suturing

Question 1

What are the suture characteristics?

Answer 1

Tensile Strength: weight required to break a suture.

Knot strength: for required for a knot to slip

Configuration: monfilament, braided multifilament (easier to handle and tie)

Elasticity: degree suture stretches and return to original length.

Memory/suture stiffness: high memory, difficult handling, unties

Tissue reactivity: inflamm response to suture. rxn peaks in 2-7days

Question 2

Two classes of sutures?

What are the types of sutures in each class?

Answer 2

Absorbable & non-absorbable.

Absorbable:

• catgut
• chromic
• vicryl*
• monocryl*
• PDS*

catgut and chromic are natural sutures, the others are synthetic.

Nonabsorbable:

• silk
• nylon
• ethibond
• prolene
• surgical steel

Question 3

What is the absorption rate/ tensil strength of each of the following sutures:

• chromic
• vicryl
• monocryl
• PDS

Answer 3

Chromic:

• absorption: 70days
• Tensil strength: 10-14days

VIcryl:

• absorption: 60-90d
• tensil strength: 3-4wks

Monocryl:

• absorption: 90-119d
• tensil strength: 21 days

PDS:

• absorption: 182-238d
• tensil strength: 5-6wks

Question 4

Sutures:

• describe suture sizes
• what areas of the body would you use 2-0 and 5-0?

Answer 4

Suture size:
-range from 5 to 11-0.
the numbers without 0 after them are thicker. 5 is the thickest and 11-0 is the thinnest.
5,4,3,2,1,0, 2-0, 3-0,4-0,5-0,6-0,7-0,8-0,9-0,10-0,11-0.

2-0: drains, chest, abdomen, back

5-0: scalp, brow, oral, chest, abd, hand, nose, lip, face

Question 5

Suture removal:

• after how many days should sutures be removed in each of the following areas:
• scalp
• face/ear
• chest/abd
• extremities
• penis
• delayed wound healing

Answer 5

Scalp: 10 days

Face/ear: 5 daus

Chest/abd: 8-10d

Extremeities: 10-14

Penis: 8-10

*delayed wound healing: 14-21d

The thicker the skin, the longer the sutures remain in the skin.

Question 6

What are the types needles?

Answer 6

Taper (SH, CT-1, CT-2 are MC)

Cutting

Reverse Cutting

Trocar point or tapercut

Blunt points

Side cutting or spatula

Question 7

When would you use blunt taper point?

micropoint spatula cutting?

Answer 7

Blunt taper point = liver

Micro: use on the eye

Question 8

Advantages of adhesive vs sutures?

CI to use of skin adhesives

Answer 8

Advantages:

• equivalent to strength to healed tissue at seven days post repair
• faster repair time
• water resistant**

CI:

• jagged or stellate lacerations
• bites, punctures, or crush wounds
• mucosal surfaces
• axillae and perineum
• hands, feet, and joints