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VET301 > Suture materials and patterns > Flashcards

Suture materials and patterns Flashcards

1
Q

What is the difference between absorbable and non absorbable suture?

A

ABSORBABLE = rapid + undergo degradation and rapid loss tensile strength <60 days

NONABSORBABLE = retains tensile strength >60 days

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2
Q

What is the difference in capillarity between monofilament and multifilament material?

A

Monofilament (noncapillary – does not carry disease or bacteria) versus multifilament (more capillary)

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3
Q 
For surgical cat state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Absorbable and natural

  1. Composition - Formaldehyde treated sub-mucosa (collagen) from cow or sheep
  2. Capillarity - Multifilament with smooth monofilament appearance
  3. Absorption - by phagocytosis, chromatisation decreases the speed of absorption, increased with acidic pepsin from the stomach + other acidic environments + highly vascular tissue, often occurs past 90 days
  4. Tensile strength - plain gut has > 67% of its tensile strength by 7 days, chromic gut looses 50% by 7 days then 83% by 14 days then 100% by 21 days - it has a poor strength to size ration
  5. Knot security - good when dry (can swell when wet)
  6. Suture reactivity - reactive foreign body
  7. Handling - easy handling
  8. Sterilisation - cannot autoclave as denatures, radiation = good, ethylene oxide may prolong absorption times
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4
Q 
For polyglactin 910 (PG910) state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Absorbable synthetic

  1. Composition -Polymer of glycolic and lactic acid (ratio of 9:1)
  2. Capillarity - Multifilament
  3. Absorption - hydrolysis greater in hot and alkaline environments think infected urine. More hydrophobic than PGA (looses tensile strength slower). Complete absorption between 40-90 days (70)
  4. Tensile strength - Good ratio– loss of strength 50% @ 14 days then 80% at 21 days
  5. Knot security - poor knot security
  6. Suture reactivity - Well tolerated in most tissues – good for vascular as no reaction is incited
  7. Handling - Good handling but ++++ tissue drag
  8. Sterilisation
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5
Q 
For Polydioxanone (PDSII) and Polyglyconate (PGT, Maxon) state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Absorbable synthetic

  1. Composition - PDS – polymer of polydioxanone, Maxon – polymer of polytrimethylene carbonate + glycolic acid
  2. Capillarity - Monofilament
  3. Absorption - Degraded by hydrolysis, PDS, Maxon – some absorption by 91 days, complete by 182 days, significantly slower than PG910 above
  4. Tensile strength - Excellent tensile strength to size ratio – initial strength > monofilament nylon and polypropylene
  5. Knot security - Good
  6. Suture reactivity - Very little tissue reactivity
  7. Handling - Minimal tissue drag, does have some memory, greater flexibility than above (PG910)
  8. Sterilisation
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6
Q 
For Poliglecaprone 25 (Monocryl) – Monocryl plus has triclosan  state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Absorbable synthetic

  1. Composition - Synthetic polymer
  2. Capillarity - Monofilament
  3. Absorption - By hydrolysis – complete within 90-120 (119 days)
  4. Tensile strength - 50% strength by 10 days then 100% by 21 days
  5. Knot security - Good
  6. Suture reactivity - Minimal to none
  7. Handling - Good – no tissue drag- soft and flexible
  8. Sterilisation
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7
Q 
For Polyglytone 6211  state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Absorbable synthetic

  1. Composition
  2. Capillarity - monofilament
  3. Absorption
  4. Tensile strength - 40-50% @ 5d, 70-80% @ 10d, 100% @ 21d – complete absorption in 56 days
  5. Knot security - Excellent
  6. Suture reactivity
  7. Handling - soft + flexible
  8. Sterilisation
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8
Q 
For silk state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Non-absorbable natural

  1. Composition - processed sil
  2. Capillarity - Multifilament
  3. Absorption - Some but limited
  4. Tensile strength - 30% @ 14 then 50% @1y then 100% @ 2y
  5. Knot security - Good – wetting decreases strength by 10-15%
  6. Suture reactivity - can cause GIT ulceration in the lumen
  7. Handling - Excellent (gold standard)
  8. Sterilisation
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9
Q 
For stainless steel state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Non-absorbable natural

