Sutures - scrub/scout Flashcards
Absorbable sutures
Don’t need to be removed
- Enzymes found in the body’s tissues naturally digest them.
Non-absorbable sutures
Will need to be removed or in some cases left in permanently.
- Suture material can be classified according to the actual suture of the material.
- Generally used for soft tissue repair including CV or neuro procedures
Monofilament sutures
Consists of a single thread.
- Allows the suture to more easily pass through tissues
Braided sutures
Consists of several small threads braided together.
- Stronger suture material but also increase the risk of infection as bacteria can live in the braid
- Antimicrobial coated sutures to further reduce the risk
Absorbable suture - Gut
Natural monofilament suture
- Used for repairing internal soft tissue wounds or lacerations.
Absorbable suture - Polydioxanone (PDS)
Synthetic monofilament suture
- Used for many types of soft tissue wound repair (abdominal closures) as well as paediatric cardiac procedures
Absorbable suture - Poliglecaprone (Monocryl)
Synthetic monofilament suture is used for general use in soft tissue repair.
Absorbable suture - Polyglactin (Vicryl)
Synthetic braided suture
- Repairing hand or facial lacerations
Non-absorbable sutures -Nylon
Natural monofilament suture
Non-absorbable - Polypropylene (prolene)
Synthetic monofilament suture
Non-absorbable - Silk
Braided natural suture
Non-absorbable - Polyester (Ethibond)
A braided synthetic suture
Suture selection
suture material is graded according to the diameter of the suture strand.
- Grading system uses the letter “O” preceded by a number to indicate material diameter.
- The higher the number the smaller the diameter of the suture strand.
Key points of selection
- Size or gauge of the needle
- Needle Sharpe
- Needle length
- Type and suture material
Continuous - suture
Involves a series of stitches that use a single strand of suture material.
- Can be placed rapidly and is strong
- Tension is distributed evenly throughout the continuous suture strand.
Interrupted - suture
Uses several strands of suture material to close the wound.
- After a stitch is made, a material is cut and tied off
Deep - suture
Type of suture is placed under the layers of tissues below (deep) to the skin.
- Either continuous or interrupted.
- Used to close fascial layers
Buried - suture
Applied so that the suture knit is found inside
- Type or suture is typically not removed and is useful when large sutures are used deeper in the body
Purse-string - suture
Type of continuous suture that is placed around an area and tightened much like the drawstring on a bag.
- Used in your intestines in order to secure an intestinal stapling device.
Sub/cut - suture
Placed in your derms the layer of tissues that lies below the upper layer of your skin.
- Anchored at either end of the wound
Scalp - suture removal
7-10 days
Face - suture removal
3-5 days
Chest or trunk - suture removal
10-14 days
Arms - suture removal
7-10 days
Legs - suture removal
10-14 days
Hands or feet - suture removal
10-14 days
Palms of hands or soles of feet - suture removal
14-21 days
Suture definition
needle attached to a thread
- needle can be from 5.5mm-13mm in size, shaped a pointed’, spatulated, reverse cutting, taper cut, straight cutting, conventional cutting and others.
Determining type of needle
The operative side and speciality will determine the body or type of needle and suture material attached that will be used.
surgical skin preparation
Intact skin is one of the pt best defences against the entry of infection
surgical skin antisepsis
- Achieved through surgical skin disinfection, which removes transient bacteria through a combination of mechanical removal, chemical killing and inhibition.
- Antimicrobial agent which has a broad-spectrum, rapid and persistent effect
Antisepsis solution
aqueous povidone-iodine and chlorhexidine solutions
3 principles of skin prep
- removal of hair
- chemical disinfection
- Mechanical washing
Skin prep technique
- Should commence from the cleanest area, usually the operative and/or incision site and proceed in a concentric fashion to the least clean area
- Never go back over a prepared site, use a new swab to go over an area in a circular manner
- the area with a lower bacterial count should be prepared first, followed by the area of a higher contamination
- avoid drying with swab or sponge as this reduces efficiency
- solution should dry completely naturally
skin preparation solutions
- Chlorhexidine Gluconate
- Aqueous chlorhexidine
- Iodophors
- Aqueous betadine
- Alcohol betadine
