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Flashcards in Suture Material Deck (48)
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What are absorbable sutures?

Sutures that lose their tensile strength within 60 days


What are non-absorbable sutures?

Sutures that are permanent


What is natural suture material?

Made from animal or plant tissue that has antigenic properties


What is synthetic suture material?

Man-made material
- Chosen for its inert character


What 12 qualities should the ideal suture material have?

1. Maintain adequate tensile strength
2. Stimulation minimal inflammation
3. Discourage bacterial growth
4. Non-capillary but predictable absorbable
5. Non-electrolytic
6. Non- allergenic
7. Non- carcinogenic
8. Good Handling properties
9. Good knot security
10. Inexpensive and readily available
11. Easily sterilised and able to be re sterilised
12. Monofilament


Quality of maintaining adequate tensile strength...

- Tensile strength affects the tissue's ability to withstand injury but isn't related to length of time it takes the tissue to heal
- Suture chosen should at least as strong as the tissue


Quality of stimulating minimal inflammation..

Natural materials provoke inflammation and potentially immune response
- Absorption by phagocytosis which leads to granulation tissue and scarring

Synthetic Materials are designed to be minimally inflammatory
- Absorption mainly by hydrolysis


Quality of discouraging bacterial growth...

Monofilaments less likely to collect bacteria when they are dragged across the skin
- Multifilament weaves trap bacteria

- Any suture material acts as a trap for infection which lowers the number of bacteria required to establish infection

- Some suture material has antibacterial coatings
-- these can actively reduce infection risk


Quality of non-capillary but predictably absorbable...

- Capillary suture material "wicks" liquids

- Absorbable sutures should degrade as predicted, and be unaffected by the presence of infection


Quality of non-electrolytic...

I.e. inorganics such as stables should be made out of material that doesn't rust or cause electrolysis


Quality of non-allergenic...

Won't cause a reaction e.g. welts or a whole body reaction


Quality of non-carcinogenic...

Non cancer causing


Qualities of good handling skills and good knot security...

Suture material needs to be pliable so knots can be formed

Memory is the tendency for the material to kink or spiral when stressed and maintain the new shape after stress is removed


What type of suture materials tend to have the best memory?



What type of suture materials tend to return to their pre-stressed state?



What type of filaments have the best knot-holding characteristics?



What is an advantage and disadvantage of coating suture material?

Reduces tissue drag i.e. friction causes trauma

- Requires more tension to ensure good tissue apposition
- Reduces knot- holding


Describe braided multifilaments...

They are made from several primary strands spun together

- Wick fluid and trap bacteria in gaps between strands


Describe catgut suture...

Made from sub-mucosa of sheep or serosa of cows

- Three strands spun together then polished to form a virtual monofilament


Describe chromic catgut suture...

Made from sub-mucosa of sheep or serosa of cows
- treated with Chromic sales to slow absorption

- A virtual monofilament
- Tensile strength: 21-28 days
- Absorbed normally around 90 days


Describe silk suture...

Natural protein fibre of raw silk spun by silkworms

- Braided and dyed


Describe polyester braided suture...

- Indefinite wound support
- Less tissue reaction than silk
- Handles and ties securely


Describe Nylon suture...

- Monofilament
- Loses about 10-15% strength per year
- Takes up fluid


Describe USP suture sizing...

7 is the largest
12/0 (12/ zero) is the smallest
- i.e. size 000000000000 is finer than 2/0 which is 00

- As the number of zeros increases, the diameter of the suture decreases


What principle should you use to select your sutures on?

The principle that different tissue have differing requirements for suture support, and they heal at different rates


What is important about tissues strengths?

There are regional and species differences

- related to the collagen layers of the organ and the submucosa

i.e. duodenum is strong and the bladder is weak


What is important about suture materials and their correlation with tissue healing rates?

A suture must last at least as long as, but not too much longer, than the time the tissue takes to heal


What kind of suture should you choose for rapidly healing tissue?

- One that will lose it's tensile strength at about the same rate as the tissue gains strength
- And one that will also be absorbed


What rule should be applied when selecting suture size?

Use the smallest diameter suture that will adequately hold the mending wounded tissue

Suture no stronger than the sutured tissue


What are the needle types?

- Needles with eyes
- Needles with swaged on suture