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Vet - notes > Suture material > Flashcards

Suture material Flashcards

1
Q

functions of suture material

A

Wound closure
Attachment of tubes
Ligation
Stay sutures

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2
Q

ideal interaction with the tissue

A

Maintains strength until wound strength develops
Rapid resorption when no longer required
Encapsulated without post-operative complications
Easily removed
Minimal tissue reaction
Does not favour bacterial growth
Minimal drag through tissues
Suitable for all wounds

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3
Q

ideal interaction with the surgeon

A

easy to handle

good knot security

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4
Q

ideal material properties

A 
Easy to sterilise 
Non-capillary (fluid doesn't stick to them) 
Non-electrolytic 
Non-corrosive 
Non-allergenic 
Non-carcinogenic
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5
Q

classification of suture material

A

natural vs synthetic
absorbable vs non
multi vs monofilament

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6
Q

Natural fibre - properties

A

Tissue inflammatory reaction

Variable absorption

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7
Q

Synthetic fibre - properties

A

Less reaction

Predictable absorption

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8
Q

Multifilament - properties

A

Easier to handle
Better knot security
 Capillarity

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9
Q

Monofilament - properties

A

Less tissue drag

Can weaken when crushed

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10
Q

coating effects

A

improves handling

reduces tissue drag

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11
Q

Synthetic Absorbable Multifilament - materials

A

Vicryl - Polyglactin 910
Dexon - Polyglycolic acid
Polysorb - Lactomer 9-1
Panacryl - Poly(L-lactide/glycolide)

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12
Q

Synthetic Absorbable Multifilament - Interaction with tissue

A

Absorption complete at 60-90d

Speed: Polysorb>Vicryl>Dexon

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13
Q

Synthetic Absorbable Multifilament - Tensile strength & loss

A

Loss 33% (7d), 80% (14d), 100% (21d)

Strength: Polysorb>Vicryl>Dexon

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14
Q

Synthetic Absorbable Multifilament - Handling & knotting

A

Good handling/knotting

Tissue drag - improved by coating

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15
Q

Synthetic Absorbable Multifilament - use

A

Vessel ligation

General soft tissue closure (skin, mouth)

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16
Q

Synthetic Absorbable Monofilament - short duration - Materials

A

Monocryl - Polyglecaprone

Caprosyn – Polyglytone

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17
Q

Synthetic Absorbable Monofilament - short duration - Interaction with tissue

A

Absorption complete @ 90-120d

Speed: Caprosyn>Monocryl

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18
Q

Synthetic Absorbable Monofilament - short duration - Tensile strength & loss

A

High tensile strength

Loss: 50%(7d),60%(14d), 100%(21d)

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19
Q

Synthetic Absorbable Monofilament - short duration - Handling & knotting

A

Monocryl - soft & pliable, low memory

Caprosyn - more sticky

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20
Q

Synthetic Absorbable Monofilament - short duration - use

A

General soft tissue closure

Visceral closure - Monocryl

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21
Q

Synthetic Absorbable Monofilament - long duration - Materials

A

PDS II - Polydioxanone
Maxon - Polyglyconate
Biosyn - Glycomer 631

22
Q

Synthetic Absorbable Monofilament - long duration - Interaction with tissue

A

Absorption complete @ 110-210d

23
Q

Synthetic Absorbable Monofilament - long duration - Tensile strength & loss

A

Strong materials (>Nylon, Prolene)
Loss: 26% (14d), 40% (28d), 75% (42d)
Strength: PDS II>Maxon>Biosyn

24
Q

Synthetic Absorbable Monofilament - long duration - Handling & knotting

A

PDS - memory, tendency to coil, 7 knots

25
Synthetic Absorbable Monofilament - long duration - use
Soft tissues needing long support | Muscle, fascia, linea alba, viscera
26
Synthetic Non-absorbable Monofilament - Materials
Prolene/SurgiPro - Polypropylene Ethilon/Monosof – Polyamide Flexon – Steel
27
Synthetic Non-absorbable Monofilament - Interaction with tissue
Minimal reaction – inert
28
Synthetic Non-absorbable Monofilament - Tensile strength
Strong | 25% loss at 2 years - nylon
29
Synthetic Non-absorbable Monofilament - Handling & knotting
Memory - Prolene>Nylon | Knot security - Prolene>Nylon
30
Synthetic Non-absorbable Monofilament - Use
Inert - skin, stoma, vessels | Prolonged support-hernia, tendon
31
Synthetic Non-absorbable Multifilament - Materials
Mersilene, Ethibond - Polyester Novafil - Polybutester Supramid - Caprolactam
32
Synthetic Non-absorbable Multifilament - Interaction with tissue
Moderate inflammation
33
Synthetic Non-absorbable Multifilament - Tensile strength
stronger than nylon | Very little loss of strength
34
Synthetic Non-absorbable Multifilament - Handling & knotting
Fair handling, slight elasticity | Sheath cracks on knotting
35
Synthetic Non-absorbable Multifilament - Use
Ligament prosthesis | ? Skin closure
36
Natural Absorbable Multifilament - Materials
Catgut – plain or chromic | Collagen – ophthalmic surgery
37
Natural Absorbable Multifilament - Interaction with tissue
Absorption complete @ 60-70d Tissue reaction marked Faster in infected, vascular or acidic wounds UNPREDICTABLE: absorption via phagocytosis cf hydrolysis
38
Natural Absorbable Multifilament - Tensile strength & loss
33% loss (7d), 67% loss (14d)
39
Natural Absorbable Multifilament - Handling & knotting
Knots weaker when wet Poor knot security so leave ends long Good handling
40
Natural Absorbable Multifilament - Use
Vessel ligation, ophthalmic surgery
41
Natural Non-absorbable Multifilament - Materials
Mersilk, PermaHand – Silk
42
Natural Non-absorbable Multifilament - Tissue interaction
Moderate-marked inflammation | Encapsulated in fibrous tissue
43
Natural Non-absorbable Multifilament - Tensile strength
Weak - will break | Very slow absorption - 2yr
44
Natural Non-absorbable Multifilament - Handling & knotting
Handling good (silk)
45
Natural Non-absorbable Multifilament - use
Large vessel ligation | NOT in viscera – ulcers and calculi
46
General rules to avoid complications
Avoid multifilament material in contaminated wounds Avoid non-absorbable sutures in hollow organs Use inert material in the skin Avoid reactive material for stoma creation Use slowly/non-absorbable material in fascia/tendons Avoid burying any suture from a multi-use cassette Avoid catgut in inflamed, infected or acidic wounds
47
Choice of suture size
Use the smallest size possible Less tissue trauma – tissue tract Smaller knots – reduced bulk
48
Advantages of swaged-on needles
``` Available for use immediately Unlikely to detach suture material Less handling of suture material Less fraying of suture material Less tissue trauma Likely to be sharper Guaranteed sterile Greater range of needles available ```
49
advantages of reverse cutting needles
stronger Danger of tissue cutout is greatly reduced Hole left by the needle leaves a wide wall of tissue against which the suture is to be tied
50
needle requirements
Sharp enough to pass through tissue No change to tissue architecture Needle resists bending/breakage Needle hole just big enough for suture

Vet - notes (32 decks)

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