Suture Materials and Suturing Flashcards
Obj: Compare and Contrast common needle types
Obj: What scenario is appropriate for the different needle types
Obj: Compare and contrast the broad classifications of suture types
Obj: what scenarios are each of the sutures appropriate?
Obj: Compare/Contrast suture patterns
Obj: what are the appropriate scenarios for the different suture patterns
What are the uses of Suture?
- Appose tissues that have been separated (intentionally/unintentionally)
- Tightly constrict vascular pedicles or individual vessels to provide hemostasis or prevent anomalous blood flow
- Permanently or temporarily secure a foreign implant to tissue/close an orifice
- Permanently or temporarily mimic the function of a normal anatomic structure (ligament/tendon)
What is the difference between a Swaged and Non-swaged needles?
- Swaged:
- Designed for single use
- minimizes tissue trauma
- Required for ocular, vascular, urogenital, and intestinal surgery
- Nonswaged:
- Manually tread suture
- Reusable
- More tissue trauma
- needles can become dull
What are the different shapes of needle? Their uses?
- Straight needles
- take very wide bites
- typically only used in skin
- placed by hand
- Curved needles
- most common
- important measurements are fraction of a circle and needle diameter length
- Other shapes - specific procedures
What are the different types of needle points?
- Taper point
- Reverse cutting
- other - less common
What is a taperpoint needle, what is it used for?
- Pierces tissue and then spreads it around the body of the needle
- small needle hole for delicate tissues
- More likely to dull
- Ex: Ethicon SH or CT
What is a reverse cutting needle, what is it used for?
- Triagnular shaped point cuts through thick tissues
- creates a larger needle hole
- Sharper needles for dense tissue (skin, tendon, periosteum)
- Ex: Ethicon FS
What issues can suture cause?
- Irritation
- rejection
- nidus of infection
What are the different suture sizes?
- Large sutures - whole numbers
- 1, 2, 3,….
- Smaller sutures - #-0
- 2-0, 3-0,…
- NO 1-0
What are the most common suture sized for small animal medicine
between 3-0 and 2
What suture would be used on external skin sutures?
- 3-0 dog
- 4-0 cat
- Monofilament nylon (Ethilon) on a reverse cutting needle
What type of suture is used for the subcuticular pattern?
- 3-0 medium/large dog
- 4-0 small dog/cat
- Monocryl on a reverse cutting needle
What suture is used for the subcutaneous layer?
- 3-0 or 4-0 Monocryl or PDS on a taper needle
- Always use Monocryl on cats
What suture is used for body wall closure?
- PDS on a taper needle
- 1 for 25kg+
- 0 for 11-25kg
- 2-0 for dogs under 10kg and large cats
- 3-0 for small cats with interrupted sutures
What suture is used for vessel ligations?
- PDS on a taper needle
- 2-0 PDS for average sized pedicles
- 0 PDS for large fatty pedicles
- 3-0 for most cats and small dogs
What is the difference between monofilament and multifilament?
- Monofilament:
- Less tissue drag and trauma
- Worse knot security and handling
- More easily damaged
- Multifilament:
- More tissue drag (can be coated to reduce)
- Can harbor bacteria and wick fluids
- Greater knot security and handling
- Stronger in general
What are the differences between absorbable and nonabsorbable suture?
- Absorbable:
- Degrades within a known period of time
- typically less than 6 months for full degradation
- Speed of degradation may be influenced by other factors (e.g. presence of enzymes)
- More likely to cause a ‘suture reaction’
- Degrades within a known period of time
- Non-absorbable:
- Stay forever or break down very slowly
- If they become infected they can act as a nidus and have to be removed
- Typically less reactive
- Used if suture must remain present forever, if animal has severely decreased haling or for external skin sutures
- Stay forever or break down very slowly
What are the Absorbable sutures?
- Catgut and chromic gut
- Monocryl (poliglecaprone 25) / Biosyn (Glycomer 631)
- Caprosyn (polyglytone)
- Vicryl (polyglactin 910) / Dexon (polyglycolic acid) / Polysorb (lactomer)
- PDS (polydioxanone) / Maxon (polyglyconate)
What is Catgut / Chromic gut? Pros / Cons?
- Made from bovine or ovine intestines
- Chromium salts added to decrease inflammation and delay absorption
- Absorbed by enzymatic degradation
- Highly unpredictable
- Loss of strength in 2-3 weeks
- Loss of strength may be < 24 hours in GI or Urinary surgery
- Use in rapidly healing tissues that don’t need support