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Surgical skills > Suture materials > Flashcards

Suture materials Flashcards

1
Q

What are the properties of ideal suture? (13)

A
  1. maintain tensile strength
  2. nonelectrolytic
  3. noncapillary
  4. nonallergenic
  5. noncarcinogenic
  6. good handling
  7. secure knots
  8. minimal reactivity
  9. dependable absorption or inert
  10. inexpensive
  11. readily available
  12. easily sterilized
  13. do not favour bacteria
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2
Q

What are the properties of ideal suture? (13)

A
  1. maintain tensile strength
  2. nonelectrolytic
  3. nonca
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3
Q

What are two classifications of suture materials?

A
  1. absorbable vs nonabsorbable

2. natural vs synthetic

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4
Q

What are 8 absorbable sutures?

A
  1. collagen
  2. surgical gut
  3. polyglycolic acid
  4. polyglactin 910
  5. polydioxanone
  6. polyglyconate
  7. poliglecaprone 25
  8. glycomer 631
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5
Q

What are 7 non-absorbable suture materials?

A
  1. silk
  2. cotton
  3. nylon
  4. polypropylene
  5. polymerized caprolactam
  6. polyester
  7. stainless steel
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6
Q

What are the most important suture material properties to consider when deciding on what to use?

A
  1. maintain tensile strength
  2. noncapillary
  3. good handling
  4. secure knots
  5. minimal reactivity
  6. dependable absorption or inert
  7. not favour bacteria
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7
Q

What are the features of surgical gut?

A
  1. absorbable
  2. small intestine of cattle and sheep
  3. multifilament
  4. formaldehyde treated
  5. ionizing radiation
  6. not autoclavable
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8
Q

What features does surgical gut not fulfill

A
  1. only maintains tensile strength 50% @ 14d
  2. picks up moisture (capillary)
  4. non-secure knots. Have to leave long tails because picks up moisture
  5. minimal reactivity NO
  6. phagocytosis so absorption unpredictable unpredictable
  7. does not favor bacteria–NO–multifilament
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9
Q

What 1 feature does surgical gut fulfill

A

good handling

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10
Q

What 1 feature does surgical gut fulfill

A

good handling

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11
Q

What are the features of polyglycolic acid suture (dexon)

A
  1. multifilament
  2. synthetic
  3. absorbable
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12
Q

What properties does polyglycolic acid fulfill?

A
  1. maintains tensile strength-but short lived (20% @ 14d)
  3. good handling–saws tissue
  4. secure knots–long tails b/c wiggles
  5. minimal reactivity
  6. dependable absorption )100-120days)
    7.
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13
Q

What properties does polyglycolic acid not fulfill?

A
  1. it is not noncapillary (braided)

2. it favours bacterial growth (braided)

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14
Q

What are the features of polyglactin 910? (coated vicryl)

A
  1. multifilament
  2. synthetic
  3. absorbable
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15
Q

What properties does polyglactin 910 fulfill?

A
  1. maintains tensile strength (50% @14, 20% @ 21)
  3. good handlinng–saws tissue
  4. secure knots but make tails long
  5. minimal reactivity
  6. dependable absorption (40-90 days)
    7.
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16
Q

What two absorbable multifilament synthetic sutures have very similar properties? What is 1 difference?

A
  1. dexxon (polyglycolic acid)
  2. coated vicryl (polyglactin)

coated vicryl absorbed a bit faster than dexxon so then maybe put coated vicryl in area where abcess/infection may occur

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17
Q

What properties does polyglactin 910 fulfill?

A
  1. maintains tensile strength (50% @14, 20% @ 21)
  3. good handlinng–saws tissue
  4. secure knots but make tails long
  5. minimal reactivity
  6. dependable absorption (40-90 days)
    7.
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18
Q

What two absorbable multifilament synthetic sutures have very similar properties? What is 1 difference?

A
  1. dexxon (polyglycolic acid)
  2. coated vicryl (polyglactin)

coated vicryl absorbed a bit faster than dexxon so then maybe put coated vicryl in area where abcess/infection may occur

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19
Q

What are the features of polydioxanone (PDS)

A
  1. absorbable
  2. monofilament
  3. synthetic
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20
Q

What properties does coated vicryl (polyglactin) not fulfil?

A

capillary

favours growth of bacteria

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21
Q

What properties does PDS (polydioxanone) fulfill?

A
  1. maintain tensile strength
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22
Q

What properties does PDS (polydioxanone) fulfill?

