Suture Patterns Flashcards
There are a ____ of suture patterns that can be used to close a surgical incision
variety
It is important to be able to perform the ____ patterns and be familiar with their ___ properties, so you can decide when their use is appropriate.
basic, basic
Important to chose a pattern that will ___ the incision and provide _____ _____ support with minimal ____ reaction
close, maximum, mechanical, tissue
There are often ____ appropriate patterns to close a specific incision.
One may be appropriate for __ species, but not another. _____ patient factor may influence pattern selection. _____ preference plays a major role in the ___ pattern selection.
several, one, Individual, Personal, final
List the different suture patterns
Interrupted vs. Continuous
Appositional vs. Inverting vs. Everting
Simple vs. Tension
What suture pattern is this?
interrupted
What suture pattern is this?
continuous
What suture pattern is this?
interrupted vs. continuous
Interrupted Patterns
Series of _____ sutures
More ____ than a continuous pattern b/c if 1 or 2 single interrupted sutures are compromised, does not usually affect the ___ of closure
Allows for adjustments of ___ throughout the suture line
Uses ___ suture material = ___ to the practice; charging ___ ____ of suture in some hospitals; suture is very ______. Increased amount of _____ material (____) in the wound
Less ___ = efficient! BUT, in this case, ____ time needed to tie the individual knots.
individual, secure, integrity, tension, more, costly, per packet, expensive, foreign, suture, time, More
Continuous Patterns
Begin with an initial ___ and continue with the pattern to the ___ of the incision [prior to tying the ___ knot] Only ___ knots, but knots MUST be tired _____.
Less precise control of suture _____ and wound _______.
Tension is adjusted after ___ bite and difficult to adjust at the ____.
Failure of the ___ leads to disruption of the suture line
Time ___ and _____ pattern to perform
_____ foreign material (suture) in the wound
Provides better __ and ____-tight closure
knot, end, final, two, properly, tension, approximation, each, end, knot, efficient, faster, Less, air, water
Suture Placement
Start
Interrupted patterns
- End of the incision nearest to your dominant hand [R vs. L handed surgeon]
- Top of incision [if vertical]
- At or just beyond the corner of the incision (~1-3mm)
Continuous patterns
- At or just beyond the corner of the incisions (~1-3mm)
Bites
- Distance from incision edge = ~3-5mm
- Distance between sutures = ~5-8mm
Tags
Appositional patterns
Used when there is no ______ tension on the incision edges.
Enables the best anatomical _____
Brings the ____ of the incision together.
Results in the ____ healing
Gives the best ____ result
Examples:?
excessive, approximation, edges, fastest, cosmetic, Simple Interrupted
Simple Continuous
Cruciate
Ford Interlocking
Intradermal
Simple Interrupted Pattern
Pattern classification – ?
Often used when ____ tension on the incision’s edges. Local tension is managed by adjusting tension on the _____ sutures
Not recommended if there is ____
_____ impact of the local blood supply to the incision edges, unless _______.
Excessive tension causes _____ of the skin margins
Uses:?
interrupted and appositional, normal, individual, tension, Minimal, overtightened, inversion, Close skin, subcutaneous layer, body wall, etc.
Ligate blood vessels or nerves
How to perform an interrupted pattern
Don’t tie the knot too tightly! Remember that in the living animal, minimal tension must be placed on the
skin otherwise post-operative swelling, redness and discomfort may occur, which can impede wound healing.
Simple continuous pattern
Pattern classification – ?
Larger effect on the _____ _____ when compared to the simple interrupted
Placed more ____ and provides better _____; provides ___ and ____-tight seal
Excessive tension can cause _____ and tissue ______
Avoid suture failure b/c you only have ____ knots.
Uses:?
continuous and appositional, blood supply , rapidly, apposition, air, water, puckering, strangulation, two, Close subcutaneous layer, body wall, hollow organ
incisions, and skin [less common - b/c other suture patterns tend to be a little bit better]
How to perform a simple continuous pattern
Step 1: Start by placing a simple interrupted suture ~5mm beyond the end of the incision. Secure suture with a knot and cut the short end of the suture
Do NOT cut the end of the suture attached to the needle
Step 2:Return to the original side of the incision [initial side] and move ~5mm down the incision
Step 3: Repeat steps #1 and #2 until the end of the incision [stop ~5mm before the end of the incision]
Step 4: When taking the final bite, do not tighten the suture all the way
This will create a small loop
Step 5: Tie the long end of the suture [end with the needle attached] to the loop previously created
Cruciate pattern
Pattern classification – ?
_____ closure than simple interrupted, since it covers greater ____ along the incision
_____ effect on the blood supply when compared to the simple interrupted b/c you are taking bites _____ together.
Helps resist _____ while preventing ______ of the skin edges
Should NOT be used when there is a concern for _____.
Uses:?
interrupted and appositional, Stronger, distance, Larger, closer, tension, inversion, tension, Close skin and body wall
How to perform a cruciate pattern
How to perform a cruciate pattern:
Step 1. Begin as if performing a simple interrupted, but after exiting through the opposite side of the skin – DO NOT TIE A KNOT
Step 2. Take a second bite on the same side of the incision [keep the bites equidistant from the incisions, so there’s a symmetrical “X” after the knot is tied]
Step 3. Tie to the “short end” of the suture from Step #1
Recommendations:
Place each bite a distance from the surgical incision edge
that is equal to the thickness of the tissue [usually 3 – 5mm]
Space sutures approximately twice the distance apart
[usually 6 – 8 mm]
Leave the loop loose enough to accommodate
post-operative swelling
How to Perform a Cruciate PATTERN Continued…
Ford interlocking pattern
Pattern classification – ?
Some _____ in the event of knot failure; be careful with knots in general
Effect on the blood supply is ____ to the simple continuous pattern
May cause pressure _____ and/or become ____ when placed under tension
Suture pattern is commonly used in ____, but can be used to close ___ in small animals
DO NOT ?
continuous and appositional, security, similar, necrosis, buried, bovine, skin, tighten too much [especially in small animals with more delicate skin]
