Suture & Needles

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Suture & Needles
2012-04-11 13:16:16
Clinical Practice

Clinical Practice
Show Answers:

  1. What are sutures?
    any material that hold tissues together until they heal.
  2. What are some uses for suture material?
    • appose tissue edges
    • stabilize joints
    • strenthen weat tissue (hernia)
    • ligate blood vessels
  3. What are the ideal characteristics of suture material?
    • non-reactive in tissue
    • easy to handle
    • monofilament
    • able to be sterilized
    • high tensile strength
    • inexpensive
    • maintain know without slipping
    • hold tissue until healing occurs
  4. How long does it typically take for tissue to heal together?
    30 - 60 days
  5. Does the ideal suture material that meets all the characteristics exist?
  6. How is suture material supplied?
    • individually packaged with swaged on needle
    • bulk containers
  7. Is the knot the weakest point of the stitch?
  8. What are the different classifications of suture materials?
    • absorbable/nonabsorbable
    • multifilament/monofilament
    • natural/synthetic
  9. How long does it take for absorbable sutures to break down?
    60 days
  10. Do non-absorbable sutures weaken over time?
  11. Do non-absorbable sutures have to be removed?
  12. What is multifilament?
    made of many strands (braided or twisted together)
  13. What are some advantages to multifilament?
    • strong
    • handles well
    • holds knots well
    • easy to work with
  14. What are some disadvantages to multifilament?
    • tissue reactions
    • more "drag" through tissue (traumatic)
    • prone to infections
    • harbor bacteria in crevices
    • capillary action can pull bacteria along crevices
  15. What is monofilament?
    one single smooth strand
  16. What are some advantages to monofilament?
    • less "drag" - pulls through tissue easily (less traumatic)
    • less bacterial hiding places
    • less prone to infections
  17. What are some disadvantages to monofilament?
    • does not handle well
    • has "memory" - tries to return to its original shape - package shape
  18. Does monofilament hold knots well?
    • no
    • takes many "throws"
    • big bulky knots
  19. What are some natural materials used for sutures?
    • gut
    • silk
    • cotton
    • linen
  20. Are natural materials more likely to cause tissue reactions?
  21. What does synthetic suture material avoid?
    variations in strength, absorption rates, and tissue reactions
  22. What are the different types of suture materials?
    • surgical gut
    • Vicryl
    • silk, cotton, linen
    • nylon
    • Prolene
    • Vetafil, Braunamid
    • stainless steel
  23. What is another name for surgial gut?
  24. Is surgical gut abosrbable?
  25. Is "Catgut" really made from cat guts? How did it get its name?
    • no
    • name comes from "kit gut" - fiddle strings
    • or "kid gut" - young goat
  26. What part of the gut is used and what animals does it come from?
    • intestinal submucosa, collagen
    • cattle, hogs, sheep
  27. What are the two types of gut?
    • plain gut
    • chromic gut
  28. Does plain gut break down more quickly than chromic gut?
  29. How long does it take for the body to absorb plain gut?
    3 - 5 days
  30. What does chromic gut look like?
    tanned with chromic acid salts
  31. Chomic gut decreases what?
    tissue inflammatory reaction
  32. How long does it take for chromic gut to resorb?
    10 - 15 days
  33. How does infected tissue affect the use of gut?
    • breaks down gut faster - especially plain gut
    • causes dehiscence
  34. What is Vicryl?
    synthetic absorbable multifilament
  35. What is PDS/PDS II?
    synthetic absorbable monofilament
  36. How long does it take PDS/PDS II to fully absorb?
    6 months
  37. What kind of tissue reaction does PDS/PDS II have?
    mild tissue reaction
  38. What is Dexon/Maxxon?
    braided absorbable
  39. What is silk?
    natural non-absorbable multifilament
  40. Does silk cause tissue reaction?
  41. Is silk commonly used now?
  42. Is silk easy to handle?
  43. What is cotton and linen?
    natural non-absorbable multifilament
  44. What is nylon?
    synthetic non-absorbable monofilament or multifilament
  45. Does nylon cause a tissue reaction?
  46. Is nylon easy to handle? Why or why not?
    no - slippery and springy
  47. What is prolene?
    synthetic non-absorbable plastic - similar to nylon
  48. Is prolene easy to handle?
  49. Does prolene weaken? What is it good for?
    • no it does not weaken
    • good for permanent support
  50. What is Vetafil and Braunamid?
    synthetic nonabsorbable fibers coated with plastic?
  51. Can we use Vetafil or Braunamid in the body? Why or why not?
    • no
    • can cause infection
  52. What is stainless steel?
    non-absorbable monofilament or multifilament
  53. What is stainless steel good for?
    infected, stressed, slow healing tissue
  54. What are the different suture sizes?
    • 9-0 to 3
    • small to large diameter
  55. What does "ought" mean?
  56. The higher the "ought" number, the ______ the diameter.
  57. The higher the number without an "ought", the _____ the diameter?
  58. What size suture should we use for weaker tissue?
    smaller size
  59. What size suture should we use for stronger tissue?
    larger size
  60. What happens if the suture size is too big?
    • may overtighten and strangulate tissue
    • has less secure knots
  61. What happens if the suture size is too small?
    • break down
    • dehisce
  62. What does dehiscence mean?
    to burst open
  63. How do you bury knots?
    cut ends as short as possible without unraveling
  64. The more suture material is buried, the more _____.
    tissue reaction
  65. When we are doing skin sutures, how much should be left for easy removal?
    0.5 to 1.0 cm
  66. Why should skin sutures be uniform in length?
    owners judge by appearance
  67. What does an inflammatory reaction look like caused by sutures?
    • general swelling around incision
    • tiny bumps where suture passes through skin
  68. What is the ranking from the most to least reactive suture materials?
    • 1. plain gut
    • 2. chromic gut
    • 3. natural multifilaments (silk, cotton, linen)
    • 4. synthetic multifilaments (Vicryl)
    • 5. synthetic monofilaments (nylon, Prolene, PDS)
    • 6. stainless steel
  69. Will the precense of an infection cause the sutures to break down faster?
  70. What are the different parts to a needle?
    • point
    • shaft
    • eye
  71. What are the different needle shapes?
    • straight
    • curved
  72. What are the different point designs?
    • cutting
    • reverse cutting
    • taper
  73. What does the cutting point look like?
    • triangular cross section
    • point of triangle on inside of curve
  74. What does the cutting point do?
    leaves hole in tussue larger than suture material
  75. What does the reverse cutting point look like?
    • triangular cross section
    • point of triangle is on outside of curve
  76. What does the reverse cutting point do?
    leaves hole in tissue larger than suture material
  77. What does the taper point look like?
    • round in cross section
    • hole is not larger than suture material
  78. What is the taper point more commonly used on?
    internal structures, organs
  79. What is the cutting and reverse cutting points used for?
  80. How do we thread the suture material through the eye?
    pass suture through once, from inside the curve
  81. What are swaged needles?
    • eyeless
    • disposable
    • individually packaged
    • more expensive
    • less traumatic
  82. When can swaged needles become a problem?
    if you accidently cut the suture, you can not thread it back through
  83. What are the different needle sizes?
    • sizes 0, 1, 2 (large coarse needles)
    • sizes 17, 18, 19 (small coarse needles)
    • sizes 14, 15, 16 (commonly used in SA surgery)