Suture Materials Flashcards
Suture definiton
Material used to promote wound healing by surgically joining margins or ends of the wound and holding them securely together to reduce wound tension
Suturing Definition
Process of applying a suture
Ligature Definition
Material used to close blood vessels and stop haemorrhage
What makes an ideal suture material?
High tensile strength
Easy-to-use for surgeons
Easy to tie, secure knot
Highly uniform tensile strength, permitting the use of finer size
Inhibit tissue reactions and wicking
Non-toxic, non-carcinogenic and non-allergenic, as should any degradation products
Easily sterilised
Surface must minimise bacterial adhesion
Standardisable characteristics
Maintain its properties for sufficient time
Inexpensive
Natural meaning and example
○ Raw materials from naturally occurring sources
E.g. Catgut - from submucosa of SI of sheep/cattle
Synthetic meaning and example
Raw material produced in an industrial process
E.g. many different polymers
Metal
Stainless steel
Absorbable meaning
Materials fully degraded and absorbed by the body
Non-absorbable meaning
Materials that stay in place for an indefinite period without changing in any way
Monofilament Meaning
Consisting of a single filament with variable thickness/diameter
Multifilament Meaning
Bundles of very fine filaments formed into a thicker thread of desired diameter
Usually braided
Tensile strength definition
Breaking strength per unit area
Resistance of a material to breaking under tension
Memory meaning
Tendency to retain original configuration
Monofilament have a higher memory than multifilament
Monofilaments may be harder to tie safe/secure knots
What is ‘chatter’ and tissue drag?
How easily suture material passes through tissues
Lack of smoothness or friction whilst passing though tissue
We want low ‘chatter’
Monofilaments have lower ‘chatter’ than multifilament
What is tissue reaction?
Response of implantation of sutures
Suture counts as foreign body and can provoke an inflammatory response
Advantages and Disadvantages of absorbable sutures
Advantages
They dissapear
Low risk of long-term foreign body reaction
Disagvantages
Lose strength
Limited period of wound support
Advantages and Disadvantages of Nom-absorbable sutures
Advantages
Permanent
Provide indefinite wound support
Disagvantages
Do not disappear
Possibility of foreign-body reactions
Advantages and Disadvantages of multifilament/braided sutures
Advantages
Easy to handle
Excellent knotting (very secure)
Disadvantages
Greater friction
More tissue trauma
Advantages and Disadvantages of monofilament sutures
Advantages
Minimal tissue trauma
Passes through tissues easily
No capillary action
Disadvantages
Harder to handle
Harder to knot
Require different knotting for greater security
Advantages and Disadvantages of natural sutures
Advantages
Easy to handle
Easy to knot (compared to synthetic monofilament)
High histocompatibility
Disadvantages
Moderate-high tissue reaction
Low tensile strength
Advantages and Disadvantages of synthetic sutures
Advantages
High tensile strength
Predictable biological behaviour
Disadvantages
Poorer knotting than natural materials
What are the consequences of using suture material?
Stimulation of tissue reaction due to present of foreign body
Potential for colonisation of bacteria
More likely with multifilament as there is higher SA for colonisation
When would hydrolysis occur?
More aggressive
Use of natural suture material
e.g. Catgut
When would hydrolysis occur?
Use of synthetic suture material
Smaller tissue reaction
What are the ways of sizing suture materials?
USP - United States pharmacopeia
Metric System
What is USP - United States pharmacopeia?
Based on tensile strength rather than diameter
11-0 to 7
Increasing size/strength
(11-0, 10-0, 9-0 … 0 … 1, 2, 3, etc)
What is the metric system?
1/10mm of diameter of suture (‘2’ = 0.2 mm)
§ Sizes are related to diameter (more logical)
§ 0.1-10
