Wound Closure Flashcards
What are the 6 physical characteristics of sutures?
Diameter Elasticity Capillarity Knot tensile strength Physical configuration Memory
What is memory for a suture?
The tendency of suture to recoil to its original shape during packaging. Higher memory results in less knot security.
What is elasticity for a suture?
The ability to regain original form and length after being stretched.
What is knot tensile strength?
The force (measured in lbs) that the suture strand can withstand before it breaks when knotted.
What is diameter?
Distance in mm. Expressed in USP sizes with zeros. Smaller cross-diameter size is indicated by more zeroes while larger is indicated by fewer zeros.
What is capillarity?
Ability to soak up fluid along a strand.
What is physical conficuration?
Monofilament is a single strand and multifilament has many strands.
What is the coefficient of friction?
Rating the ability to glide through tissue and retain a knot.
Sutures are classified in TWO main types:
Absorbable and Non-absorbable
What are absorbable sutures?
Derived from collagen or synthetic polymer. Can be hydrolyzed by tissue during the healing process.
What are non-absorbable sutures?
Derived from natural or synthetic material. No change to suture during the healing process. Can be encapsulated via inflammatory process and must be removed.
Describe the two types of Natural Absorbable Sutures:
Surgical Gut and Collagen (“Chromic Gut”)
**These are packaged in fluid and can dry out!
Characteristics of Synthetic Absorbable?
- Dyed/Undyed
- Monofilament/Multi-filament
- Long Lasting (3 weeks-6 mo)
Monocryl, Vicryl, PDS, PDS II
What are four types of Natural Non-absorbable Sutures?
- Silk
- Cotton
- Linen
- Steel
Steel
Used in orthopedics, may also be used in the presence of infection.
Linen
Tensile strength is inferior to other nonabsorbables; used for GI
Surgical Cotton
Weakest of all the nonabsorbable material choices. Gains strength when wet.
Dermal silk
Strands are encased in gelatin or protein substance; used for skin sutures
Virgin silk
Compsoed of natural fibers; opthalmic surgery
Surgical silk
Gives good support during early ambulation and promotes rapid healing; used to close fascia when no infection is present.
What are the advantages of synthetic nonabsorbable sutures?
Higher tensile strength
Less tissue reaction
Material retains its strength in tissue
What are the disadvantages of synthetic nonabsorbable sutures?
knot tying is difficult cuz it’s slick
What are the three forms of surgical nylon?
- Monofilament
- Coated
- Uncoated
Surgical nylon is also known as….?
Synthetic nonabsorbable suture.
Monofilament example
Ethilon
Uncoated example
Neurolon
Top guidelines when handling synthetic polymers:
- Handle as LITTLE as possible.
- NO PULLING or STRETCHING
- DO NOT use instruments to aid in tying
- Use a SPECIAL KNOT
- Multifilament is easier to tie than monofilament.
