Sutures Flashcards
Simple continuous
Running stitch
Rapidly placed, prone to patient interference if in skin
Theoretically insecure
Typically fascia, Inc midline, muscle, viscera
Continuous intradermal / sc
Buried continuous stitch to close skin
Slower than other skin patterns, resists tension, avoids patient interference, doesn’t require removal
Usually skin,:presence of tension: sites prone to interference (eg castrate)
Interrupted
Simple interrupted appositional
Horizontal mattress
Cruciate mattress
Vertical mattress
Simple interrupted appositional (sia)
Individual stitches placed as simple loops across wound
Standard pattern: produces good apposition
Skin closure, midline closure, viscera closure
Horizontal mattress
Placed as loops with bite on each side of wound parallel to wound edge
Produces some Eversion, resists effects of tension more than sia
Skin, especially in presence of tension
Cruciate mattress
Similar to horizontal mattress but strands cross over wound
Less Eversion than above, resists effects of tension more than sia, faster than horizontal
Skin especially where tension
Vertical mattress
Placed as loops with bite on each side of wound perpendicular to wound edge
Some Eversion, resists tension more than sia, interferes with blood supply less than horizontal mattress
Skin, most commonly used interspersed with sia to resist effects of tension
Polyamide (nylon)
- ethilon (ethicon)
- monosof( ussc)
Non absorbable Monofilament Synthetic Not coated Fair knot security Permanent Minimal tissue reaction Little tissue drag
Polybutester
-novafil
Davis and geck
Non absorbable Monofilament Synthetic Not coated Fair knot security Permanent Very similar to ethilon with similar properties
Polypropylene
- prolene (ethicon)
- surgipro (ussc)
Monofilament
Synthetic
Not coated
Fair knot security but can produce bulky knots that untie easily
Permanent
Very inert, minimal tissue reaction, very strong but also very springy
Little tissue drag
Braided silk
-mersilk (ethicon)
Non absorbable Multufilament Natural Wax coat Excellent knot security Eventually may fragment and breakdown Natural material with good handling properties but high tissue reactivity should not be used in infected sites
Braided polyamide
-supramid or nurolon(ethicon)
Non absorbable Multufilament Synthetic Encased in outer sheath Good knot security Outer sheath can be broken Better handling characteristics than monofilament polyamide Can be used in skin but not as a buried suture
Surgical stainless steel wire
Mono or multi
Synthetic
Not coated
Excellent knot security but difficult to tie
Permanent
Not commonly used but useful in bone or tendon
Difficult to handle, may break
Polyglactin 910
- vicryl
- “polysorb
Absorbable Multi (braided) Synthetic Coated calcium stearate Retains50% tensile strength at -14 days, 20% at 21 days Absorption 60-90days by hydrolysis Dyed or undyed Low tissue reactivity Subcutis, muscle, eye, hollow viscera
Polydioxanone
-pds II
Mono Absorbable Synthetic not coated 70% t/s 14 days 14% 56 days Minimal absorption by 90 days Absorbed by 180 days Absorbed by hydrolysis Good for infected sites as monofilament very strong but springy Minimal tissue reaction Subcutis, muscle, eyes
