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Surgery Exam 2 > Suture Patterns > Flashcards

Suture Patterns Flashcards

1
Q

what is an interrupted pattern

A

series of individual sutures

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2
Q

which is more secure interrupted or continuous

A

interrupted

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3
Q

which allows for adjustment of tension interrupted or continuous

A

interrupted

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4
Q

which uses more suture interrupted or continuous

A

interrupted – more expensive, increased foreign material in wound

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5
Q

which takes longer interrupted or continuous

A

interrupted

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6
Q

what is a continuous pattern

A

start with a knot than continue with pattern to end of incision prior to tying final knot

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7
Q

how many knots in a continuous pattern

A

2

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8
Q

how do you adjust tension in continuous

A

tension adjusted after each bite taken
difficult to adjust tension at the end

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9
Q

which provides better air and watertight closure interrupted or contiuous

A

continuous

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10
Q

where do you start a suture pattern

A

at or just beyond the corner of the incision (1-3mm)

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11
Q

distance of bites from incision edge

A

3-5 mm

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12
Q

distance between bites

A

5-8 mm

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13
Q

which patterns are appositional

A

simple interrupted
simple continuous
cruciate
ford interlocking
intradermal

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14
Q

what type of suturing allows for best anatomical approximation and brings edges of incision together

A

appositional patterns

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15
Q

what results in fastest healing and gives best cosmetic results

A

appositional patterns

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16
Q

classification of simple interrupted

A

interrupted and appositional

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17
Q

is simple interrupted recommended if there is tension

A

no

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18
Q

simple interrupted impact on blood supply to incision edges

A

minimal, unless overtightened

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19
Q

uses of simple interrupted

A

close skin, subcutaneous layer, body wall
ligate blood vessels or nerves

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20
Q

classification of simple continuous

A

continuous and appositional

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21
Q

simple continuous effect on blood supply compared to simple interrupted

A

larger effect

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22
Q

uses of simple continuous

A

close subcutaneous layer, body wall, hollow organ incisions
less common in skin

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23
Q

classification of cruciate pattern

A

interrupted and appositional

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24
Q

strength of closure compared to simple interrupted

A

stronger – covers greater distance along incision

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25
Q

cruciate effect on blood supply compared to simple interrupted

A

larger effect

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26
Q

should cruciate be used when there is a concern for tension

A

no

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27
Q

uses of cruciate

A

close skin, body wall

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28
Q

does cruciate help prevent inversion of skin

A

yes

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29
Q

classification of ford interlocking pattern

A

continuous and appositional

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30
Q

ford interlocking and knot failure

A

some security in case of knot failure

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31
Q

ford interlocking effect on blood supply

A

same as simple continuous

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32
Q

what can ford interlocking cause when placed under tension

A

pressure necrosis
may become buried

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33
Q

what species is ford interlocking commonly used in

A

bovine
but can be used in small animals

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34
Q

classification of intradermal pattern

A

continuous and appositional

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35
Q

what does intradermal do

A

apposes skin and diminishes tension on skin closure

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36
Q

how does intradermal run

A

horizontally through dermis

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37
Q

intradermal impact on local blood supply

A

minimal

38
Q

what do you do to the knot in intradermal

A

bury it

39
Q

why is important to bury knot in intradermal

A

if knot sticks out patient may lick or chew it
prevents access of dirt and bacteria to deepest layers

40
Q

in intradermal should bites backtrack

A

yes, about halfway

41
Q

what can tissue forceps cause in intradermal and why

A

post operative bruising due to excess pressure needed to stabilize skin

42
Q

what do inverting patterns do

A

turn incision edges inward

43
Q

where are inverting patterns used

A

larger lumen hollow organs

44
Q

what happens to lumen with inverting patterns

A

decreases lumen size

45
Q

what helps provide watertight seal in inverting patterns

A

serosa-serosa apposition

46
Q

where do you avoid using inverting and why

A

avoid when closing skin – delays healing

47
Q

which patterns are inverting

A

lembert
cushing
purse string

48
Q

what is the holding layer when suturing hollow organs

A

tunica submucosa

49
Q

complications when suturing hollow organs

A

dehiscence
calculi or stone formation
adhesions

50
Q

what patterns are used with single layer closure

A

simple interrupted or simple continuous commonly used

51
Q

what type of pattern is used in double layer closure on the stomach

A

first layer – appositional pattern
second layer – inverting pattern

52
Q

what type of pattern is used in double layer closure on the urinary bladder

A

first layer – inverting pattern
second layer – similar to stomach (inverting??)