A

all of them

  1. maintain tensile strength (75% @14d, 58%@4weeks, 14%@8weeks)
  2. noncapillary
  3. good handling–can kink
  4. secure knots
  5. minimal reactivity
  6. dependable absorption (180d)
  7. does not favor bacteria
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23
Q

Why is PDS (polydioxanone) better than vicryl or dexxon?

A

much better strength retention
noncapillary
doesn’t favor bacteria

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24
Q

What are the features of polyglyconate? (maxon)

A
  1. absorbable
  2. monofilament
  3. synthetic
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25
Q

What properties does polyglyconate (maxon) have?

A
  1. maintains tensile strength–similar to PDS
  2. noncapillary
  3. good handling–doesn’t kink?
  4. secure knots–can be slippery
  5. minimal reactivity
  6. dependable absorption (180 d)
  7. does not favor bacteria
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26
Q

What are the features of poliglecaprone 25 (ethicon)

A
  1. absorbable
  2. monofilament
  3. synthetic
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27
Q

What properties does poliglecaprone (ethicon) have?

A
  1. maintains tensile strength (30% @ 14d)
  2. noncapillary
  3. good handling
  4. secure knots
  5. minimal reactivity
  6. dependable absorption (60-90d)
  7. does not favor bacteria
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28
Q

What is poliglecaprone 25 (ethicon) a good choice for?

A

subcutaneous/cutaneous closures where don’t need strength for long after and for wounds where there may be a few bacteria left in the wound

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29
Q

What are the features of glycomer 631 (biosyn)

A
  1. absorbable
  2. monofilament
  3. synthetic
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30
Q

What properties does glycomer 631 (biosyn) have?

A
  1. maintains tensile strength (50% @ 21 days)
  2. noncapillary
  3. good handling
  4. secure knots
  5. minimal reactivity
  6. depndeable absorption (90-110 days)
  7. does not favour bacteria
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31
Q

What is one good use for glycomer 631 (biosyn)

A

in uterine closure in cows where need more than 14 days of hoding power

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32
Q

What are the general features of dexon and vicryl?

A
  1. braided

2. relatively short lastinng

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33
Q

What are the general features of PDS and maxon?

A
  1. monogliament
  2. long holding capacities
  3. good for fascia closure
34
Q

What are the general features of biosyn and monocryl?

A

can be used any place that would use dexon, vicryl, or gut

35
Q

What are the features of poliglecaprone 25 (monocryl)

A
  1. absorbable
  2. monofilament
  3. synthetic
36
Q

What properties does poliglecaprone (monocryl) have?

A
  1. maintains tensile strength (30% @ 14d)
  2. noncapillary
  3. good handling
  4. secure knots
  5. minimal reactivity
  6. dependable absorption (60-90d)
  7. does not favor bacteria
37
Q

What is poliglecaprone 25 (monocryl) a good choice for?

A

subcutaneous/cutaneous closures where don’t need strength for long after and for wounds where there may be a few bacteria left in the wound

38
Q

What are the general features of biosyn and monocryl?

A

can be used any place that would use dexon, vicryl, or gut

39
Q

Place the absorbable sutures in order of maintenance of tensile strength

A
  1. PDS
  2. . maxon
  3. biosyn
  4. dexon
  5. coated vicryl
  6. surgical gut
  7. monocryl
40
Q

Place the absorbable sutures in order of their absorption rate (slowest to fastest)

A
  1. PDS 180d
  2. Maxon 180d
  3. dexon 100-120d
  4. biosyn 90-110d
  5. monocryl 60-90d
  6. vicryl 40-90d
  7. surgical gut (unreliable)
41
Q

What are the features of silk?

A
  1. non-absorbable
  2. multifilament
  3. natural
  4. ligature
  5. standard
42
Q

What properties does silk have?

A
  1. maintains tensile strength 50%@1yr
  3. good handling
  4. secure knots
    5.
    6.
    7.
    8.
43
Q

What properties does silk not have?

A

it is capillary
it is irritating (reactivity)
it is not inert
it favours bacterial growth

44
Q

What are the features of cotton?

A
  1. non-absorbable

2. multifilament

45
Q

What are the features of cotton?

A
  1. non-absorbable
  2. multifilament
  3. natural
  4. umbilical tape (?)
46
Q

What properties does cotton have?

A
  1. tensile strength (50% @ 60 months)
  3. good handling
  4. secure knots–get tighter when wet
  7. 8.
47
Q

What properties does cotton not have?

A

it has capillary effects
it has reactivity
it is not inert
it favors bacteria

48
Q

What is cotton used for?

