Surgical Knots & Suture Patterns Flashcards
(68 cards)
A knot consists of at least…
2 throws laid on top of each other and ignited
the knot is the _____ point of the suture
weak
incorrectly tied knots may lead to…
dehiscence/opening
Knot security is influenced by:
- configuration of the knot
- coefficient of friction of the material
- Length of the cut ends
What are the 4 types of basic knots that are important to recognize?
- Granny knot
- Square knot
- half-hitch/slip/tumble
- surgeon’s
When is a good time to use a hand tie with suture material?
confined areas
Which knot do you want to avoid doing?
Granny knot
What type of knot is this?
Square knot
Failure to reverse the throws of a square knot results in a …
granny knot
What type of knot is this?
Granny knot
How is a half-hitch knot created?
by pulling one suture end vertically when tightening a knot
What type of knot is this?
Surgeon’s knot
What type of tissue is the surgeon’s knot used for?
elastic tissue or an area under tension
to ligate vascular pedicles where tissue tension precludes adequate tightening of a square knot
A Secure knot requires…
- a correctly thrown knot
- correctly tightened throws
- correct type of first throw (single or double)
- correct number of throws
How do you prevent the loosening of knots?
- use square knots
- ensure enough throws are placed for the material being used
- leave sufficiently long ears (3mm)
What are the principles of suture placement?
- use square or surgeon’s knot
- ensure enough throws are placed
- leave ears sufficiently long
- choose suitable suture material & pattern
- Choose appropriate size/strength
- place a sufficient number of sutures
- place sutures approx. 5 mm from wound edge
Do not over-tighten sutures
What are the general rules & things of note for the number of throws?
- 4 throws for interrupted patterns
- 5 throws at the start of a continuous pattern - single strand to single strand
- 6 throws at end of a continuous pattern (single strand to loop)
- extra throws do not increase security
- extra throws increase the amt of foreign material wound
What type of ligature is this?
When do you use it?
Single ligature
Use on small vessels
What type of ligature is this?
When do you use it?
Double ligature
Use on large vessels/arteries
What type of ligature is this?
Transfixing ligature
When is the 3 forceps technique commonly used?
for ovarian & uterine pedicles during spay (OVE/OVH)
What is the 3 forceps technique used for?
it allows for the placement of a ligature to a crushed line of tissue on a vascular pedicle
What are some important things to remember about knots?
- knot security is inversely proportional to suture diameter
- inadequate tightening of each throw results in bulkier, less secure knots
- suture ears must be adequately long
- Don’t include a frayed portion of material in a suture or ligature
- Extra knots result in extra bulk
How do you classify suture patterns?
Based on:
-anatomical location
- tendency to cause tissue apposition, inversion, eversion
- continuous or interrupted pattern