53
Q

what type of pattern is used in closure on the intestines

A

1 layer closure – appositional pattern

54
Q

classification of lambert pattern

A

continuous and inverting

55
Q

is lambert partial or full thickness

A

partial thickness – non penetrating pattern

56
Q

uses of lambert

A

GI surgery
large lumen hollow organs
colon, bladder, stomach, rumen

57
Q

is lambert continuous or interrupted

A

can be either

58
Q

what is penetrated in lambert

A

serosa
muscularis
submucosa

59
Q

what is not penetrated in lambert

A

mucosa of the hollow organ

60
Q

how to make tissue more inverted in lambert

A

place bites farther from incision edge

61
Q

classification of cushing pattern

A

continuous and inverting

62
Q

is cushing partial or full thickness

A

partial thickness – non penetrating pattern

63
Q

what is and is not penetrated in cushing

A

penetrates submucosa
does not penetrate organs lumen

64
Q

what is cushing commonly used with

A

2 layer closure

65
Q

uses of cushing

A

hollow viscera
urinary bladder
stomach
uterus

66
Q

classification of connell pattern

A

continuous and inverting

67
Q

is connell partial or full thickness

A

full thickness – penetrating

68
Q

can this be used in 2 layer closure

A

yes, but only as first (inner) layer

69
Q

uses of connell

A

hollow viscera
urinary bladder
stomach
uterus

70
Q

purse string classification

A

continuous and inverting

71
Q

is purse string pattern partial or full thickness

A

partial thickness – non penetrating

72
Q

what is purse string pattern commonly used on

A

hollow organ viscera

73
Q

what is purse string pattern used for

A

temporarily close anus during perianal surgery
maintain rectal prolapse reduction
close defect in hollow organ wall

74
Q

what is finger trap pattern used for

A

secure tubes to patient

75
Q

what is used in finger trap pattern

A

hand throws

76
Q

what do everting patterns do

A

turn incision edges outwards

77
Q

what is everting pattern used for

what can it lead to

A

suturing edges under tension
decrease tension on the suture line

can lead to delayed healing

78
Q

what is tension

A

tendency of the incision to open up

79
Q

which patterns are everting

A

mattress – horizontal and vertical
walking sutures
near-far patterns (surgeons stich) – near-far-far-near and far-near-near-far

80
Q

classification of vertical mattress pattern

A

interrupted and tension relieving (everting)

81
Q

effect of vertical mattress on blood supply

A

less than horizontal mattress
more than simple interrupted

82
Q

degree of eversion of vertical mattress compared to horizontal mattress

A

horizontal mattress has more eversion than vertical

83
Q

uses on vertical mattress

A

closure of high tension areas
commonly used for skin closure

84
Q

how to differentiate horizontal and vertical mattress

A

vertical – sutures are perpendicular to incision
horizontal – sutures are parallel to incision

85
Q

classification of horizontal mattress pattern

A

interrupted and tension relieving (everting)

86
Q

uses of horizontal mattress

A

closure of high tension areas
commonly used for skin closure

87
Q

which patterns require backing the needle in

A

horizontal and vertical mattresses

88
Q

classification of near-far-far-near and far-near-near-far patterns

A

variation of vertical mattress
interrupted and everting (tension relieving)

89
Q

what is the most appropriate pattern to use for considerable tension

A

near-far-far-near
far-near-near-far

90
Q

uses of near-far-far-near and far-near-near-far patterns

A

closure of high tension areas
commonly used for skin closure

Surgery Exam 2 (6 decks)

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