Term
| What is a swaged suture needles? |
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Definition
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Term
| When do we use blunt suture needles? |
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Definition
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Term
| When do we use tapered suture needles? |
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Definition
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Term
| What is the difference between a cutting and reverse cutting suture needle? |
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Definition
-cutting has a cutting edge on the concave side
-reverse cutting has a cutting surface on the convex side |
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Term
| What is the advantage of a reverse cutting suture needle over a cutting suture needle? |
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Definition
| -has less risk of needle hole elongation and suture pull through |
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Term
| What are the major suture characteristics that we are concerned with? |
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Definition
-sterility
-uniform diameter and size
-pliability
-uniform tensile strength
-minimal tissue irritation/reaction
-minimal tissue drag
-good knot security
-freedom from impurities |
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Term
| Describe the range of suture sizes. |
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Definition
| -12-0 (smallest) to 5 (largest) |
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Term
| True or False: Because we cause trauma during surgery, we select the size of suture that will best accomodate the traumatic tissue. |
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Definition
| -FALSE, choose size that healthy tissue would need |
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Term
Describe monofilament and multifilament suture types based on the following characteristics:
a) composition
b) catasstrophic damage
c) tissue drag
d) strength
e) pliability
f) capillarity
g) knot security
h) infection risk |
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Definition
a) monofiliment = single & multifilament = braided or twisted
b) monofilament = more susceptible
c) mono < multi
d) mono < multi
e) mono < multi
f) mono < multi
g) mono < multi
h) mono < multi |
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Term
| When does absorbable suture lose strength? HOw is it broken down? |
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Definition
-loses strength in < 60-90 days
-broken down by phagocytosis (catgut) or hydrolysis (rest of them) |
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Term
| What suture is a natural absorbable suture? |
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Definition
-catgut
-made from submucosa of sheep, serosa of cattle |
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Term
| Which of the synthetic absorbable sutures are rapidly absorbed? |
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Definition
-Vicryl (polyglactin 910)
-Decon (polyglycolic acid)
-Monocryl (poliglecaprone) |
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Term
| Which of the synthetic absorbable sutures are slowly absorbed? |
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Definition
-PDS (polydioxanone)
-Maxon (polyglyconate)
-Biosyn (glycomer 631) |
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Term
| Which of the absorbable suture types are monofilament? |
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Definition
-Poliflecaprone (Monocryl)
-Polydioxanone (PDS II)
-Polyglyconate (Maxon)
-Glycomer 631 (Biosyn) |
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Term
| Which of the absorbable suture types are multifilament? |
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Definition
-Catgut
-Polyglycolic acid (Dexon)
-Polyglactin 910 (Vicryl) |
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Term
| Which of the absorble sutures are long term? Medium term? SHort term? |
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Definition
-L: PDS / Maxon
-M: Monocryl, Vicryl, Dexon, Biosyn
-S: Catugut, Caprosym |
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Term
| Which of the absorbable sutures has high, moderate, and low knot security? |
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Definition
-H: Dexon, Maxon
-M: vicryl, caprosyn, monocryl, biosyn, PDS II
-L: catgut |
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Term
| What is the major clinical concern with catgut? HOw is it avoided? |
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Definition
-incites an inflammatory response (also not uniform in diameter)
-add chromic salts as a coating: delays absorption and dec inflammation |
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Term
| When do we use catgut suture? |
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Definition
-temporary stay suture, ligation of small vessels, suturing mucosa
-absorbable multifilament that is weak |
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Term
| When is the only time we use multifilament? |
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Definition
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Term
Which monofilament do you choose for the following locations?
a) SI
b) infected urinary bladder closure
c) LI
d) vessel ligation
e) linea alba |
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Definition
a) long term
b) medium/ long term
c) long term
d) short/ medium term
e) long term |
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Term
| Which of the nonabsorbable sutures are monofilament? Multifilament? |
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Definition
-Mono: Polypropylene (Prolene) Nylon (Ethilon), Polybutester (Novafil)
-Multi: Silk, Polyester (Ethibond), Polytetrafluoroethylene (Gora-tex) |
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Term
| What are our four major concerns when selecting a suture pattern? |
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Definition
-want to maintain tensile strength throughout the healing process
-suture technique should be simplest and quickest
-maintain precise wound edge approximation
-blood supply is inversey proportional to wound closure tension |
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Term
| What are the two classifications on suture patterns? How about the three ways in which they can affect the wound margin? |
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Definition
-interrupted or continuous
-appositional, inverting, or everting |
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Term
| What are the advantages and disadvatnages of an interrupted suture pattern? |
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Definition
-Advantages: more precise apposition, allows point adjustment of tension, failure of one knot does not mean failure of entire closure
-Disadvantages: takes longer, uses more suture, more expensive, less tight seal |
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Term
| What are the advantages and disadvantages of a continuous suture pattern? |
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Definition
-Advantages: quicker, evenly distributed tension, better seal, uses less suture
-Disadvantages: failure of knot means complete cailure, suture must be handled cautiously |
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Term
| What are the three inverting suture patterns? What are they used for? |
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Definition
-Cushing (extends only to submucosa), Connell (enters lumen), Lembert (version of a verticl mattress)
-used to close stomach and uterus |
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Term
| What are the types of everting suture patterns? When are they used? |
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Definition
-horizontal and vertical mattress, Halsted
-used on skin and fascia (Areas of tension) |
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Term
| Is vertical or horizontal mattress stronger? |
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Definition
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Term
| Is horizontal or vertical mattress better for healing? |
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Definition
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Term
| What is the weakest point of a suture? |
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Definition
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Term
| What are the 4 components of knot security? |
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Definition
-multi is better
-length of cut ends
-more security with smaller size
-sturctural configuration: square knot is better |
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Term
| When do you use a surgeon's knot? |
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Definition
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Term
| Is a square knot or surgeon's knot stronger? |
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Definition
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Term
| What are the advantages and disadvantages of skin staples? |
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Definition
-Advantages: easy application, fast, better tissue oxygenation, minimum reaction
-Disadvantages: scar, cost, get everion, difficult to remove |
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Term
| What do we use for tissue adhesives? |
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Definition
| -Cyanoacrylates: N-butyl and isobutyl-2 |
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Term
| True or FAlse: We do NOT place tissue adsive between skin edges. Why or why not? |
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Definition
-TRUE
-leads to granuloma formation, dehiscence, and inflammation |
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