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test > Sutures and Stitches > Flashcards

Sutures and Stitches Flashcards

1
Q

What is a suture?

A

Any strand of material used to ligate blood vessels or to approximate tissues

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2
Q

How are sutures sized?

A

By diameter, stated as number of O’s. The higher the number of O’s, the smaller the diameter.

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3
Q

What are the 2 most basic suture types?

A

Absorbable and non-absorbable

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4
Q

What is an absorbable suture?

A

Suture that is completely broken down by the body (dissolving suture)

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5
Q

What is a non-absorbable suture?

A

Suture that is not broken down (permanent suture)

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6
Q

What are catgut sutures made of?

A

Purified collagen fibers from the intestine of healthy cows or sheep

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7
Q

What are the two types of gut sutures?

A

Plain and chromic

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8
Q

What is the difference between plain and chromic gut?

A

Chromic gut is treated with chromium salts (chromium trioxide), which results in more collagen cross links, making the suture more resistant to breakdown by the body

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9
Q

What is a Vicryl suture?

A

Absorbable, braided, multifilamentous copolymer of lactide and glycoside

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10
Q

How long does Vicryl retain its strength?

A

60% at 2 weeks, 8% at 4 weeks

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11
Q

Should you ever use purple-colored Vicryl for skin closure?

A

No, it may cause purple tattooing

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12
Q

What is PDS?

A

Absorbable, monofilament polymer of polydioxanone (absorbable fishing line)

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13
Q

How long does PDS maintain its tensile strength?

A

70-74% at 2 weeks, 50-58% at 4 weeks, 25-41% at 6 weeks

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14
Q

How long does PDS take to complete absorption?

A

180 days

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15
Q

What is a silk suture?

A

Non-absorbable, braided protein filaments spun by the silkworm larva.

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16
Q

What is a Prolene suture?

A

Non-absorbable suture (used for vascular anastomoses, hernias, abdominal fascial closure)

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17
Q

What is a nylon suture?

A

Non-absorbable fishing line

18
Q

What is a monocryl suture?

A

Absorbable monofilament

19
Q

What kind of suture should be used for the biliary tract or the urinary tract?

A

Absorbable (otherwise the suture will end up as a nidus for stone formation)

20
Q

What is the purpose of a suture closure?

A

To approximate divided tissues to enhance wound healing

21
Q

What are the 3 types of wound healing?

A
  1. Primary closure (intention) 2. Secondary intention 3. Tertiary intention
22
Q

What is primary intention?

A

When the edges of a clean wound are closed in some manner immediately (e.g. suture, Steri-Strips, staples)

23
Q

What is secondary intention?

A

When a wound is allowed to remain open and heal by granulation, epithelialization, and contraction. Used for dirty wounds, otherwise an abscess can form.

24
Q

What is tertiary intention?

A

When a wound is allowed to remain open for a time and then closed, allowing for debridement and other wound care to reduce bacterial counts prior to closure

25
Q

What is another term for tertiary intention?

A

Delayed primary closure (DPC)

26
Q

What is classic time to wait before closing an open abdominal wound by DPC?

A

5 days

27
Q

What rule is constantly told to medical students about wound closure?

A

Approximate, don’t strangulate: If sutures are pulled too tight, then the tissue becomes ischemic because the blood supply is decreased possibly resulting in necrosis, infection, or scar.

28
Q

What is a taper-point needle?

A

Round body, leaves a round hole in tissue

29
Q

What is a taper-point needle used for?

A

Suturing of soft tissue other than skin (e.g. GI tract, muscle, nerve, peritoneum, fascia)

30
Q

What is a conventional cutting needle?

A

Triangular body with the sharp edge toward the inner circumference. Leaves a triangular hole in tissue.

31
Q

What is a conventional cutting needle used for?

A

Suturing of skin

32
Q

What is a vertical mattress stitch?

A

Simple stitch is made, the needle is reversed, and a small bite is taken from each wound edge. The knot ends up on one side of the wound.

33
Q

What is the vertical mattress stitch also known as?

A

Far-far, near-near stitch. Oriented perpendicular to the wound.

34
Q

What is a vertical mattress stitch used for?

A

Difficult-to-approximate skin edges. Everts tissue well.

35
Q

What is a horizontal mattress stitch?

A

Simple stitch is made, the needle is reversed, and the same size bite is taken again. Oriented parallel to wound.

36
Q

What is a simple running (continuous) stitch?

A

Stitches made in succession without knotting each stitch

37
Q

What is a subcuticular stitch?

A

Stitch (usually running) placed just underneath the epidermis, can be either absorbable or non-absorbable (pull-out stitch if non-absorbable)

38
Q

What is a purse-string suture?

A

Stitch that encircles a tube perforating a hollow viscus (e.g. gastrostomy tube), allowing the hole to be drawn tight and thus preventing leakage

39
Q

What is a GI anastomosis device?

A

Stapling device that lays two rows of small staples in a hemostatic row and automatically cuts in between them

40
Q

What is a suture ligature?

A

Suture is anchored by passing it through the vessel on a needle before wrapping around and occluding the vessel. Prevents slippage of knot. Used on larger vessels.

41
Q

What is a retention suture?

A

Large suture that is full thickness through the entire abdominal wall except the peritoneum. Used to buttress an abdominal wound at risk for dehiscence.

42
Q

What is a pop-off suture?

A

Suture that is not permanently swaged to the needle, allowing the surgeon to pop-off the needle from the suture without cutting the suture

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