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Flashcards in suture patterns Deck (27)
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1

surgeon's knot

first throw passed through loop twice

creates friction, less slippage

bulkier, asymmetrical, less knot security

2

ligation

use of suture and knots to occlude blood vessels

suture-chromic gut, silk, synthetic absorbable

more secure than hemostatic clips

more time consuming

3

simple vessel ligature

square knot in crush from a hemostat

place several mm from cut end of vessel

3-4 throws

4

double ligature

transfixation ligature

one simple ligature

one transfixing ligature-halsted or modified

transfixing prevents slippage

5

tissue ligatures

used when vessels cannot be isolated

loosens when entrapped tissue dies

6

vascular pedicle ligatures

three hemostatic forceps technique-ligature placed in crush

not good on very large pedicles

7

modified miller's knot

8

interrupted sutures

precisely adjust tension

time consuming

suture separate

more foreign material

poor suture economy

fibrin forms seal

 

9

continuous suture

cannot adjust tension

less time

break disrupts entire closure

less foreign material

better suture economy, better immediate seal

10

interrupted cruciate

stronger than simple interrupted

resists tension

prevents eversion

11

ford interlocking

great seal

LA-thoracotomy-fast

12

continuous intradermal

used in place of skin sutures

modified horizontal mattress in dermis

saves time and suture

weaker than interrupted

13

gambee

inverting

prevents eversion of mucosa

used for intestinal resection and anastomosis

14

lembert

inverting

vertical mattress-like

interrupted or continuous

penetrates submucosa

does not enter lumen

15

Cushing 

horizontal mattress-like

penetrates submucosa-does not enter lumen

less inverting than lembert

16

connell

horizontal mattress like

penetrates all layers

enters lumen-may wick bowel contents-->bacteria in abdomen

17

double layer closure

closing large hollow viscera

layer 1-cushing

layer 2-continuous lembert

18

vertical mattress

tension relieving

apposes or everts

resists tension well

19

near and far

tension relieving

like vertical mattress

edge approximation-no tension on edge

excess tension-->inversion

far-far-near-near

far-near-near-far

 

20

horizontal mattress

apposes or everts

resists tension less than vertical

can be stented

21

locking loop

tendon suture

22

triple loop pulley

tendon suture

difficult

one on left

23

abdominal wall closure

linea alba/external rectus sheath-simple interrupted

SQ tissue-simple continuous

skin-simple interrupted or cruciate

24

ovarian pedicle

modified miller's knot

encircling ligature

transfixation ligature

25

uterine body

transfixation vs stick ligature

encircling ligature

26

testicular pedicle

modified miller's knot

encircling ligature

transfixation ligature

SQ tissue-simple continuous or cruciates

skin-intradermal with buried knots

27

buried suture

goal-suture ends deep to bury knot

first bite-deep to superfiicial

second bite-superficial to deep