Unit 10: sutures and hand ties Flashcards
What is a suture
A stitch or series of stitches made to secure the edges of a surgical or accidental wound in apposition
Noun → the material used to close a wound
Verb → to suture, the application of a stitch or stitches
What is the function of a suture
To hold tissues on apposition while healing takes place
Selection of the suture type and size is determined by
The purpose of the suture
Its biological properties in the tissue
The type and condition of the tissue it will be used on
What type of needles are there for sutures
Described by shape and point
Shape is described as that portion of a circle represented by the entire needle
Most common needle shapes used in vet med are
Curved – varying degrees of curvature can be found (ie: ⅜ circle; half circle)
Double curved – used in large animal surgery
Body means the configuration of the cross section
Described as round, triangular or flat
What are taper point needles used for
As a general rule, tapered needles may be used for all tissue closures except skin
What are the types of needle attachemnts
Swaged on refers to the suture material being attached directly to the needle without the use of an eye
The eyes are a further description of the character of the needle
French
Closed
What is the purpose of suture material
To hold together and support wound edges until wound can heal sufficiently
What are the characteristics of suture
Tensile strength
- Amount of force in psi that suture can withstand as an untied fiber before it breaks
Memory
- Ability or tendency of the suture to return to its original packaged form
Flexibility
- Ease at which suture is manipulated
Capilarily
- Ability of the suture to allow microbes to wick to the interior of the strand
Absorbability
- Absorbable vs nonabsorbable
Structure
- multifilament/braided vs monofilament
Knot security
- Some types of sutures hold knots better than others
- Braided generally has better knot security
Colour
- Some sutures are dyed, which makes them easier to see on the patient
What is the ideal suture material
No knot slippage
High tensile strength
Absorbable
Minimal tissue reactivity
Be easy to handle
Other things fo the surgeon to consider
Patient size
Area of placement
Healing potential of tissue
Cosmetic appearance
What are ligatures
A ligature is a loop of suture material around a blood vessel
When properly tied, functions to occlude lumen of the vessel
A transfixation ligature is one in which the suture material is passed through the middle of the vessel
It is first tied around the outside of the vessel and then around the entire vessel
Classification of suture materials
Absorbable or nonabsorbable
Natural or synthetic fibers
Multifilament or monofilament
How are sutures absorbed
Can be broken down by the body via different processes
Phagocytosis
- Leukocytes (usually neutrophils) are released and travel to the site of concern (incision) to ingest and destroy the foreign suture material
Hydrolysis
- The chemical compound in the suture is decomposed as it is exposed to water
Absorption may begin as soon as 7 days after placement
What influences the rate of suture absorbance
Inflammation
Infection
Vascularity of the tissue
What are the characteristics of non absorbable suture
Remain intact in the body for at least 2 years
Have a high tensile strength and most have a low tissue reactivity
What is multifilament suture
Also called braided suture
Has 2 or more strands braided together to form single strand of suture
What is monofilament suture
Single solid strand of suture material
Tends to have less tissue drag or friction than braided
What are common suture materials
Natural
- Fibers found in nature (eg., cotton, silk, “catgut”)
Synthetic
- Manufactured products (e.g, nylon, polyglactin 910)
Metallic
- Stainless steel (e.g., suture wire, staples)
