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Flashcards in 1: Suture Materials - Bennett Deck (35)
1

use of ____ sutures decrease foreign body volume with the sacrifice of knot pull strength

smaller

2

elasticity

ability to return to original length after applied strain

- stainless steel, braided polyester, catgut, silk

3

plasticity

elongation persist with cessation of strain
- polypropylene

4

intermediate b/w plastic and elastic

- possesses properties of both
- nylon, polyglactin 910

5

flexibility

based on material and diameter of suture
- small diameter is more flexible than large
- silk and dexon are more flexible than nylon and catgut

6

better suited for contaminated wounds

monofilament

7

higher coefficient of friction, greater strength, and capillarity

braided f

8

capillarity

- fluid and bacteria may penetrate into interstices of braided structure
- PMNs, macrophages are too large too reach interstices

9

coating

- helps decrease capillarity
- improves handling
- reduces drag

10

characteristics of handlign

- pliability
- tissue drag
- knot tying
- knot slippage

11

classification of non-absorbable surgical suture (I-III)

class I - suture composed of silk or synthetic fibers, monofilament or braided
class II - suture composed of natural or synthetic fibers but consisting of a coating
class III - suture composed of monofilament or multifilament metal wire

12

name the synthetic nonabsorbable surgical sutures

- nylon: dermalon, ethilon, nurolon, surgilon
- popypropylene: surgilene, prolene
- polybutester : novafil
- polyester: mersilene, dacron, polydeck, tevdek, ethibond, ticron

13

nylon, silk, polyester/polypropylene - which is resorbed more?

silk most (350 d)
polyester and polyrpropylene least (800 day +)

- even though structures remain in the body, they can loose tensile strength

14

relative tensile strength of non- absorbable sutures (greatest to least)

stainless steel wire
coated braided polyester
uncoated braided polyester
monofilament nylon
polybutester
braided nylon
polypropylene
natural fibers (silk, cotton, linen)

15

relative tissue reaction of nonabsorbable sutures (least to greatest)

monofilament polypropylene
monofilament polybutester
monofilament nylon
stainless steel wire
polybutilate-coated polyester
teflon/silicone-coated polyesters
uncoated braided polyester
natural fiber materials

16

when do absorbable structures lose tensile strength?

around 60 days
- natural are degraded by lysosomes, synthetic degraded by hydrolysis

17

natural absorbable sutures

catgut
collagen

18

polyglycolic acid/ dexon

- synthetic
- absorbable
- braided
- good tensile strength and knot pull
- inert
- may be coated
- skin and subcutaneous

19

polyglactin 910 / vicryl

- synthetic
- absorbable
- 65% tensile strength at 14 d
- completely hydrolyzed at 80 days
- may be coated with polyglactin 370 and calcium stearate

20

polyglyconate/maxon

- synthetic
- absorbable
- monofilament
- resists kinking and curling
- becomes softer with exposure to tissue fluid
- 70% tensile strength at 2 wk
- completely hydrolyzed at 180 d

21

poliglecaprone/monocryl

- synthetic
- absorbable
- monofilametn
- very pliable and inert
- hydrolyzed in 90-120 d
- 70-80% tensile strength at 14d

22

non-absorbable sutures gnereally maintain tensile strength longer than _____ d

60 days

23

silk

natural nonabsorbable
- handles well
- impregnated and coated in waxes
- low tensile strength
- highly tissue reactive

24

cotton/linen

- natural nonabsorbable
- similar to silk
- increased tissue rxn
- WEAKEST suture ie very low tensile strength

25

nylon (ethilon, surgilon)

- synthetic nonabsorbable
- possesses memory
- elastic
- high tensile strength
- low tissue reactivity
- monofilament or braided
- can be used in contaminated wounds

26

polyester (ethibond, dacron)

- synthetic nonabsorbable
- braided
- high tissue strength
- low tissue reactivity
- may be coated with silicone
-used when strong apposition of tissue needed

27

used when strong apposition of tissue needed

polyester (ethibond, dacron)

28

polypropylene (prolene, surgilene)

- synthetic nonabsorbable
- very inert
- monofilament
- pliabiilty and handling
- excellent tensile strength
- minimal tissue drag
- often used in contaminated wounds and plastics

29

used for bone fixation, tendon repair and retention sutures

stainless steel (flexon = braided)

30

stainless steel (flexon-braided)

- synthetic nonabsorbable
- monofilament and braided
- may corrode at stress points
- mild to moderate tissue reactivity
- may fracture, fatigue or kink
- used for bone fixation, tendon repair and retention sutures

31

most common suture attachment

swaged (Eyeless)
- suture attachment directly into needle
- decrease tissue damage

32

most common body length needle

1/2 circle

33

used for friable tissue

blunt point
ex: fat or granulation

34

used for paratenon, tendon sheath or subQ

tapered point
- useful for tissue with slight resistance

35

reverse vs. conventional cutting point

conventional
- cutting edge on concave
- cuts through dense tissue
- need to be careful

reverse
- cutting edge on convex
- prevents cutting through tissue
- greater strength

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