1: Suture Materials - Bennett

Question 1

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

Answer 1

smaller

Question 2

elasticity

Answer 2

ability to return to original length after applied strain

• stainless steel, braided polyester, catgut, silk

Question 3

plasticity

Answer 3

elongation persist with cessation of strain

- polypropylene

Question 4

intermediate b/w plastic and elastic

Answer 4

• possesses properties of both

- nylon, polyglactin 910

Question 5

flexibility

Answer 5

based on material and diameter of suture

• small diameter is more flexible than large
• silk and dexon are more flexible than nylon and catgut

Question 6

better suited for contaminated wounds

Answer 6

monofilament

Question 7

higher coefficient of friction, greater strength, and capillarity

Answer 7

braided f

Question 8

capillarity

Answer 8

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

Question 9

coating

Answer 9

• helps decrease capillarity
• improves handling
• reduces drag

Question 10

characteristics of handlign

Answer 10

• pliability
• tissue drag
• knot tying
• knot slippage

Question 11

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

Answer 11

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

Question 12

name the synthetic nonabsorbable surgical sutures

Answer 12

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

Question 13

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

Answer 13

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

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

Question 14

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

Answer 14

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

Question 15

relative tissue reaction of nonabsorbable sutures (least to greatest)

Answer 15

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

Question 16

when do absorbable structures lose tensile strength?

Answer 16

around 60 days

- natural are degraded by lysosomes, synthetic degraded by hydrolysis

Question 17

natural absorbable sutures

Answer 17

catgut

collagen

Question 18

polyglycolic acid/ dexon

Answer 18

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

Question 19

polyglactin 910 / vicryl

Answer 19

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

Question 20

polyglyconate/maxon

Answer 20

• 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

Question 21

poliglecaprone/monocryl

Answer 21

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

Question 22

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

Answer 22

60 days

Question 23

silk

Answer 23

natural nonabsorbable

• handles well
• impregnated and coated in waxes
• low tensile strength
• highly tissue reactive

Question 24

cotton/linen

Answer 24

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

Question 25

nylon (ethilon, surgilon)

Answer 25

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

Question 26

polyester (ethibond, dacron)

Answer 26

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

Question 27

used when strong apposition of tissue needed

Answer 27

polyester (ethibond, dacron)

Question 28

polypropylene (prolene, surgilene)

Answer 28

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

Question 29

used for bone fixation, tendon repair and retention sutures

Answer 29

stainless steel (flexon = braided)

Question 30

stainless steel (flexon-braided)

Answer 30

- 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

Question 31

most common suture attachment

Answer 31

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

Question 32

most common body length needle

Answer 32

1/2 circle

Question 33

used for friable tissue

Answer 33

blunt point | ex: fat or granulation

Question 34

used for paratenon, tendon sheath or subQ

Answer 34

tapered point | - useful for tissue with slight resistance

Question 35

reverse vs. conventional cutting point

Answer 35

conventional - cutting edge on concave - cuts through dense tissue - need to be careful reverse - cutting edge on convex - prevents cutting through tissue - greater strength