Suture materials and needles Flashcards by Delaney Garcia

3 Properties of Suture classification

Absorbable vs. non absorbable
Monofilament vs. multifilament
Organic vs. synthetic

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Suture characteristics (6)

Size, flexibility, surface characteristics/coating, capillarity, tensile strength, knot security

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Properties of ideal suture material (8)

Minimal tissue reaction
gentle passive through tissues
High knot safety and security
Consistent performance
good and predictable absorption
Comfortable handling

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Standard unit of measure for suture size

United States Pharmacopeia

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Smallest suture size

12-0

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Largest suture size

7-0

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Smaller suture size…

Less tensile strength and more breakable

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T/F Sutures need to be no stronger than the sutured tissue

True

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More flexible suture is better for ___

Vessel ligation

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More flexible suture =

Less memory/stiffness

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What is suture flexibility related to

material and size of suture

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T/F: Multifilament suture has more flexibility compared to monofilament

True

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Affects ease of passing suture through tissue

Suture characteristics and coating
FRICTION

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Less friction and less traumatic to tissues
Decreased knot security

Smooth suture

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Increased friction and more traumatic (more tissue drag)
Improved knot security

Braided material

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What can braided material be coated to do?

Decrease drag

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process by which fluid and bacteria are wicked along multifilament materials

Capillarity

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Capillarity allows what to persist in suture

infection

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T/F: All braided sutures have capillarity

true - but it is reduced in coated structures

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Measure of a tissue or fibers ability to resist deformation or breakage

Tensile strength

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Amount of force necessary to cause a knot to slip

Knot strength

Knot strength is related to

Static friction and plasticity of material

Lower friction

Decreased knot strength

Which suture will have decreased knot strength compared to 2-0 multifilament

2-0 monofilament

Larger diameter suture has

Decreased knot security

Absorbable suture materials

Chromic gut, polyglactin 910, polyglycolic acid, Glycomer 631, capro, poliglecaprone 25, polydiaxonone

Non absorbable suture

Nylon, silk, polyproylene, polymerized capro, stainless steel wire

How should needle type and size be chosen?

Based on tissue being sutured and depth of wound being sutured

What are surgical needles made of?

Stainless steel

More common used needle shape

1/2 circle

Commonly used and more easily manipulated through superficial tissue and also closing vessels

3/8 circle

Used for opthalamic procedures

1/4 circle

Used in confined locations or deep tissue

5/8 circle

Manipulated with fingers - placement of purse string suture

Straight needle

sharp tip that pierces and spreads tissue without cutting. Used for intestine, SQ tissue and fascia

Taperpoint

COmbination of reverse cutting and taperpoint Used for heavy, thick fascia, vascular grafts

Tapercut

Cutting edge on concave portion of needle. Tends to cut out of tissue

Cutting

Cutting edge on convex surface reducing risk of tissue cut out. used for skin

Reverse cutting

Flat on top and bottom. Used for opthalamic procedures

Spatula point

blunt point that dissects thru friable tissues without cutting used for parenchymal organs (liver, kidney)

Blunt point

Absorbable (phagocytosis) multifilament (twisted) organic (90% collagen, sheep gut) Knot security decreases when wet Not used frequently in practice

Chromic gut

Absorbable (hydrolysis), multifilament (braided), synthetic (copolymer of lactide and glycolide and coated with calicum stearate) Used in dental surgery Stable in contaminated wound, rapidly degraded in infected bladder

Polyglactin 910

Absorbable (Hydrolysis), multifilament (braided), synthetic (filaments from glycolic acid) Used in dental surgery Stable in contaminated wound, rapidly degraded by bladder

Polyglycolic acid

Absorbable (hydrolysis), Monofilament, synthetic Used in closure of cystonomies (non infected bladder), SQ tissues

Poliglecaprone 25 - monocryl

Absorbable (hydrolysis), monofilament, synthetic (polyester) UseS: Closure of enterotomies, cystomies, body wall closure, fascia closure

Glycomer 631 (biosyn)

Absorbable (hydrolysis, prolonged absorbable), monofilament, synthetic (uncoated) Uses: Closure of enterotomies, cystotomies, body wall closure, fascia closure

Polidioxanone (PDS)

Non absorbable, multifilament (braided), natural Used for CV surgery

Silk

Non absorbable (susceptible to degradation, hydration leads to disruption of H bonds leading to loss of tensile strength), monofilament, synthetic Used for skin closure, orthopedic repair (lateral tibiofabellar suture)

Nylon

Nonabsorbable (resistant to degradation, lack of hydrolyzable bonds), monofilament, synthetic Uses: tendon, ligament, fascial, joint capsule closures, immunocompromised ptx

Polypropylene

Non absorbable, multifilament (twisted), synthetic (nylon based), Uses: Skin sutures ONLY Not recommended for implantation in tissues due to sinus formation

Polymerized caprolactam

Nonabsorbable, monofilament or twisted form Uses: Orthopedic application

Stainless steel

Metal contents of stainless steel suture

High nickel and chromium content