Suture Patterns Flashcards
What are the suture pattern classifications?
What kind of suture pattern is this?
Interrupted
What kind of suture patten is this ?
Continuous
Which is interrupted and which is continuous?
A is interrupted
B is continuous
What are interrupted patterns? Are they secure? What is important to remember about interrupted patterns? Would you use this in a a long surgery, or in surgery with an unstable patient?
What is a continuous pattern? What is important to remember? What is the problem with excessive tension? What can it be used for?
How do you do a simple continuous?
What is a crucial pattern? When would you use this? What is the benefit of it? How does it affect blood supply? What does it resist? When should you not use it?
How do you tie a cruciate pattern?
Steps to performing cruciate incision
What is a ford interlocking pattern? When is it used? What is the benefit? What is its effect on blood supply? What are potential complications? Is it used a lot in small animal?
What is ford interlocking similar to?
How do you perform a ford interlocking?
What is an intradermal pattern? What is the pattern classification? What occurs to the suture at the end of the pattern? What is its impact on blood supply.
How do you bury the knot in the beginning of intradermal suturing?
How do you bury the knot at the end of intradermal suture patterns?
Why is it important to bury the knot in intradermal suture patterns?
What kind of closure was used for this wound?
How do you perform an intradermal pattern?
What are the recommendations for intradermal pattern bites? How is tension adjusted? What must we remember about tissue forceps?
What are inverting patterns? When are they typically used? What are the pros? What what are the cons?
What is this suture pattern?
Inverting patterns
Examples:
- Cushing
- Lemberg
- Purse string
What is this suture pattern?
Ford Interlocking pattern
What is this suture pattern?
Cruciate pattern
What are the hollow organs of the body?
- Bladder
- Gall bladder
- Stomach
- Intestines
- Uterus
- Esophagus
What is the holding layer of hollow organs?
Tunica Submucosa
What are some complications of suturing hollow organs?
- Dehiscence
- Calculi/ Stone formation
- Adhesion
What in the body is known for increased likelihood of adherence? What can occur if this happens?
The omentum likes to adhere to things. We need to be careful since the body can respond by trying to adhere organs together and we do not want that.
What can cause calculi/ stone formation in a hollow organ with sutures?
This could be from bacterial components using the suture as a template, and essentially giving it a tract to grow on. *** EMAIL HER
What should you consider when doing Single layer closure?
Partial thickness vs. Full thickness
- simple interrupted vs. simple continuous.
What may you see some surgeons do in terms of closure choice for the stomach?
1st layer appositional
2nd layer inverting
What may you see some surgeons do in terms of closure choice for the Urinary bladder?
1 layer closure : inverting pattern
2 layer closure:
▪ 1st layer = appositional pattern
▪ 2nd layer = inverting pattern
What may you see some surgeons do in terms of closure choice for the intestines?
1 layer closure-> appositional pattern
What are double layer closures consisting of?
2 layers
1st layer - Inner
2nd layer - outer
What is the lembert pattern? what is its pattern classification? Is it full or partial thickness? When can it be used? When is it commonly used?
What suture pattern is this?
Lembert pattern
How do you perform a lembert pattern suture?
What are some general recommendations for a lembert pattern?
What is a cushing pattern? What layers does it traverse?
Pattern classification – continuous and inverting
▪ Partial thickness [non-penetrating pattern]
▪ Penetrates the submucosa, but NOT the organs’
lumen
What is the most important thing to remember when deciding to preform this patten?
When are cushing patterns typically used?
How do you preform a cushing pattern?
What layers are you going through with a cushing pattern?
submucosal and muscular layers.
What is a connell pattern? What layers does it traverse?
▪ Pattern classification – continuous and
inverting
▪ Full thickness [penetrating] pattern
▪ Similar to the Cushing pattern, except
bites penetrate the lumen
If used with 2 layer closure, can you use the connell pattern with any layer?
What are the uses for connell patterns?
What is the difference between cushing pattern and connell pattern?
The connell pattern is full thickness, while the cushing is partial thickness.
What is a purse string pattern? What thickness does it traverse? Where is it used?
What are examples of times a purse string may be used?
Hold a feeding tube in place
How do you preform a purse string?
In a patient with a rectal prolapse, what must you do first before putting in a purse string?
Reduce prolapse manually
What is a finger trap suture pattern? How do you preform it?
What are everting suture patterns? What is it used for? What is important about healing with these patterns? When are they recommended?
What is tension? What can happen if there is too much tension?
What are tension relieving patterns? What are they used for?
What are examples of tension relieving suture patterns?
What is the pattern classification of vertical mattress pattern? What is its effect on blood supply?
When is a vertical mattress used?
Which has more eversion: Vertical or Horizontal Mattress pattern?
Horizontal has more eversion
How do you preform a vertical mattress?
What is the pattern classification of horizontal mattress pattern? What is its effect on blood supply?
What are the uses of the horizontal mattress pattern?
Stents commonly used
How do you complete a horizontal mattress?
What is the Near Far, Far Near pattern? What is it a variation of? What should it be used for ?
What is the most appropriate pattern for closure of wounds with high tension? What is the benefit of this pattern?
Near far far near
far near near far
How to preform the far near near far pattern?
How to preform the near far far near pattern?
How far away should your placement be of a “far” suture be from your incision?
6-8 mm. ideal: ~8mm
How far should your placement of a near suture be from your incision?
3-4 mm ideal ~3-4 mm
