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Flashcards in Suture material Deck (50)
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1

functions of suture material

Wound closure
Attachment of tubes
Ligation
Stay sutures

2

ideal interaction with the tissue

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

3

ideal interaction with the surgeon

easy to handle
good knot security

4

ideal material properties

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

5

classification of suture material

natural vs synthetic
absorbable vs non
multi vs monofilament

6

Natural fibre - properties

Tissue inflammatory reaction
Variable absorption

7

Synthetic fibre - properties

Less reaction
Predictable absorption

8

Multifilament - properties

Easier to handle
Better knot security
 Capillarity

9

Monofilament - properties

Less tissue drag
Can weaken when crushed

10

coating effects

improves handling
reduces tissue drag

11

Synthetic Absorbable Multifilament - materials

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

12

Synthetic Absorbable Multifilament - Interaction with tissue

Absorption complete at 60-90d
Speed: Polysorb>Vicryl>Dexon

13

Synthetic Absorbable Multifilament - Tensile strength & loss

Loss 33% (7d), 80% (14d), 100% (21d)
Strength: Polysorb>Vicryl>Dexon

14

Synthetic Absorbable Multifilament - Handling & knotting

Good handling/knotting
Tissue drag - improved by coating

15

Synthetic Absorbable Multifilament - use

Vessel ligation
General soft tissue closure (skin, mouth)

16

Synthetic Absorbable Monofilament - short duration - Materials

Monocryl - Polyglecaprone
Caprosyn – Polyglytone

17

Synthetic Absorbable Monofilament - short duration - Interaction with tissue

Absorption complete @ 90-120d
Speed: Caprosyn>Monocryl

18

Synthetic Absorbable Monofilament - short duration - Tensile strength & loss

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

19

Synthetic Absorbable Monofilament - short duration - Handling & knotting

Monocryl - soft & pliable, low memory
Caprosyn - more sticky

20

Synthetic Absorbable Monofilament - short duration - use

General soft tissue closure
Visceral closure - Monocryl

21

Synthetic Absorbable Monofilament - long duration - Materials

PDS II - Polydioxanone
Maxon - Polyglyconate
Biosyn - Glycomer 631

22

Synthetic Absorbable Monofilament - long duration - Interaction with tissue

Absorption complete @ 110-210d

23

Synthetic Absorbable Monofilament - long duration - Tensile strength & loss

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

24

Synthetic Absorbable Monofilament - long duration - Handling & knotting

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