Suturing Flashcards
Describe a swaged needle
Passes through tissue with less drag than eyed needle
As a new needle is used each time, it is sharp
Suture is secured to the needle
Relatively expensive
Useful for delicate tissue as less traumatic
Describe an eyed needle
Greater bulk at eye increases drag (needle should not be double threaded)
Needles are commonly re-used and therefore cheaper
Care must be taken to keep needle joined to the suture
The choice of needle shape is often governed by…
the accessibility of the tissue to be sutured. The more confined the operative site, the greater the curvature needed
What are the most commonly used needles in practice?
1/2 curved
1/2 circle
curved needle
straight needle
Round bodied needles are designed to…
separate tissue fibres rather than cut them. Leak proof suture line.
Describe a taper point needle
Needle body is rounded and tapers to a point
Combines initial penetration of a cutting needle with the minimised trauma of a round bodied needle.
Describe a blunt point needle
Designed for suturing extremely friable tissue such as the liver
.
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What are cutting needles used for?
Required for suturing fibrous or dense tissues
Describe a reverse cutting needle
Body of needle is triangular with apex on outside of needle curvature
Describe a regular cutting needle
Body of needle is triangular with apex on inside of the needle curvature
Describe absorbable suture material
Undergo degradation and loss of strength after 60 days
Used internally where long term support is not required
Describe non-absorbable suture material
Maintain their tensile strength for longer than 60 days
Neither phagoctosed or hydrolysed, encapsulated within fibrous tissue
Describe natural suture materials
Come from naturally occurring organic fibres
Describe synthetic suture materials
Made from ‘man made’ fibres
Synthetic materials are hydrolysed and tend to produce minimal tissue reaction
What are suture materials described as monofilament or multi-filament?
Depends if they are made from multiple strands or single strand
Describe capillarity
Extent to which tissue fluids are attracted along a length of suture material
Describe chatter
The lack of smoothness as a throw of knot is tightened down
smoothness = no chatter
Describe coated
Secondary coating over primary material to modify
Describe knot security
Relates to the surface frictional characteristics of the material
Describe memory
The tendency of the material to return to its original shape
Often mono-filaments that have good memory
Describe tensile strength
Breaking strength per unit area of tissue
Describe tissue drag
The degree of frictional force as the material is pulled through the tissue
Describe tissue reaction
The response of the tissue to the suture material involved
Synthetic suture materials cause…
less tissue reaction
Mono-filament materials are…
less reactive and much less likely to harbour bacteria
Braided materials…
have more tissue drag and cause more tissue tension
Bacteria harbour in between…
the fibres of braided materials
Most braided materials are now…
coated to reduce tissue drag, but this reduces knot security
Mono-filaments have…
significant memory and can be difficult to handle
Describe interrupted sutures
Sutures that are individually tied giving this suture pattern the ability to maintain strength and tissue apposition if part of the suture line fails
What is a disadvantage of interrupted sutures?
More time consuming so animal anaesthetised longer
Can work out more expensive as using more suture material
Describe continuous sutures
One length of suture material tied at the beginning and end of the suture line only. Quicker to place and distribute wound tension
What is a disadvantage of continuous sutures?
If it breaks, the whole stitch breaks
Describe a simple interrupted suture
Easiest suture to place
Provides a secure closure through the complete layer of skin
Care should be taken not to place too tightly
Needle should enter the skin around 3-5mm away from the wound edge
Can be used for skin suturing and GI tract
Describe cruciate sutures
Covers a greater length of wound than the simple interrupted suture so making it quicker to suture
Cruciate sutures improve apposition
It can be easy to make these sutures too tight causing them to cut into the skin and also make removal difficult
Can be used for skin suturing and in muscle and fascia
Describe horizontal mattress sutures
Quick to apply
Over tightening sutures will results in wound eversion and reduction in blood supply to the wound edges
Eversion can be avoided by not allowing the needle to go much deeper than the dermis
This type of suture is placed some way from the wound edge, useful in reducing wound tension
Can be used for skin suturing and in muscle and fascia
Describe simple continuous sutures
Difficult to tension this pattern correctly and avoid puckering of the wound edges
Can be used for skin suturing and in muscle and fascia
Describe ford interlocking sutures
With practice, a very quick stitch to perform giving excellent apposition
Works best on straight wounds
Used in skin suturing and muscle and fascia
