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Surgical Recall > Sutures and Stitches Chapter7 P53-60 > Flashcards

Sutures and Stitches Chapter7 P53-60 Flashcards

1
Q

GENERAL INFORMATION
1. What is a suture?
P53

A

Any strand of material used to ligate blood vessels or to approximate tissues

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2
Q
  1. How are sutures sized?

P53

A

By diameter; stated as a number of O’s: the higher the number of O’s, the smaller the diameter (e.g., 2-O suture has a larger diameter than 5-O suture)

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3
Q
  1. Which is thicker, 1-O suture or 3-O suture?

P53

A

1-O suture (pronounced “one oh”)

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4
Q

CLASSIFICATION
1. What are the two most basic suture types?
P53

A

Absorbable and nonabsorbable

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5
Q
  1. What is an absorbable suture?

P53

A

Suture that is completely broken down by the body (dissolving suture)

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6
Q
  1. What is a nonabsorbable suture?

P53

A

Suture is not broken down (permanent suture)

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7
Q

SUTURES
1. Catgut
a) What are “catgut” sutures made of?
P54

A

Purified collagen fibers from the intestines of healthy cows or sheep (sorry, no cats)

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8
Q

b) What are the two types of gut sutures?

P54

A

Plain and chromic

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9
Q

c) What is the difference between plain and chromic gut?

P54

A

Chromic gut is treated with chromium salts (chromium trioxide), which results in more collagen crosslinks, making the suture more resistant to breakdown by the body

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10
Q
  1. Vicryl® Suture
    a) What is it?
    P54
A

Absorbable, braided, multifilamentous copolymer of lactide and glycoside

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11
Q

b) How long does it retain its strength?

P54

A

60% at 2 weeks, 8% at 4 weeks

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12
Q

c) Should you ever use PURPLE-colored Vicryl® for skin closure?
P54

A

NO—it may cause purple tattooing

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13
Q
  1. PDS®
    a) What is it?
    P54
A

Absorbable, monofilament polymer of polydioxanone (absorbable fishing line)

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14
Q

b) How long does it maintain its tensile strength?

P54

A

70% to 74% at 2 weeks, 50% to 58% at 4 weeks, 25% to 41% at 6 weeks

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15
Q

c) How long does it take to complete absorption?

P54

A

180 days (6 months)

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16
Q

d) What is silk?

P55

A

Braided protein filaments spun by the silkworm larva; known as a nonabsorbable suture

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17
Q

e) What is Prolene?

P55

A

Nonabsorbable suture (used for vascular anastomoses, hernias, abdominal fascial closure)

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18
Q

f) What is nylon?

P55

A

Nonabsorbable “fishing line”

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19
Q

g) What is monocryl?

P55

A

Absorbable monofilament

20
Q

h) What kind of suture should be used for the biliary tract
or the urinary tract?
P55

A

ABSORBABLE—otherwise the suture will end up as a nidus for stone formation!

21
Q

WOUND CLOSURE
GENERAL INFORMATION
1. What is the purpose of a suture closure?
P55

A

To approximate divided tissues to enhance wound healing

22
Q
  1. What are the three types of wound healing?

P55

A
  1. Primary closure (intention)
  2. Secondary intention
  3. Tertiary intention (Delayed Primary Closure DPC)
23
Q
  1. What is primary intention?

P55

A

When the edges of a clean wound are closed in some manner immediately (e.g., suture, Steri-Strips®, staples)

24
Q
  1. What is secondary intention?

P55

A

When a wound is allowed to remain open and heal by granulation, epithelization, and contraction—used for dirty wounds, otherwise an abscess can form

25
Q
  1. What is tertiary intention?

P55

A

When a wound is allowed to remain open for a time and then closed, allowing for débridement and other wound care to reduce bacterial counts prior to closure
(i.e., delayed primary closure)

26
Q
  1. What is another term for tertiary intention?

P55

A

DPC = Delayed Primary Closure

27
Q
  1. Classic time to wait before closing an open abdominal
    wound by DPC?
    P56
A

5 days

28
Q
  1. What rule is constantly told to medical students about
    wound closure?
    P56
A

“Approximate, don’t strangulate!” Translation: If sutures are pulled too tight, then the tissue becomes ischemic
because the blood supply is decreased, possibly resulting in necrosis, infection, and/or scar

29
Q

SUTURE TECHNIQUES
1. What is a taper-point needle?
P56 (pictures)

A

Round body, leaves a round hole in tissue

spreads without cutting tissue

30
Q
  1. What is it used for?

P56

A

Suturing of soft tissues other than skin

e.g., GI tract, muscle, nerve, peritoneum, fascia

31
Q
  1. What is a conventional cutting needle?

P56 (pictures)

A

Triangular body with the sharp edge toward the inner circumference; leaves a triangular hole in tissue

32
Q
  1. What are its uses?

P56

A

Suturing of skin

33
Q
  1. What is a simple interrupted stitch?

P56 (pictures)

A

see picture

34
Q
  1. What is a vertical mattress stitch?

P57 (pictures)

A

Simple stitch is made, the needle is reversed, and a small bite is taken from each wound edge; the knot ends up on
one side of the wound

35
Q
  1. What is the vertical mattress stitch also known as?

P57

A

Far-far, near-near stitch—oriented perpendicular to wound

36
Q
  1. What is it used for?

P57

A

Difficult-to-approximate skin edges; everts tissue well

37
Q
  1. What is a horizontal mattress stitch?

P57 (pictures)

A

Simple stitch is made, the needle is reversed, and the same size bite is taken again—oriented parallel to wound

38
Q
  1. What is a simple running (continuous) stitch?

P57 (pictures)

A

Stitches made in succession without knotting each stitch

39
Q
  1. What is a subcuticular stitch?

P58 (picture)

A

Stitch (usually running) placed just underneath the epidermis, can be either absorbable or nonabsorbable (pull-out stitch if nonabsorbable)

40
Q
  1. What is a pursestring suture?

P58 (picture)

A

Stitch that encircles a tube perforating a hollow viscus (e.g., gastrostomy tube), allowing the hole to be drawn tight and
thus preventing leakage

41
Q
  1. What are metallic skin staples?

P58 (picture)

A

see picture

42
Q
  1. What is a staple removal device?

P59 (pictures)

A

see picture

43
Q
  1. What is a gastrointestinal anastomosis (GIA) device?

P59 (pictures)

A

Stapling device that lays two rows of small staples in a hemostatic row and automatically cuts in between them

44
Q
  1. What is a suture ligature (a.k.a. stick tie)?

P60 (pictures)

A

Suture is anchored by passing it through the vessel on a needle before wrapping it around and occluding the vessel; prevents slippage of knot-use on larger vessels

45
Q
  1. What is a retention suture?

P60 (pictures)

A 
Large suture (#2) that is full thickness through the entire abdominal wall except the peritoneum; used to buttress
an abdominal wound at risk for dehiscence
46
Q
  1. What is a pop-off suture?

P60

A

Suture that is not permanently swaged to the needle, allowing the surgeon to “pop off” the needle from the suture without cutting the suture

Surgical Recall (33 decks)

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