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Surgery final > Suture Materials (Kim) > Flashcards

Suture Materials (Kim) Flashcards

1
Q

Ideal suture material

A
  • bioinert
  • easily sterilizable without consequences
  • handles well and produces secure knots
  • cheap
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2
Q

Suture Classification

A
  • Absorbable vs non-absorbably
  • multifilament vs monofilament
  • natural vs synthetic
  • coated or impregnated
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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

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4
Q

Multifilament

A
  • flexible, handles well
  • has capillary action
  • nidus?
  • tissue drag
  • superior knot security?
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5
Q

Monofilament

A
  • stiff, memory
  • non-capillary
  • nominal tissue drag
  • poorer knot security?
  • more easily damaged?
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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
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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
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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
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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
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10
Q

biosyn

A
  • glycomer 631
  • synthetic, absorbable, monofilament
  • complete absorption is rapid
  • 50% loss tensile strength in 2-3 weeks
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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
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12
Q

Dexon

A
  • Polyglycolic acid
  • like vicryl
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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
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14
Q

Maxon

A
  • polyblyconate
  • ‘like PDS’
    • slightly greater memory
    • cheaper
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15
Q

Silk

A
  • from silkworm cocoon
  • natural, non-absorbable, multifilament
  • vessel ligation
    • patent ductus arteriosus
    • portosystemic shunts
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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
23
Q

musculotendinous tear dog

tendon suture

A
  • Good
    • Prolene/nylon
      • synthetic and non-absorbable
    • PDS
      • may be ok in young rapidly healing animal
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

Surgery final (9 decks)

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