Suture Materials Flashcards
absorbable monofilament suture
Polydioxanone - PDS
Polyglyconate - Maxon
Poliglecaprone 25 - Monocryl
Glycomer 631 - Biosyn
Caprosyn
absorbable multifilament
Polyglycolic Acid - Dexon
Polyglactin 910 - Vicryl & Vicryl Rapide
Glycolide/Lactide Copolymer - Polysorb
non-absorbable monofilament
Polyamide - Nylon (Ethilon, Dermalon, Monosof)
Polypropylene (Prolene, Surgipro, Surgilene)
Polybutester (Novafil)
Steel
Gore-Tex (polytetrafluoroethylene)
non-absorbable multifilament
Silk
Polymerized caprolactam (Vetafil, Supramide (Braunamide))
Polyester (Dacron, Ticron, Mersilene, Ethibond)
Polyethylene (Fiberwire, Ultrabraid, Nespron)
what are the 2 natural sutures
surgical gut
silk
surgical steel
pros:
cons:
example sx:
pros: minimal tissue reaction, stable in contaminated/infected wounds, excellent knot security
cons: inflam reaction to knot ends
sternal closure
surgical gut
pros:
cons:
pros: broken down by phagocytosis, inexpensive
cons: marked inflam reaction, poor knot security if wet, tissue drag/poor handling, unpredictable loss of strength and rate of absorption
silk
pros:
cons:
pros: excellent handling
cons: does not maintain tensile strength after 6 mo, avoid in contaminated sites, essentially non-absorbable > 2 yr
what are the absorbable monofilament sutures pros and cons
pros:
-minimal tissue reaction
-consistent times for tensile strength loss/absorption
-broken down by hydrolysis
-good knot security
cons: stiff, poor handling
Maxon (polyglyconate) & PDS II (polydioxanone)
significant tensile strength loss:
complete absorption:
sig loss of tensile strength 4-5 weeks
complete absorption 180 day (6 mo)
Biosyn (Glycomer 631) & Monocryl (poliglecaprone 25)
significant tensile strength loss:
complete absorption:
significant tensile strength loss 2-3 weeks
complete absorption 3 months
3 types of synthetic absorbable multifilament
dexon (polyglycolic acid)
vicryl (polyglactin 910)
polysorb (glycolide/lactide)
synthetic absorbable multifilament
pros:
minimal tissue reaction
consistent times for tensile strength loss
broken down by hydrolysis
good knot security
faster absorption than monofilaments
high capillarity
excellent handling
synthetic absorbable multifilament
cons:
rate of degradation increases with infection
Vicryl
tensile strength loss:
complete absorption:
50% at 21 days
complete absorption - 60 days
ANTIBACTERIAL
Vicryl Rapide
tensile strength loss:
complete absorption:
50% 5 days, 100% 10 days
complete absorption - 42 days
Polysorb
tensile strength loss:
complete absorption:
20% 14 days, 70% 21 days
complete absorption - 56 days
EXCELLENT WOUND SUPPORT FOR 3 WEEKS
Velosorb
wound support:
absorption:
7-10 days
40-50 days absorption
what are the 3 Abx impregnated suture (triclosan)
PDS, monocryl, vicryl
synthetic nonabsorbable monofilament
pros:
cons:
pros: strong, indefinite tensile strength, min tissue reaction
cons: predispose infection or fistulation, poor knot security
what are the main synthetic nonabsorbable monofilament
Nylon - dermalon, ethilon, monosof
Polybutester - novafil
Polypropylene - prolene, surgilene, surgipro
steel
gore-tex
synthetic nonabsorbable multifilament
pros:
cons:
pros: larger, stronger
cons: more tissue reactivity, predispose infection or fistulation
main types of synthetic nonabsorbable multifilament
Silk
Polymerized caprolactam (Vetafil, Supramide (Braunamide))
Polyester (Dacron, Ticron, Mersilene, Ethibond)
Polyethylene (Fiberwire, Ultrabraid, Nespron)
types of barbed suture
pros:
V-LOC, STRATOFIX, Quill
pros: knotless suture, min invasive
smallest suture?
largest suture?
smallest 12-0
largest 9
size suture for skin
4-0
3-0
size suture for SQ
4-0
3-0
size suture for fascia
4-0 to 0
size suture for muscle
4-0 to 0
size suture for viscera
5-0 to 3-0
what needle is good for soft tissues
taper
what needle is good for tough tissue
taper-cutting
