Sutures and Suturing

Question 1

What are swedged needles?

Answer 1

there are needles that already contain a suture within the end of the needle

Question 2

what are non-swedged needles?

Answer 2

they are needles that have an eyelet and the suture must be looped through/around it; they thus have a wider diameter than the needle itself

Question 3

Are swedged or non-swedged needles better? why?

Answer 3

swedged - does not stick out beyond cross-section of needle, less drag, less trauma to tissues
non-swedged - wider diameter allows for dragging/friction/trauma, delaying healing

Question 4

When should taper point needles be used?

Answer 4

they are used for hollow organs, as cutting needles would allow suture to tear the tissue

Question 5

when should cutting point needles be used?

Answer 5

they are used for skin, to facilitate passage of the needle through the denser tissue

Question 6

Why is “perfect” apposition of the wound margin appropriate? what happens when eversion or inversion of the wound margin occurs?

Answer 6

perfect apposition allows faster healing with minimal scar tissue formation. eversion or inversion of the wound margins results in scarring and scarring tissue is not as strong as normal tissue.

Question 7

What tissues have greater or lesser tensile strength?

Answer 7

skin > muscle fascia > muscle > subcutaneous fat

Question 8

What type of suture is image 6?

Answer 8

horizontal mattress

Question 9

What type of suture is image 7?

Answer 9

continuous interlocking

Question 10

What type of suture is image 8?

Answer 10

simple interrupted

Question 11

What type of suture is image 9?

Answer 11

simple continuous

Question 12

What type of suture is image 10?

Answer 12

vertical mattress

Question 13

what are the advantages and disadvantages for the simple interrupted suture pattern?

Answer 13

advantages: good apposition of the margins, loss of one suture has minimal effect

disadvantage: takes a little longer to do than continuous suture patterns, may tea through tissue when tension present

Question 14

what are the advantages and disadvantages for the horizontal mattress suture pattern?

Answer 14

advantage: good for areas where tension tries to pull margins apart, loss of one suture has minimal effect

disadvantage: takes a little longer to do than continuous suture patterns, cause eversion of the margins (if tied to tightly), may “strangulate” blood flow and affect healing

Question 15

what are the advantages and disadvantages for the vertical mattress suture pattern?

Answer 15

advantages: good for areas where tension tries to pull the margins apart, loss of one suture has minimal effect, not as likely to restrict blood flow

disadvantage: takes a little longer to do than continuous suture patterns, cause eversion of the margins (if tied too tightly)

Question 16

what are the advantages and disadvantages for the simple continuous suture pattern?

Answer 16

advantages: very fast to complete, fair apposition of the margins

disadvantages: may tear through tissue when tension present, breaking of suture allows entire wound to gape open (don’t use on abdominal wall and skin)

Question 17

what are the advantages and disadvantages for the continuous interlocking suture pattern?

Answer 17

advantages: very fast to complete, fair apposition of the margins, good for tension relief

disadvantages: breaking of suture allows entire to gape open

Question 18

What are the proper steps in removing sutures?

Answer 18

1. elevate the suture to expose a segment that was under the skin
2. cut the portion that was “buried”
3. pull the suture out

note: this prevents dragging contamination into the suture tract