Chapter 16 Suture material, tissue staplers, ligation devices, and closure methods

Question 1

How many suture throws to start a continuous pattern with PDS

Answer 1

5 throws at the start or end

Question 2

Tensile strength of vicryl (polyglactin 910) after 2 weeks

Answer 2

50% of its tensile strength at 2-3 weeks

Question 3

Strength of monocryl (poliglecaprone 25)

Answer 3

Loses 50% of tensile strength at 1-2 weeks and 70-80% at 2 weeks*

Question 4

Strength of PDS

Answer 4

50% at 5-6 weeks

Question 5

GIA

Answer 5

Gastrointestinal anastomosis - 4 staggered rows of staples with linear incision between two middle rows

Side to side anastomosis

Question 6

EEA

Answer 6

End to end anastomosis

Purse string sutures used to secure bowel around the stapling device and removable anvil. Tissues stapled together and the purse string suture and the associated tissue excised when the stapler is activated.

Question 7

What size vessel can Ligasure seal

Answer 7

up to 7mm
Vessel diameter should be no more than 2/3 the length of the clip or no less than 1/3 the length

Question 8

Skin staple width regular vs wide

Answer 8

Regular: width 4.8-5.7mm
Wide: 6.5-6.9

Question 9

What is the byproduct of glue polymerization

Answer 9

Cyanoacrylate and formaldehyde

Question 10

Advantages of cyanoacrylate glue

Answer 10

Speed, no need for suture removal, barrier to microbial penetration, and antibacterial effects.

Question 11

Chromic gut - strength

Answer 11

0% tensile strength at 2-3 weeks.
Completely absorbed in 2-3 weeks but can lose strength in as fast as 12 hours if in the stomach

Question 12

How is chromic gut absorbed

Answer 12

By enzymatic processes
More rapid absorption in gastric or intestinal surgery