Wound Closure

Question 1

What are the 6 physical characteristics of sutures?

Answer 1

Diameter
Elasticity
Capillarity
Knot tensile strength
Physical configuration
Memory

Question 2

What is memory for a suture?

Answer 2

The tendency of suture to recoil to its original shape during packaging. Higher memory results in less knot security.

Question 3

What is elasticity for a suture?

Answer 3

The ability to regain original form and length after being stretched.

Question 4

What is knot tensile strength?

Answer 4

The force (measured in lbs) that the suture strand can withstand before it breaks when knotted.

Question 5

What is diameter?

Answer 5

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.

Question 6

What is capillarity?

Answer 6

Ability to soak up fluid along a strand.

Question 7

What is physical conficuration?

Answer 7

Monofilament is a single strand and multifilament has many strands.

Question 8

What is the coefficient of friction?

Answer 8

Rating the ability to glide through tissue and retain a knot.

Question 9

Sutures are classified in TWO main types:

Answer 9

Absorbable and Non-absorbable

Question 10

What are absorbable sutures?

Answer 10

Derived from collagen or synthetic polymer. Can be hydrolyzed by tissue during the healing process.

Question 11

What are non-absorbable sutures?

Answer 11

Derived from natural or synthetic material. No change to suture during the healing process. Can be encapsulated via inflammatory process and must be removed.

Question 12

Describe the two types of Natural Absorbable Sutures:

Answer 12

Surgical Gut and Collagen (“Chromic Gut”)

**These are packaged in fluid and can dry out!

Question 13

Characteristics of Synthetic Absorbable?

Answer 13

1. Dyed/Undyed
2. Monofilament/Multi-filament
3. Long Lasting (3 weeks-6 mo)

Monocryl, Vicryl, PDS, PDS II

Question 14

What are four types of Natural Non-absorbable Sutures?

Answer 14

1. Silk
2. Cotton
3. Linen
4. Steel

Question 15

Steel

Answer 15

Used in orthopedics, may also be used in the presence of infection.

Question 16

Linen

Answer 16

Tensile strength is inferior to other nonabsorbables; used for GI

Question 17

Surgical Cotton

Answer 17

Weakest of all the nonabsorbable material choices. Gains strength when wet.

Question 18

Dermal silk

Answer 18

Strands are encased in gelatin or protein substance; used for skin sutures

Question 19

Virgin silk

Answer 19

Compsoed of natural fibers; opthalmic surgery

Question 20

Surgical silk

Answer 20

Gives good support during early ambulation and promotes rapid healing; used to close fascia when no infection is present.

Question 21

What are the advantages of synthetic nonabsorbable sutures?

Answer 21

Higher tensile strength
Less tissue reaction
Material retains its strength in tissue

Question 22

What are the disadvantages of synthetic nonabsorbable sutures?

Answer 22

knot tying is difficult cuz it’s slick

Question 23

What are the three forms of surgical nylon?

Answer 23

1. Monofilament
2. Coated
3. Uncoated

Question 24

Surgical nylon is also known as….?

Answer 24

Synthetic nonabsorbable suture.

Question 25

Monofilament example

Answer 25

Ethilon

Question 26

Uncoated example

Answer 26

Neurolon

Question 27

Top guidelines when handling synthetic polymers:

Answer 27

1. Handle as LITTLE as possible.
2. NO PULLING or STRETCHING
3. DO NOT use instruments to aid in tying
4. Use a SPECIAL KNOT
5. Multifilament is easier to tie than monofilament.