The body sees suture material as a ____ ______ and may _______.
-foreign material -react
The degree of tissue reaction to suture material is based on what four factors?
1. Type of material 2. Type and location of tissue 3. Presence of infection 4. Individual's immune system
List some qualities of the ideal suture material (7)
1. Monofilament 2. Small size with high tensile strength 3. Completely absorbable 4. Inexpensive 5. Easily manipulated 6. Good knot security 7. No tissue reaction
What are the three parameters that define suture materials?
1. Braided vs. Monofilament 2. Absorbable vs. Nonabsorbable 3, Synthetic vs. Natural Origin
Why is braided suture material different from monofilament?
1. Braided has more tissue drag 2. Braided is made of individual fibres braided together while monofilament is made of one strand 3. Monofilament has a decreased chance of wicking infection into tissues (braid wicks)
When is absorbable suture material used?
When sutures are buried in the body and removal isn't possible
Non-absorbable suture material is used in the ______ it must be _______, Is there ever a time it is used in the body?
-skin -removed -Only time it's used in the body is as a support mechanism (i.e. stabilizing joints)
Natural suture material supports _______ ________. Is it expensive?
-Bacterial growth -No
Cat gut is actually _____ gut, is it absorbable?
Is silk absorbable? Is it braided?
which are the two braided suture materials? which one is occassionally braided?
vicryl and silk -stainless steel
list the three natural suture materials
1. plain catgut 2. chromic catgut 3. silk
Which of the suture materials are non-absorbable? (5)
1. Simple continuous 2. Subcuticular 3. Ford Interlocking
One of the most important parts of the suture is the ______, why?
-Knot -If the knot fails the suture will fail
If the knot fails the _____ will fail, this is especially critical with ___________ patterns, why?
-Suture -Continuous -Because they only have one knot at either end
In order for a knot to hold it must be a _____ knot and not a _____ knot or a ________
-Square -Granny -half hitch
For knot security it is recommended that there are at least ____ _________ knots or _______ put together as _____ _______ knots
-four simple -throws -two square
A _______ knot creates more fiction due to the _____ _____ on the _____ throw and can aid in ensuring correct _______ of the suture
-Surgeon's extra twist -first -tightness
Simple Knot aka _____
Sutures should only be removed when what two things have occurred?
Tissues are 1. Healed 2. Have good strength
What is important to remember when removing sutures?
It is important not to drag contaminated surface suture material back into the wound.
When removing sutures use ______ ______ and cut where while holding what?.... never do what?
-Suture scissors -While holding the suture ends or the knot with a dressing forcep or your fingers -Never cut the knot
Reverse cutting needle ( flat edge in direction of pull, sharp edge toward wound)
What is the benefit of a reverse cutting needle compared to the cutting needle and where in the body are they used most?
A reverse cutting needle has a sharp edge on the outer curve of the needle that is directed away from the wound edge, which reduces the risk of the suture pulling through the tissue which may happen with a cutting needle whose sharp edge is toward the wound. For this reason, the reverse cutting needle is used more often than the cutting needle in cutaneous surgery
Subcuticular pattern (continuous under the skin in the subcutaneous layer)