A/S - sutures
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- What are 4 porposes of sutures?
- ligate, secure drains, temp closure of an orifice, closure of wounds
- Although there isn't one, what would the properties of an ideal suture material be (8)?
- non-reactive, easy to handle, monofilament, easy to sterilize, high knot strength, lack of memory, absorbs in a predictable manner, economical
- RE suture sizes, the suture does not need to be any stronger than the ___ on which it is used.
- tissue
- Re: suture material, the knot security ___ as the size increases.
- decreases
- If suture sizes are 2,1,0,2-0,3-0,4-0, whic h is the thinnest?
- 4-0, finest avail is 9-0
- What are two types of sutures?
- absorbable and non-absorbable
- What are three features of absorbable suture material?
- digested and assimilated by the body, doesn't req suture removal, produces some degree of tissue reaction
- What are 3 situations in which absorbable suture material may be used?
- Internal sutures, when animal is factious, in an area where removal would be difficult (near eye)
- Name 4kinds of absorbable suture material
- Surgical/CAT gut, PGA, PLA, PDS
- What does CAT stand for?
- Chromic-Acid Treated
- What is surgical/CAT gut made from?
- submucosal layer of sheep or hog intestine
- Why is CAT gut treated w/ chromic acid?
- prolong absorption time, decrease soft tissue reaction
- How long does it take plain gut to absorb? CAT gut?
-
plain - 3-5 days
CAT - 10-15 day - What are some advantages of surgical/CAT gut?
- easy to handle, ties well: good knot security, economical
- What are some disadvantages ofsurgical/CAT gut?
- hydroscopic(swells), tissue reaction, strong capillary reaction
- What is PGA suture material?
- Polyglycolic Acid (Dexon), aborbable, is a synthetic suture made in fine threads then woven into suture material of different guages.
- How long does PGA retain its strength?
- 2-3 weeks
- What are some advantages of PGA? disadvantages?
-
handles well, low tissue reaction
knotslippage, high tissue drag - What is PLA?
- Polygalactica 910 (Vicryl or Polymend) - similar to PGA, synthetic, braided or monofilament, retains strength 3 weeks absorbed in 90 days
- What is PDS? Unique feature?
- Polydioxanone (Monomend), synthetic monofilament, longest lasting absorbable suture avail
- What are some advantages of PDS? disadvantages?
-
+ - low tissue drag, good retention of strength, monofilament, long lasting
- expensive, high memory, knot slippage - What are 6 kinds of non-absorbable suture materials?
- silk, nylon, polypropylene, polyester fibers, ploymerized caprolactam, metal
- What are the four groups of non-absorbable suture materials?
- silk & cotton, braided synthetics, monofilament synthetics, metal
- What happens to non-aborbable sutures if they are burried?
- become encysted
- Why is braided silk usually preferred over monofilament?
- stronger and easier to handle
- +/- of silk?
-
+ high tensile strength, easy to handle, excellent knot stability, inexpensive, easy to sterilize
- capillary action, mod high tissue reaction - What are silk sutures used for?
- cardiovascular & ophthalmic surgery
- What is a general disadvantage for all synthetic non-absorbable suture materials?
- Req many throws due to poor knot security
- What synthetic non-absorbable suture material has many uses including skin and fascia?
- polypropylene (Prolene)
- What synthetic non-absorbable suture material are teflon or silicon coated?
- Polyester fibers (Mersilene, Dacron)
- What synthetic non-absorbable suture material is a twisted synthetic fiber w a smooth coating & is dispensed on a roll w/o a needle attached?
- Polymerized caprolactam (Vetafil)
- What synthetic non-absorbable suture material is made of surgical stainless steel?
- metal
- What suture materials are destroyed by autoclaving?
- gut, PDS, PLA, PGA (absorbables)
- What suture materials experience a decrease in strength when autoclaved?
- nylon, polyester, polypropylene
- Autoclaving is safe for what type of suture material?
- metal
- What sterilization methods are safe for all suture materials?
- Ethylene Oxide (gas), radiation (not common)
- What are two types of needle points?
- trocar and blunt
- What are three types of needle bodies?
- taper, cutting, reverse cutting
- what are 6 needle shapes?
- 5/8 circle, 1/2 circle, 3/8 circle, 1/4 circle, 1/2 curve, straight
- What are two needle attachment methods?
- Eyed, swaged (pre-attached)
- The lower the number, the ___ the needle
- larger
- What are the two basic suture pattern types?
- interrupted and continuous
- Explain interrupted suture pattern
- Sutures that are tied or cut after one or two passages through the tissue
- Explain continuous suture pattern
- multiple passages through the tissue running from point of origin to some point distant, w/ a knot at each end
- What are some advantages of an interrupted suture pattern?
- maintains strength and tissue apposition if part of suture line fails, technique for each suture is easy & rapid
- What are some disadvantages of an interrupted suture pattern?
- uses more material, takes more time to complete suturing, increased foreign material in the body
- What are some advantages of a continuous suture pattern?
- ease of application, minimal suture material, easy to remove, more rapid closure of incisions
- What is the disadvantage of a continuous suture pattern?
- entire line breaks down if one component fils
- Name 4 kinds of interrupted suture patterns
- simple interrupted, horizontal mattress, vertical mattress, cruciate
- Name 6 kinds of continuous suture patterns
- simple continuous, Ford interlocking (blanket stitch), Lembert, Cushing, Connell, Cushing-Lembert (Parker-Kerr)
- What are special tension-relieving sutures?
- used when normal suture patterns would be subject to excessive tension or pressure (Stent & quill, Bunnell, Cerclage, Hemicerclage)
- What are subcuticular sutures?
- continuous horizontal suture pattern w/ the suture hidden w/i the dermis
- What are subcutaneous sutures?
- simple interrupted or continuous pattern used to close the fat layer below the skin