Suturing Flashcards
Needle holders
Mayo hegaer
Olsen hegaer
Gillies
Forceps
Serrated
Rat tooth
Scissors
Mayo
Taper cut needle
Sharp point but creates small hole
Used in gut and bladder
Reverse cutting
Strong
Used for skin, fascia
Round bodied
Quite blunt
Used for fat
What properties do we require a suture material to have
Strong
Uniform size and diameter
Easy to handle
Good knot holding
Not reactive
Sterile
Cost effective
Suture material properties
Memory
Handling
Tensile strength
Duration
Monofilament
Made of a single strand
Causes less resistance- tissue drag
Less likely to harbour bacteria
Multifilament
Made of several filament that are twisted- catgut or braided- polyglactin 910 together
Easier to handle but higher friction
Can have capillary action and can wick bacteria
Non absorbable
Does not dissolve therefore long lasting
Used when sutures will be removed or long standing support needed from them
Examples of non absorbable material
Nylon
Polypropylene
Absorbable
Provide support while wound is healing and are absorbed once the wound has sufficient strength
Different material break down at different rates
Absorbable examples
Polydioxone
Polyglicaprone
Polyglactin 910
Catgut
Polyglactin 910 features
Vicryl
Multifilament
Easy to handle
Strength reduced to 50 percent at 21 days
Very popular
Poliglecaprone 25
Monocryl
Monofilament
Strength reduced to 50 percent at 7 days
Easy to handle
Used for sub cut tissue, intradermal sutures, bladder and intestine
Polydioxanone
PDS
Monofilament
Long duration- 50% strength loss at 5-6weeks
Has a lot of memory
Knot security is poorer
Useful when longer support is needed- Linea alba, muscle, intestine
Catgut
Multifilament
Derived from sheep or cattle intestine
Sometimes treated with chromium salts
Intense tissue reaction
Used for ligastures
Unpredictable absorption
Natural materials
Absorbed by phagocytosis and proteolysis which varies- inflammatory reactions
Synthetic material
Chemical polymers which are absorbed by hydrolysis
What are the features of an ideal suture
Synthetic
Monofilament
Low memory
Good knot security
Smaller diameter suture is
Poorer knot security
Throw is
Basic unit of knot
Surgeons knot
Double throw followed by a single throw
Commonly used knot
Secure