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What does the law state about LVT's suturing?
closures performed upon a diagnosis and pursuant to direct orders from a vet
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We use aseptic technique to prevent ____ during suturing
nosocomial infections
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Does the length of incision affect healing rate? How does an incision heal?
- no
- heals side - to - side, not end - to - end
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What can blood clots and hematomas do to the healing process?
prevents apposition of tissue and delays healing time
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How do we avoid tension on the sutured wound?
use retention sutures placed parallel to the incision
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What happens if the suture is too loose?
not apposed, delayed healing
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What happens if the suture is too tight?
- strangulates tissue (blood can't flow to tissue)
- suture breaks
- suture cuts through tissue
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What is a "throw"?
passing one strand of suture material over the other and pulling down
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What is a surgeon's knot?
has an extra loop on the first throw
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Why do we do a surgeon's knot?
to keep the suture from slipping
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How many throws should we do in order to secure a knot in synthetic suture material?
four or five
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What is a granny knot?
incorrect attempt at a square knot
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Why is it best to use instruments to tie knots?
can work in "holes" and use less suture material
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How do we use instruments to tie knots?
- only grasp the very ends of the suture, which will be cut off after the knot is formed
- the part of the suture held with the instrument should not be included in the loop of suture or in the knot
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Why should we never use an instrument to hold a knot as it is being tightened?
it will crush and weaken the suture and will make it more likely to break
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Where should the knot be on the suture?
to the side of the incision
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What are the two general types of patterns?
- interrupted suture patterns
- continuous suture patterns
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Sutures should be placed with an ____ on each side of the incision
equal bite
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Can we suture skin to skin? SQ to SQ? Muscle to muscle? Skin to SQ? Skin to muscle?
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What is an interrupted pattern?
the suture material is tied and cut after each stitch is placed
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What is the advantage to an interrupted pattern?
if one suture breaks, the entire suture line will not open
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What is the disadvantage to an inerrupted pattern?
- time-consuming
- results in a greater bulk of suture material - may cause an increased inflammatory reaction
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Which patterns are interrupted?
- simple interrupted
- mattress sutures (horizontal and vertical)
- cruciate stitch
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Out of the three interrupted patterns, which one will LVTs use the most?
simple interrupted
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What is a continuous pattern?
- uses running stitches to close the incision with knots placed only at the beginning and the end
- place one or two extra throws on these knots
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What are the advantages to a continuous pattern?
- takes less time to place
- less bulk of suture material in patient's body to cause an inflammatory reaction
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What are the disadvantages to a continuous pattern?
if one part of the suture material or knot breaks, the entire incision will become undone
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What are the different types of continuous patterns?
- simple continuous
- interlocking continuous
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Make your stitches as _____ and _____ as possible
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Who is going to judge you on the appearance of your suture line?
the client
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Which direction should the needle point?
towards yourself
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When we are tying a knot, how should we hold the suture material? Why?
- parallel to the surface
- makes the knot form better and keeps the tension even on each end of the suture
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What instruments do you need to suture?
- needle holders
- thumb forceps
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How should you hold the needle holders?
- hold in your dominant hand
- first and fourth fingers in the finger rings
- second and third finger to stabilize the shanks of the needle holder
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How should you hold the thumb forceps?
hold in your non-dominant hand and held in a modified pencil grip (like the dental tools)
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Where should you grasp the needle with the needle holders?
1/3 of the way from the swage or eye end to the tip
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Why should we not grap the tip of the needle with the needle holders?
it will damage the tip and can be traumatic to the patient
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Why should we not grasp the joint between the swage end and the suture material?
damages and breaks the suture
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Place the needle through the sking about _____ from the edge.
5 mm
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What kind of knot is this?
continuous interlocking
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What kind of knot is this?
continuous subcuticular
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What kind of knot is this?
cruciate stitch
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Which one is good, which one is bad?
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Which type of "tightening of the knot" is good and which one is bad?
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Which one is the correct way to place the needle holders on the needle?
the one to the far left...1/3 of the way down the needle
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Which type of knot is this?
horizontal mattress
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Which type is this?
simple continuous
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Which type is this?
simple interrupted
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What type of knot is this?
square knot
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What type is this?
vertical mattress
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