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Principles of Science > Suturing > Flashcards

Suturing Flashcards

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1
Q

What are the functions of suture material?

A

Wound closure - Ligation - Attachment of tubes - Stay sutures

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2
Q

What are the ideal properties of suture material in relation to tissue interaction?

A

Maintains strength until healing - Rapid resorption after use - Easily removed - Minimal tissue reaction - Doesn’t favour bacterial growth - Minimal drag - Suitable for all wounds

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3
Q

What are the ideal properties of suture material in relation to the surgeon?

A

Easy to handle - Pliable - Good knot security

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4
Q

What are the ideal properties of suture material?

A

Easy to sterilise - Non-capillary - Non-electrolytic - Non-corrosive - Non-allergenic - Non-carcinogenic

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5
Q

What suture materials are synthetic absorbable multifilament?

A

Vicryl - Dexon - Polysorb - Panacryl

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6
Q

For synthetic absorbable multifilament suture materials, how long does it take for it to be absorbed?

A

60 to 90 days

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7
Q

What are the main uses of synthetic absorbable suture material?

A

Vessel ligation - General soft tissue closure (skin & mouth)

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8
Q

What are the two suture materials that are synthetic absorbable monofilaments?

A

Monocryl - Caprosyn (short duration) PDS II - Maxon - Biosyn (long duration)

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9
Q

What are the uses of synthetic absorbable monofilament suture materials?

A

General soft tissue closure - Visceral closure (monocryl) (short duration) Soft tissues needing a lot of support - Muscle, fascia, linea alba, viscera (long duration)

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10
Q

What materials are non-absorbable monofilament?

A

Prolene (surgi pro) - Ethilon (monosof) - Flexon

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11
Q

What’s the use for non-absorbable monofilament suture material?

A

Inert (skin, stoma, vessels) - Prolonged support (hernia/tendon)

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12
Q

What materials are non-absorbable multifilament?

A

Mersilene - Ethibond - Novafil - Supramid

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13
Q

What are the uses of non-absorbable multifilament suture materials?

A

Ligament prosthesis - Skin closure

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14
Q

What are the natural suture materials? Are they multifilament or monofilament?

A

Catgut - Collagen (absorbable) Mersilk - PermaHand (non-absorbable) Mutifilament

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15
Q

What are natural suture materials used for? Which type does what?

A

Vessel ligation Absorbable for small - Non-absorbable for large

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16
Q

What general rules should be followed to avoid suture complications?

A

Avoid multifilament material in contaminated wounds - Avoid non-absorbable in hollow organs - Use inert material for skin - Avoid reactive material for stoma creation (opening) - Use slow or non-absorbable material in fascia/tendons - Avoid catgut in inflammed, infected or acidic wounds

17
Q

When choosing the size of suture material, what should you always aim to do? Why?

A

Choose smallest size possible - Reduce trauma, smaller knots, greater security

18
Q

What would the metric measurement of suture material which is 0.02mm be?

A

0.2

19
Q

What is the advantages of a reverse cutting needle over a normal cutting needle?

A

Point is reversed so they - are stronger -reduce the danger of tissue cutout -leave a hole which leaves wide wall of tissue for suture to be attached

20
Q

What are the advantages of interrupted suturing against continuous?

A

If one knot fails they don’t all fail - More accurate approximation (bringing skin together uniformly) - Adjust tension at each suture

21
Q

What are the advantages of continuous suturing against interrupted?

A

Quicker - Less suture material in wound - Even distribution of tension - More air and water tight - Cheaper

22
Q

What is appositional suturing? Why is it beneficial?

A

Suturing two sides in approximation - Easy, Accurate alignment, Quicker muscosal regeneration - Less inflammation and scar tissue

23
Q

What is inverted suturing? What is good and bad about it?

A

Two sides invert back into the tissue Good - greater bursting strength, reduced risk of adhesions Bad - Necrosis of tissue cuff, possible luminal compomise

24
Q

What is everted suturing? What is good and bad about it?

A

Two sides everted out of the tissue Good - Ease of placement, increased tensile strength, thrombosis reduction Bad - Prolonged inflammation, vascular compromise, increased adhesion, increased stenosis and leakage

25
Q

What are the advantages of a) partial thickness suture b) full thickness suture?

A

a) not exposed to luminal contents - reduces wicking from lumen b) better apposition - suture holding layer engaged

26
Q

Where would you find a simple interupted appositional pattern of suturing?

A

Skin - GIT - fascia

27
Q

What suture pattern is this?

A

Buried knot - intradermal/subcuticular closure

28
Q

What are two other types of approximating suture pattern other than the simple? Why are they not used?

A

Poth and Gold crushing - more necrosis and poor apposition

Gambee - difficult to place and risk of not engaging the submucosa

29
Q

What sort of suture pattern is this? What is good about it?

A

Cruciate mattress pattern

Stronger than simple - resists tension - prevents eversion - quicker than simple

30
Q

What is this suture pattern? What does it tend to do?

A

Horizontal mattress suture

Strangulates the tissue and causes edge ischemia

31
Q

What kind of suture pattern is this? What advantage does it have over a similar suture pattern?

A

Vertical matress suture - Resists tension and doesn’t cause edge ischemia

32
Q

What is the difference between the mayo mattress suture pattern and a horizontal mattress suture pattern?

A

A mayo mattress will cause layers to overlap and tighten tissues planes - whereas a horizontal mattress causes eversion of tissue

33
Q

Name and describe the features of this suture pattern

A

Simple continous - series of linked ‘uniterrupted’ sutures, suture line advances only on one side of wound, good for low tension areas

34
Q

Name this type of suture. What is the main advantage of this suture?

A

Runnning suture - Quick and rapid closure

35
Q

What is this suture pattern is this? Why is it better than simple continuous stitching?

A

Ford interlocking (blanket stitch) - Greater security, better apposition

36
Q

Name the non-appositional suturing patterns used on inverting tissue

A

Cushing - Connell - Lembert - Halsted - Czemy - Parker-Kerr - Purse-string

Principles of Science (11 decks)

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