  1. Composition - Alloy
  2. Capillarity - Available as either
  3. Absorption - none
  4. Tensile strength - 30% by 14d then 50% by 1y then 100% by 2y
  5. Knot security - Good – wetting decreases strength by 10-15%
  6. Suture reactivity - tissue reaction - silk may induce ulceration in GIT if present in lumen
  7. Handling - gold standard
  8. Sterilisation
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10
Q 
For nylon state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Non-absorbable synthetic

  1. Composition - Amine coated thermoplastic
  2. Capillarity - Available as monofilament + multifilament
  3. Absorption - Little – some extent by chemical degradation
  4. Tensile strength - Good strength to size ratio – intermediate in strength (similar to polypropylene). Monofilament will loose tensile strength 30% by 2 years, multifilament – 70-90% by 180 days
  5. Knot security - poor to fair
  6. Suture reactivity - inert
  7. Handling - poor with memory
  8. Sterilisation
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11
Q 
For polymerized caprolactam state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Non-absorbable synthetic
1. Composition - Polyamide suture of the nylon family – enclosed in a sheath of proteinaceous material
2. Capillarity - Multifilament
3. Absorption - Non-absorbable
4. Tensile strength - Good size to strength ratio>than nylon
Caprolactam loses about 15-20% strength when wet
5. Knot security - Fair
6. Suture reactivity - breaking down of coating increases the degree of tissue reaction
7. Handling - good handling characteristics
8. Sterilisation - autoclaving results in decreased tensile strength, chemical sterilisation does not make it safe or sterile for use in other tissues (Ethylene oxide is required)

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12
Q 
For polyester fibres  state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Non-absorbable synthetic

  1. Composition - Plain or coated forms
  2. Capillarity - Multifilament
  3. Absorption - Non-absorbable
  4. Tensile strength - High tensile strength , Excellent tensile strength to size ratio
  5. Knot security - Uncoated polyester has high co-efficient of friction
  6. Suture reactivity - Causes significant tissue reaction + incidence of sinus tract formation is highest with polyester implantation
  7. Handling - coatings improve handling and reduce tissue drag
  8. Sterilisation
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13
Q 
For polypropylene and polybuster state whether it is absorbable or non-absorbable and whether it is natural or synthetic: 
And then its: 
1. Composition
2. Capillarity
3. Absorption 
4. Tensile strength 
5. Knot security 
6. Suture reactivity 
7. Handling
8. Sterilisation
A

Non-absorbable synthetic
1. Composition - PL – plastic poylmer of propylene , PB – polymer of polybutylene and polytetramethylene
2. Capillarity - Monofilament
3. Absorption - Nonabsorbable
4. Tensile strength - PL – fair to good,
PB – good
5. Knot security - PL- fair to good,
PB – good
6. Suture reactivity - Pl least thrombogenic so good in vascular surgery
7. Handling - PL – quite difficult to handle
PB – excellent handling somewhat elastic meaning its V.good for plastics and tendon + ligament repair
8. Sterilisation

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14
Q

Does increase the gauge or increasing the number of throws increase the strength of the suture more?

A

Increasing the gauge increases the strength more than number of sutures

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15
Q

Does increasing gauge or number of throws increase the bulk and suture reaction more?

A

Increasing the gauge has a greater effect

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16
Q

Briefly explain the difference between a closed eye needle and a swaged needle:

A

Closed eye needle - similar to a household needle and may be round oblong or square
Swaged needle - eyeless needle with the suture permanently attached it is then sterilised and pre-packaged

17
Q

What is a cutting needle and when may it be used?

A

has the cutting edge on the inside an is used for difficult to penetrate tissue (e.g. skin and fibrous tissue)

18
Q

What is a reverse cutting needle and when might it be used?

A

Outside of the needle - less likely to tear through tissue

19
Q

When are skin staples used?

A

Closure of wound skins - quick and inexpensive however they tend to pucker the skin

20
Q

What are some examples of wound adhesives and when are they used?

A

Cyanoacrylate polymers are catalysed by minute amounts of water on tissue surface. Heat is generated and they are self sterilising

VET301 (12 decks)

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