Sx Suture Flashcards
Function of suture
Hold tissue in apposition until wound healing progresses
Suture properties (4)
Tensile strength
Knot strength
Pliability
Capillarity
Tensile strength
Sutures ability to resist breakage
Suture should be as strong as the tissue
Larger size= inc TS
Knot strength
amount of force necessary to cause a knot to slip or break
Related to coefficient of friction
Knot is weakest point
Pliability
Ease of handling
Related to material and size
Capillarity
Process which fluid or bacteria is wicked along suture
Allows infection to persist in the suture
Avoid in infected tissue
Absorbable
Looses most of its tensile strength by 60 days
Mechanism of absorption of suture
hydrolysis
Enzymatic
Factors affecting absorption rate
Material
coating
size
biochemical environment (urine, pH, infection)
Non-absorbable
Retains tensile strength longer than 60 days
natural or synthetic
Braided or monofilament
Suture structure
Braided, twisted or monofilament
Suture coating funtion
Decreases tissue drag
Increases pliability
Suture coating option
Teflon, silicone, wax, calcium stearate,
Antibiotic coating- triclosan
Catgut
Natural/absorbable Twisted Derived from small intestine of cattle Plain or chromic Inflammatory Unpredictable enzymatic absorption Short TS duration
Polyglactin 910- vicryl
Braided multifilament
Coated for handling
Absorbed by hydrolysis
Vicryl
TS for 14-21 days
Rapidly degraded in infected urine
Ophthalmic surgery
Vicryl Plus
Tricolasan coating
Anitmicrobial
Infected wounds
Vicryl Rapid
Irradiated form
0% TS in 2 weeks
Dental surgery
Polyglycolic Acid- Dexon
Braided Multifilament Absorbed by hydrolysis Rapidly degraded in infected urine TS for 14-21 days Coated or uncoated
Poliglecaprone 25- Monocryl
Monofilament absorbable Hydrolysis TS for 7-14 days Regular or AB coated Used for non infected bladders/SC tissue
Polyglytone 6211- Caprosyn
Absorbable monofilament
TS 0% at 14-21 days
Hydrolysis
Used for noninfected bladders/SC tissue
Glycomer 631- Biosyn
Monofilament absorbable
Hydrolysis
Maintains strength for 21 days
Many uses: enterotomy, cystotomy, body wall, SC
Polyglyconate- Maxon
Absorbable monofilament
Maintains strength for 6 weeks
Hydrolysis
Similar to PDS
Polydioxanone- PDS
Absorbable monofilament Hydrolysis 50% TS at 6 weeks Similar to Maxon Many uses
Braided- absorbable
Polyglactin 910- Vicryl rapid
Polyglactin 910- Vicryl
Polyglycolic acid- Dexon
Monofilament- absorbable
Poligelcapron 25- monocryl Polygytone 6211- Caprosyn Glycomer 631- Biosyn Polydioxanone-PDS Polyglyconate- Maxon
Silk
Natural/nonabsorb Braided Very inflammatory Excellent handling Cardiovascular surgery
Stainless steel
Natural/nonabsorb monofilament or twisted multifilament Highest TS Best knot security Non inflammatory very poor handling Orthopedic uses Skin staples
Polypropylene- Prolene
Synthetic/nonabs Monofilament Very high TS Low reactivity Used where need for prolonged strength -tendons -ligaments -joint capsules
Nylon- Ethilon
Synthetic/non-abs Monofilament Low reactivity High TS Poor handling Used for skin closure and orthopedic repair
Polymerized Caprolactam Vetafil
Synthetic/nonabs Twisted multifilament High tissue reactivity Good handling Used for skin only Implantation leads to sinus formation
Polyester- Ethibond
Synthetic/nonabs Braided multifilament Good TS Coated Poor knot security High tissue reactivity Musculoskeletal surgery
Straight Needle
Can be used for tension relieving sutures on skin because more room to work
Curved Needle
Most commonly used in small animals
J needles
Combination of curved and straight
Cutting needle
Cutting surface on concave side
Increased risk of suture pull through
Reverse cutting needle
Cutting surface on convex side
typically used for skin
