by which fluid and bacteria are carried into the interstices of multifilament fibers
● Infection can persist in suture
● Do NOT use multifilament suture in infected/contaminated tissues
● Monofilament are considered non-capillary - one strand/ fiber, no place for bacteria to get into.
● All braided sutures have capillarity- areas suture can hang out
What is tissue reactivity? What suture type is more reactive? Natural or Synthetic? Multifilament or Monofilament?
● Degree to which the body tends to react to the presence of a particular suture material (suture is a foreign body
Reactivity:
● Natural fibers»_space; synthetic suture
● Multifilament > monofilament
What are the properties of an ideal suture material?
- Minimal tissue reaction
- Gentle passage through tissues
- High knot safety and security
- No capillarity
- Maximum tensile strength
● High breaking strength - Consistent performance
● Comfortable to handle - Good and predictable absorption
What is the ideal suture for all procedures?
“No single suture is ideal for every surgical situation… Certain suture materials are better suited for different wound environments and uses”
What are the classifications of sutures?
-Fiber Origin
◦ Synthetic (human made) vs. natural (biological sources : silk, catgut)
Structure
● Monofilament (one fiber) vs. multifilament (multiple fibers)
◦ Multifilament sutures have more tissue drag and can harbor bacteria
◦ Sometimes coated to prevent tissue drag.
* Behavior in tissue
◦ Absorbable vs. nonabsorbable
◦ Antimicrobial
‣ “Plus” sutures
* Size
Are these sutures absorbable or non absorbable? monofilament or multifilament?
Are these sutures absorbable or non absorbable? monofilament or multifilament?
Are these sutures absorbable or non absorbable? monofilament or multifilament?
Are these sutures absorbable or non absorbable? monofilament or multifilament?
What is the absorption rate of non absorbable suture?
- Nonabsorbable:
● Maintains >50% of tensile strength for greater than 60 days
What is the absorption rate of absorbable suture?
- Absorbable
● Loses >50% of tensile strength in less than 60 days
Does tensile strength determine rate of absorption?
No
What can occur if there is accelerated or premature absorption?
- Accelerated and premature absorption may lead to post-operative complications.
How are natural fibers absorbed? What causes an increase of the rate of absorption?
Natural fibers
● Enzymatic digestion
● Rate of absorption increases in the presence of infection and inflammation
How are synthetic suture absorbed? What causes an increase of the rate of absorption?
Synthetic suture
● Hydrolysis
● Water molecules penetrate suture material causing breakdown of suture polymer chain
● Less tissue reaction than enzymatic digestion
What suture has less tissue reaction, synthetic or natural sutures?
Synthetic- ● Less tissue reaction than enzymatic digestion
What is included in suture duration?
Suture duration includes loss of tensile strength (loss of suture strength) and absorption
What should you consider when choosing suture?
What kind of sutures would you use for tendons, fascia, ect? Why?
What kind of sutures would you use for bladder, stomach, colon ect? Why?
What should you avoid with a contaminated wound? Whar ahouls you uaw>
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture? What does chromic mean?
coated in chromic acid which decreases tissue reactions a little bit but is still highly reactive with tissues.
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
Bit more memory. Not much tissue reactivity. Used for things like spays to let it spend time healing. Bladder heals quickly but you dont want to use quick absorption.
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?$
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
What kind of suture is this? What is the suture classification? Does it cause inflammation? What is it made of? What is it used for? What is important to remember about this suture/ its tensile strength?
What are the suture sizes/ how are they classified?
What is the issue when choosing the wrong suture size?
What is important about suture size in relation to security?
What are the potential suture complications and reasons for them?
What are the characteristics of a suture needle?
Label the surgical needle
A.) Point
B.) Swagged end
C.) Body (shaft)
What is trauma proportional to?
What is the difference between taper and cutting suture needle?
What should you consider when choosing your suture needle? What are the various shapes used for?
What is the shape of this suture needle? When is it used typically and what is its important characeristic in terms of how it cuts/ penetrates tissue?
What is the shape of this suture needle? When is it used typically and what is its important characteristic in terms of how it cuts/ penetrates tissue?
What is the shape of this suture needle? When is it used typically and what is its important characteristic in terms of how it cuts/ penetrates tissue?
What is the shape of this suture needle? When is it used typically and what is its important characteristic in terms of how it cuts/ penetrates tissue?
What is the shape of this suture needle? When is it used typically and what is its important characteristic in terms of how it cuts/ penetrates tissue?
What is tissue glue? How long does it take to set? What should you make sure when applying? What should it be used for?
What is a complication of skin glue use?
What should you NEVER use skin glue for?
Dont use it if you cant bury your knot.
What are skin staples? What is important to remember about application? What are the advantages?
What are the disadvantages of skin staplers?
What are the specialized staplers? What can they be used for? What are their characteristics?
What are the stages of wound depth?
Label the layers we need to close? Which is questionable?
Questionable: Peritoneum
What are the absorbable suture options for skin? What size should you use? What is the absorbable suture that could be used? What size is idea?
Blue: Non absorbable
Green: Absorbable
What are the tension suture options for skin? non tension sutures?
What are the suture options for subcutaneous tissues? What patterns can you use? What is the ideal size/ tissue reactivity?
What are the suture options for body wall and fascia? What patterns can you use? What is the ideal size/ tissue reactivity?
What are the suture options for the stomach? What patterns can you use? What is the ideal size/ tissue reactivity?
What are the suture options for the small intestine? What patterns can you use? What is the ideal size/ tissue reactivity?
What are the suture options for the bladder? What patterns can you use? What is the ideal size/ tissue reactivity? What is important to remember?
- Dont pick the most rapid. Monocryl/pds never steers you wrong.
What are the suture options for the colon? What patterns can you use? What is the ideal size/ tissue reactivity? What is important to remember?
What are the suture options for vessel and pedicle ligation? What patterns can you use? What is the ideal size/ tissue reactivity? What is important to remember?
- you want to make sure you have good hemostasis.
- High energy dogs just use larger suture. Also use friction knots, millers and modified millers.
What are the suture options for tendons and ligaments? What patterns can you use? What is the ideal size/ tissue reactivity? What is important to remember?
What are special circumstances to consider for suture pattern selection?
When is one layer closure preferred? Is two layer acceptable?
What is the type of closure is used for the stomach and bladder? What are potential complications of this kind of closure?