A

can be used for circumferencial loops around vulva or holding bandages on (not used that much)

49
Q

What are the features of nylon?

A
  1. non-absorbable
  2. monofilament
  3. synthetic
50
Q

What properties does nylon have?

A
  1. maintains tensile strength
  2. noncapillary
  3. good handling (memory)
  4. secure knots
  5. minimal reactivity
  6. inert
  7. does not favour bacteria–actually antibacterial
51
Q

What is nylon a good choice for?

A

skin closure

52
Q

What are the features of polypropylene (novafil, prolene)

A
  1. maintains tensile strength (but less than nylon)
  2. noncapillary
  3. good handling–slippery!!
  4. secure knots
  5. minimal reactivity
  6. inert
  7. does not favor bacteira
53
Q

What are the features of polymerized caprolactam (vetafil/supramid)

A
  1. non-absorbable
  2. multifilament
  3. synthetic
  4. related to nylon
54
Q

How is polymerized caprolactam (vetafil/supramid) typically packaged?

A

in cassettes

55
Q

What are the properties of polymerized caprolactam (vetafil, supramid)

A
  1. maintains tensile strength (stronger than nylon)
  3. good handling
  4. secure knots
  6. inert
    7.
56
Q

What properties does caprolactam (vetafil, supramid) not have

A

it is not noncapillary because the coating breaks down and reveals multifilament
it is reactive–may cause animal to want to chew out sutures
it can favour bacteria

57
Q

What suture should NOT be buried?

A

polymerized caprolactam

58
Q

What suture should NOT be buried?

A

polymerized caprolactam

59
Q

What are the features of polyester (ethibond)

A
  1. non-absorbable
  2. multifilament
  3. synthetic
60
Q

What properties does polyester (ethibond) have?

A
  1. maintain tensile strength (better than nylon), very strong!
  3. good handling-saw tissue
  4. secure knots but must do 6 throws :(
    5.
  6. 8.
61
Q

What properties does polyester (ethibond) not have?

A

is has capillary action
it is reactive
it is not inert
it favors bacteria

62
Q

What is pretty well the only thing that polyester is used for?

A

laryngoplasty

63
Q

What are the properties of stainless steel?

A
  1. maintain tensile strength (>nylon)
  2. noncapillary
  4. secure knots
  5. minimal reactivity
  6. inert
  7. not favour bacteria
64
Q

What is a problem with stainless steel?

A

it can be hard to handle (requires experience)

65
Q

What can stainless steel be used for in large animal?

A

to repair abomasal fistulas following plexy to abdominal wall

66
Q

What are the non-absorbable sutures

A
  1. silk
  2. cotton
  3. nylon
  4. polypropylene (novafil)
  5. vetafil/supramid
  6. polyester (ethibond)
  7. stainless steel
67
Q

What must strength of suture be related to when choosing a suture material?

A

the strength of the tissue

68
Q

What must suture decay be related to when choosing a suture material?

A

tissue healing

69
Q

What is the ideal suture type for skin?

A

monofilament non-absorbable

70
Q

What is the ideal suture type for subcutaneous tissue?

A

synthetic absorbable (monocryl or biosyn)

71
Q

What is the ideal suture type for facia?

A

monofilament absorbable or nonabsorbable

72
Q

what is the ideal suture type for tendon?

A

monofilament absorbable (PDS, maxon) or nylon

73
Q

What are two different types of suture needles in terms of attachment to suture? What are the differences?

A 
1. swaged on
less traumatic
technically easier
2. eyed needle
more traumatic
technically difficult
74
Q

What are two different types of suture needles in terms of attachment to suture? What are the differences?

A 
1. swaged on
less traumatic
technically easier
2. eyed needle
more traumatic
technically difficult
75
Q

What are 4 different shapes of needles?

A
  1. half circle
  2. 3/8 circle
  3. 1/2 curved
  4. straight
76
Q

What are three types of points of suture needles?

A
  1. taper
  2. cutting
  3. reverse cutting
77
Q

What is a taper cut?

A

The needle has a tapered body and a cutting point

78
Q

What is a trocar point?

A

it has a round body and a point with edges

79
Q

What determines the type of circle used for a wound?

A

the depth of the wound

80
Q

What type of needle should be used for the skin?

A

cutting

81
Q

What type of needle should be used for the bowel and subQ?

A

taper

82
Q

What type of needle should be used for fascia, tendon?

A

taper or modfied cutting

Surgical skills (23 decks)

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