Suturing Decisions

Question 1

what is the wicking effect?

Answer 1

also called capillarity

fluid is drawn into suture material from environment or surrounding tissue

this fluid is likely to hold bacteria so an SSI is likely

SSIs then delay wound healing and can cause wound breakdwon

this is occurs more commonly with multifilament sutures rather than monofilaments

Question 2

what is the comparison between metric sizing and USP sizing for suture material

Answer 2

Metric = USP

0.7 = 6-0
1 = 5-0
1.5 = 4-0
2 = 3-0
3 = 2-0
3.5 = 1-0/0
4 = 1
5 = 2

Question 3

what is 2-0 USP sizing in metric sizing?

Answer 3

3 metric

Question 4

what is 4-0 USP sizing in metric sizing?

Answer 4

1.5 metric

Question 5

what is 2 metric sizing in USP sizing?

Answer 5

3-0

Question 6

What are the different needle types?

Answer 6

round bodied
- designed to separate fiber tissues instead of cutting them
- use on friable tissue - eg bladder or uterus

taper point
- gradually broadens from the tip
- allows better separation of the tissues

cutting
- designed to cut through tissue
- use on dense tissue - eg skin
Conventional = cutting edge on inside of curve
- suture pulls against cut edge skin
- likely to rip skin
Reverse = cutting edge on outside of curve
- suture pulls against flat edge of skin
- more secure

Question 7

what is the difference between a swaged and eyed needle?

what are the pros and cons?

Answer 7

swaged = no eye so suture material attached to end of needle

advantages of swaged
- saves time
- reduces tissue drag as constant diameter so no larger hole need to be made necessary

disadvantages of swaged
- can’t reuse the needles
- if runout of material have to open new pack/needle
- if suture unthreads then have to open new pack

advantages of eyed needle
- can reuse - bin once blunt
- can use the desired amount of suture material with less waste

disadvantaged of eyed needle
- more trauma to skin
- spend time threading the suture through the eye

Question 8

what are the benefits of using surgical staples?
what considerations need to be made?

Answer 8

benefits
- rapid placement - no time tying sutures
- low tissue reaction - made from stainless steel or titanium
- strong wound closure - good for wounds under tension - eg very dense skin

considerations
- must be removed - harder to remove than sutures - need very tolerant patient
- can increase scaring due to less accurate tissue alignment - think about client preferences