Suturing Flashcards
Why should you bury the knot?
To prevent the ends of the knot in a subcutaneous layer sticking out between the edges of the skin, which will allow wicking of bacteria and is also a source of irritation
Most commonly used in the subcutaneous and intradermal layers
When should you not bury the knot?
When the location of where the knots will be buried will act as an irritant and cause trauma - Closing a joint capsule, closing linea alba
What are the 2 advantages of using a slip knot?
Securing the first throws of suture into a deep, difficult to access space
Applying tension to the first throw of a monofilament suture
What is useful about the technique to suture a corner?
It minimises compromise to blood supply at the tip of the corner
When might you use a suture pattern where the knot lies away from the incision site?
When the incision site is delicate and the knot would cause irritation -eyelid margin, urethra to skin
When should you use the millers knot?
Tying a secure ligature around a large vasculature bundle - ovarian pedicle in a spey
What is the benefit of using a transfixing knot?
To prevent a ligature slipping off
What is the preferred suture pattern for tendons?
The three loop pulley - it is more able to resist gap formation
After suturing a tendon what else do you need to do?
Make sure the tendons are protected from tension for 3-4 weeks
What are the important questions to answer when deciding on a suture material?
Mono or multifilament Natural or synthetic Absorbable or non-absorbable Swaged on or loose Size
When ligating a vessel using a 3 ligature system, do you tie the circumfrential or transfixing ligature first on the upstream side?
Circumfrential first - this occludes blood flow, otherwise when doing a transfixing ligature it will bleed a lot
