Suture Materials (Kim) Flashcards
1
Q
Ideal suture material
A
- bioinert
- easily sterilizable without consequences
- handles well and produces secure knots
- cheap
2
Q
Suture Classification
A
- Absorbable vs non-absorbably
- multifilament vs monofilament
- natural vs synthetic
- coated or impregnated
3
Q
Absorbability def
A
- loss of significant tensile strength around 60 days
- absorption via enzymatic degradation or hydrolysis
- absorption rates depend on environment
*know absorption rates
4
Q
Multifilament
A
- flexible, handles well
- has capillary action
- nidus?
- tissue drag
- superior knot security?
5
Q
Monofilament
A
- stiff, memory
- non-capillary
- nominal tissue drag
- poorer knot security?
- more easily damaged?
6
Q
Natural vs synthetic
A
- moderate to marked reaction with natural sutures
- advantage if we want tissue rxn
- absorption rate more variable with natural sutures
7
Q
Considerations
A
- tissue type
- how quick does it heal
- consequence of foreign material at site
- systemic or local conditions that may delay healing
8
Q
Cat Gut
A
- absorbable, natural, ‘twisted’
- sheep intestine submucosa or bovine intestinal serosa
- formaldehyde treated collagen
- +/- chromic salt treatment
- 50-100% loss tensile strength w/in 2-3 weeks
- very cheap
9
Q
Monocryl
A
- rapidly absorbing
- olyglecaprone 25
- synthetic, absorbable, monofilament
- strong, but rapidly loses stregth
- bladder, subcu tissue, vessel ligation
- 50% loss of tensile strength within 1-2 weeks
10
Q
biosyn
A
- glycomer 631
- synthetic, absorbable, monofilament
- complete absorption is rapid
- 50% loss tensile strength in 2-3 weeks
11
Q
Vicryl
A
- polyglactin 910
- absorbable, synthetic, multifilament
- most popular suture in human sx
- intradermal sutures, small vessel ligation, oral surgery
- 50% loss of tensile strength within about 2 weeks
12
Q
Dexon
A
- Polyglycolic acid
- like vicryl
13
Q
PDS II
A
- polydioxanone
- syntehtic, absorbable, monofilament
- most popular suture in veterinary surgery
- slowly absorbed
- default for most internal suturing
- 50% loss tensile strength 5-6 weeks
14
Q
Maxon
A
- polyblyconate
- ‘like PDS’
- slightly greater memory
- cheaper
15
Q
Silk
A
- from silkworm cocoon
- natural, non-absorbable, multifilament
- vessel ligation
- patent ductus arteriosus
- portosystemic shunts
16
Q
Braided synthetic non-absorbable sutures
A
- Mersiline, Vetafil, Supramid, ethibond
- very strong
- cheap
- can come non-sterile
- tissue trauma
- nidus
17
Q
Nylon
A
- polyamide
- synthetic, non-absorbable, monofilament
- braided available
- memory/stiffness/poorer knot security
- cheap
- commonly used in skin in SA
18
Q
Prolene
A
- Polypropylene
- Synthetic, non-absorbable, monofilament
- strong with good handling properties
- least likely of all non-absorbables to potentiate infection/thrombi
- skin, tendon, ligament, herniorrhaphy
19
Q
Stainless steel
A
- cheap, autoclavable, strong
- poor handling
- cycle to failure
20
Q
bladder in small/medium dog
good choice
bad choice
size
A
- Good choice
- monocryl/biosyn
- Bad choice
- cat gut: not reliable, irritation
- prolene: nidus for stones/infection
- size: 4-0/3-0
21
Q
Linea in a small/med dog
Good choice
A
- Good
- nylon
- prolene
- Biosyn (may be too rapidly absorbing)
22
Q
Subcutis small/med dog
Good choice
A
- Good
- biosyn/monocryl
- rapidly absorbing
- biosyn/monocryl
23
Q
musculotendinous tear dog
tendon suture
A
- Good
- Prolene/nylon
- synthetic and non-absorbable
- PDS
- may be ok in young rapidly healing animal
- Prolene/nylon
24
Q
Enterotomy
good choice
size
A
- Good
- monosyn/biocryl
- PDS/Maxon
- Size 4-0/3-0
25
Q
when we want tissue reaction
A
- vessel ligation: PDA
- Hernia repair
- portosystemic shunts: partial ligation with silk!
26
Q
Summary
A
- Sutures can be classified according to 3 main categories
- suitability according to class of suture material
- wide array of suture materials
- know trade names
- know common applications
