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Surgery I > LA Suture Materials & Patterns (10) > Flashcards

LA Suture Materials & Patterns (10) Flashcards

Dr. Devine (49 cards)

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1
Q

T/F: The strength of the wound is more dependent on the tissue’s ability to hold the suture than the suture material itself

A

TRUE

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2
Q

When are sutures with high stiffness chosen?

A

for abdominal closure, herniorraphy, prosthesis

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3
Q

What happens if you use oversized suture?

A

it will weaken your closure due to excessive tissue reaction

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4
Q

What is better than increasing suture size for wounds under tension?

A

increasing the number of sutures (or using tension relieving suture pattern)

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5
Q

Which parts of the body heal relatively fast? Slow?

A

fast: internal organs and SQ - few days

slow: fascia - a few weeks

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6
Q

How does skin heal? When does it seal?

A

based on quality of apposition

seals within 1 day

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7
Q

What is needed for suture absorption when using absorbable suture?

A

inflammatory response (tissue reaction)

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8
Q

What are the most common needle selections?

A

3/8 or 1/2 circle

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9
Q

T/F: You normally use a needle where you can reach across both sides of the skin with it

A

TRUE

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10
Q

What effect does a taper point needle have? Which kind of tissue?

A

round needle shaft does not enlarge hole as it passes through

delicate tissue

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11
Q

What effect does a reverse cutting needle have? Which kind of tissue?

A

cutting edge on the convex (outer) side - stronger than conventional cutting

skin, fibrous tissue

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12
Q

LA instrument? Purpose?

A

Buhner needle - used to purse string prolapses

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13
Q

LA instrument? Purpose?

A

S needle

  • used to close cow skin and replaces needle drivers
  • use suture on a reel
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14
Q

What needle was probably used for this?

A

buehner needle

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15
Q

Instrument? Purpose?

A

S needle - closing ruminant skin

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16
Q

What is the weakest point in the suture pattern?

A

a knot

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17
Q

What is a square knot?

A

two simple throws that are reversed

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18
Q

Which suture material in LA needs 4 throws to be secure?

A

2-0 PDS or nylon

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19
Q

Which suture material in LA needs 5 throws to be secure?

A

larger suture #2 or #3 vicryl

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20
Q

How do you suture fascia in LA?

Study These Flashcards
A

bites are 15 mm away from the cut edge

close using vicryl or PDS

size 2-7

21
Q

What is commonly used in cattle for fascia suturing?

Study These Flashcards
A

catgut - cheap

22
Q

What do you suture in LA for delicate tissues (SQ, GI organs?)

Study These Flashcards
A

PDS, vicryl, monocryl

typically 2-0

23
Q

What suture patterns do you use for the LA GI tract normally?

Study These Flashcards
A

Lembert

simple continuous oversewn with a Cushings

24
Q

How do you suture contaminated wounds in horses?

Study These Flashcards
A

monofilament!

nonabsorbable suture - inert

elastic allows for tissue swelling

25
What suture do you use in farm animals to reduce cost?
- chromic cat gut - suture on a reel
26
When do you remove sutures in the skin?
10-14 days
27
Do this
28
When do you use skin staplers in LA?
wounds with no tension - appose wound edges
29
What are inverting suture patterns? Which organs?
invert the tissue edges to help make a seal - suture does NOT come out the tissue edge uterus, GI tract, urinary bladder
30
What are suture patterns that invert?
utrecht, Cushing, lembert
31
Where are Utrecht patterns used for in LA?
on the **u**terus
32
Suture pattern?
utrecht
33
When are Cushing suture patterns commonly used?
on GI, urinary bladder - often combined with a simple continuous first
34
Suture pattern?
cushing
35
When are Lembert suture patterns commonly used?
also for GI or urinary bladder - interrupted or continuous don't accidentally invert a lot of tissue in - could lead to obstruction
36
How should you make an incision line regarding skin tension lines?
**parallel**
37
A horse has a puncture wound cranial to its cubital joint. What direction would the incision be?
incision vertical - in this case
38
How do you suture wounds under tension?
- use limb immobilization - add more sutures - use tension-relieving techniques **NOT BIGGER SUTURE**
39
What are some other tension-relieving techniques?
- release incisions - walking sutures - can use stent, combo patterns
40
What does this show?
closing the primary wound and leave the relief incisions to heal by second intention
41
What are walking sutures?
using your suture to "pull" the skin over the top of the defect - obliterate dead space, no closer than 2-3 cm apart
42
What do stents do?
distribute tension more evenly along suture to **prevent pull-through**
43
What are the characteristics a vertical mattress suture pattern?
- less impingement of blood supply compared to horizontal mattress - good apposition but some eversion - bites perpendicular to cut edge
44
What are the characteristics of a horizontal mattress suture pattern?
- strong tension relieving - will not tear through but **tends to impede blood supply** - most eversion possible can be continuous
45
What are the characteristics a near-far-far-near suture pattern?
- excellent apposition and tension relief - interrupted only - most suture in wound
46
What are the characteristics a ford interlocking suture pattern?
- mild tension relieving - reduces suture disruption in one part breaks - good apposition
47
What is this?
mesh for large defects
48
What are the differences in suturing LA than in small animal?
thicker skin need tightness on skin sutures more surgeon's NO PDS II on linea alba
49
Practice

Surgery I (30 decks)

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