Suturing materials and epidermal closure techniques Flashcards
Buried sutures can be used to close dead space, redistribute tension, decrease dehiscence and increase wound eversion.
T
When undermining wound edges, skin hooks are the least traumatic means of stabilising and mobilising wound edges.
T
The configuration of a suture denotes its composition.
T
Advantages of suture braiding include lower propensity for infection.
F Increased propensity to retain microorganisms.
Advantages of suture braiding include increased tensile strength.
T
Advantages of suture braiding include decreased fraying of cut ends.
T
Newer innovations include suture coating with either antibacterial or antitumor qualities
T
Disadvantages of braided sutures include poorer handling and knot-tying properties.
F Improved
Disadvantages of braided sutures include more resistance when pulled through tissue.
T
Sutures coated with silicone, Teflon and wax decreases friction.
T
Capillarity denotes a suture’s ability to wick fluid from an immersed end to its dry end.
T
Braided sutures have decreased capillarity.
F Increased
Sutures with increased capillarity are more likely to harbor bacteria
T
Tensile strength refers to the weight necessary to break a suture divided by the cross-sectional area.
T
Larger sutures have decreased tensile strength.
F Increased
Synthetic sutures tend to have decreased tensile strength compared to sutures of natural materials.
F Increased
Tensile strength can be decreased by physical factors, such as wetness or increased age of sutures
T
Due to shearing forces between the strands, braided sutures have decrease tensile strength
T
The number/size ranks of sutures refer to their tensile strength – the greater the tensile strength, the fewer the zeros.
T Ie 2-0 suture has more strength than 6-0.
All sutures with the same tensile strength will have the same calibre.
F Eg. The calibre of a 5-0 nylon will be smaller than a 5-0 gut because nylon is stronger.
Knot strength refers to the security of a tied knot and is defined by the degree of slippage that occurs in a knot.
T
Sutures with a decreased coefficient of friction slide more easily and have a lower knot strength.
T
Memory is the ability of a suture to return to its original size and shape after being stretched.
F This is true for elasticity.
Elasticity denotes the ability of a suture to regain its former shape after bending.
F This is true for memory
Knots in sutures with increased memory (eg. polypropylene and nylon) have a greater tendency to untie themselves.
T Should throw extra ties with these sutures.
Sutures with increased memory are less difficult to handle.
F More difficult
Elasticity is a desirable quality for a surface suture as it means the suture will stretch with the tissue and also recoil when the swelling subsides.
T
Plasticity refers to a suture’s ability to retain their deformed shape rather than return to their original shape when stretched.
T
Plasticity is advantageous in knot tying because deformation of the suture may lead to a more secure knot.
T
Sutures made of natural materials are less immunogenic than synthetic materials.
F More immunogenic.
Sutures with a multifilament configuration are more immunogenic than those with a monofilament configuration.
T
Non-absorbable sutures are more immunogenic than absorbable sutures.
F Less immunogenic. The immune response elicited by absorbables cause their dissolution.
Large diameter sutures are more immunogenic than small diameter sutures.
T
All sutures exhibit at least some inflammatory response when placed in tissue.
T
Sutures made of natural material are degraded by proteolysis in contrast to synthetic sutures which are degraded by hydrolysis
T
Non-absorbable sutures cause less tissue reaction because they induce a fibrous shell which coats the suture and decreases the host response.
T
True suture allergy does not occur.
F Rarely.
Absorbable sutures are defined as those that lose the majority of their tensile strength within 60 days after placement in living tissue.
T non-absorbable sutures maintain their tensile strength for periods >60 days.
The presence of wound infection does not affect suture absorption.
F Increases suture absorption.
Suture placement location does not affect the rate of suture absorption.
F Mucosa absorbed faster.
Surgical gut is the only absorbable suture made of natural materials.
T
Surgical gut is a twisted multifilament suture composed mostly of collagen.
T
Fast absorbing gut is recommended for internal use
F
There are two varieties of gut sutures: plain and chromic.
F Three varieties. Also fast-absorbing.
Plain surgical gut loses much of its tensile strength in 3 weeks.
F 7-10 days.
Plain surgical gut is completely absorbed by 70 days.
T
Fast-absorbing gut is heat treated for more rapid deterioration.
T
Fast absorbing gut is used in facial wound closure, or the placement of skin grafts where rapid absorption of the suture is desirable
T
Nearly all of the tensile strength of a fast-absorbing gut suture is lost within 7 days, and complete absorption takes 21-42 days.
T
PDS II has lower tensile strength than fast-absorbing gut initially does
F Fast-absorbing gut –low initial tensile strength, PDSII high initial tensile strength, 50% at 4 weeks, 25% at 6 weeks
The initial tensile strength of Glycomer 631 (Biosyn) has not been studied
T Known at have 49% retained tensile strength at 3 weeks
Chromic gut has been treated with chromate salts which increases the rate of absorption in tissue.
F
Decreases rate of absorption
Chromic gut maintains its tensile strength for 10-21 days and is completely absorbed after approximately 90 days.
T
Chromic gut is best used to suture skin edges.
F Ligate vessels or suture mucosal wounds.
A history of chromate sensitivity does not preclude use of the chromic gut suture.
F
dont use if chromate sensitivity/allergy
Disadvantages to gut sutures include unpredictable absorption rates, low tensile strength, and increased tissue sensitivity.
T
Polyglycolic acid (Dexon) is a synthetic absorbable suture.
T
Polyglycolic acid is a non-braided suture.
F Braided multifilament suture.
Polyglycolic acid sutures can be coated with polycaprolate coating to reduce drag when pulled through tissues.
T
The polyglycolic acid suture retains 65% of tensile strength for 2 weeks after placement and 35% 3 weeks after implantation.
T
The polygycolic acid suture is completely resorbed between 30-60 days after placement.
F 60-90 days.
