Unit 2- Suture Patterns

Question 1

Interrupted Patterns

Answer 1

Series of sutures, more secure in case of failure, allows for tension adjustment, uses more suture, takes more time

Question 2

Continuous Patterns

Answer 2

Only 2 knots, more risk of failure, less control of tension, time efficient, less suture in wound, tighter closure

Question 3

Interrupted Suture Start

Answer 3

Start nearest your dominant hand, at or beyond corner of incision, top of incision

Question 4

Continuous Suture Start

Answer 4

At or just beyond corner of incision

Question 5

Distance from incision for bites

Answer 5

3-5mm

Question 6

Distance between sutures

Answer 6

5-8mm

Question 7

Appositional Patterns

Answer 7

No tension, best anatomical approximation, fastest healing, best cosmetic result

Question 8

Simple Interrupted

Answer 8

Interrupted and appositional, normal tension on edges, minimal impact to local blood supply

Question 9

Simple Interrupted Uses

Answer 9

Close skin, SQ, body wall, ligate vessels or nerves

Question 10

Simple Continuos

Answer 10

Continuous and appositional, larger effect on blood supply than interrupted, air and water tight, excessive tension leads to tissue strangulation, risk of failure

Question 11

Simple Continuous Uses

Answer 11

Close SQ, body wall, hollow organ incisions, and skin

Question 12

Cruciate

Answer 12

Interrupted and appositional, stronger closure and larger effect on blood supply than simple interrupted, resists tension and prevents inversion, should not be used with concerns of tension

Question 13

Cruciate Uses

Answer 13

Skin and body wall

Question 14

Ford Interlocking

Answer 14

Continuous and appositional, security in event of failure, similar effect on blood supply as simple continuous, can cause pressure necrosis or become buried

Question 15

Ford Interlocking Uses

Answer 15

Used in bovine, do not tighten too much in small animal

Question 16

Intradermal

Answer 16

Continuous and appositional, diminishes tension on skin closure, modified simple continuous, minimal impact on local blood supply

Question 17

Burying the Knot

Answer 17

Avoid having knots protruding, prevents access of dirt and bacteria to deeper layers

Question 18

Inverting Patterns

Answer 18

Turns edges inward, used in large lumen hollow organs, serosa-serosa apposition forms water tight seal, minimizes adhesion

Question 19

Suturing Hollow Organs

Answer 19

Tunica submucosa is the holding layer

Question 20

Hollow Organ Suture Complications

Answer 20

Dehiscence, calculi or stone formation, adhesions

Question 21

Single Layer Closure

Answer 21

Partial or full thickness

Question 22

Double Layer Closure

Answer 22

Inner first layer and outer second layer

Question 23

Stomach Double Layer Closure

Answer 23

First layer appositional and second layer inverting

Question 24

Urinary Bladder Closure

Answer 24

Single layer inverting or double layer

Question 25

Intestine Closure

Answer 25

Appositional pattern

Question 26

Lembert Pattern

Answer 26

Continuous and inverting, partial thickness, continuous or interrupted, single or double layer closure

Question 27

Lembert Uses

Answer 27

GI surgery, large lumen hollow organs

Question 28

Cushing Pattern

Answer 28

Continuous and inverting, partial thickness, start on side of dominant hand, used with a 2 layer closure

Question 29

Cushing Pattern Uses

Answer 29

Hollow viscera: urinary bladder, stomach, uterus

Question 30

Connell

Answer 30

Continuous and Inverting, full thickness, can only be used as first layer in 2-layer closure, followed by cushing or lembert

Question 31

Connell Uses

Answer 31

Urinary bladder, stomach, uterus

Question 32

Purse String

Answer 32

Continuous and inverting, partial thickness, used for wound care

Question 33

Purse String Uses

Answer 33

Hollow organ viscera, close anus during perineal surgery, maintain prolapse reduction, close defect in hollow organ wall

Question 34

Finger Trap

Answer 34

Secures tubes to the patient

Question 35

Everting Patterns

Answer 35

Turn edges out, sutures edges under tension, can lead to delayed healing

Question 36

Tension Relieving Patterns

Answer 36

Decreases tension on suture line, used in tissues with slow healing

Question 37

Vertical Mattress

Answer 37

Interrupted and tension relieving, commonly used with stents, less effect on blood supply and less eversion than horizontal

Question 38

Horizontal Mattress

Answer 38

Interrupted and tension relieving, commonly used with stents, can evert, greater impact on blood supply than vertical mattress