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Flashcards in Suture patterns Deck (68)
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1

What are the rules for wound closure?

close tissue in the same number of layers as incised appositional pattern unless good reason not to choose the simplest pattern avoid closure under tension careful suturing more important than pattern choice

2

What is tissue bite?

the distance between the incision/wound and the suture

3

How are patterns classified?

simple versus mattress interrupted versus continuous appositional versus inverting versus everting partial versus full-thickness 1 layer versus 2 - layer

4

What is a mattress ligature?

include tissue that isn't in your bite

 

5

What is this?

 

Simple suture

6

What is this?

Mattress suture

7

What is this?

Mattress ligature

8

What are the benefits of interrupted sutures?

if 1 knot fails, the whole line won't fail More accurate approximation You can adjust tension at each suture

9

What are the benefits of continuous suture?

quicker less suture material in wound more even distribution of tensionmore air-tight and water-tight cheaper - economic use and shorter anaesthetic

10

What does an appositional suture do?

it brings tissues into close approximation

11

What does an inverting suture do?

turns tissue edges towards the patient, away from the surgeon or into a hollow cavity

12

What does an everting suture do?

turns tissue edges outward away from the patient, towards the patient. rarely used

13

What are two appositional (approximating sutures)?

Bennett and de Hoff

14

Why do appositional suturing?

easy accurate wall layer alignment quicker mucosa regeneration less inflammation and fibrous scar tissue

15

What is an example of an inverting suture pattern?

Lembert

16

What are the advantages of an inverting suture pattern?

greater bursting strength similar tensile strength reduced risk of adhesions necrosis of tissue cuff *luminal compromise possible*

17

What are examples of an everting suture?

Travers and Knowles

18

What are the benefits/disadvantages of everting sutures?

ease of placement increased tensile strength endothelial contraction reduces thrombosis BUT.... prolonged inflammation and vascular compromise increased incidence adhesions increased risk of stenosis increased risk of leakage

19

What are the advantages of a partial thickness suture?

not exposed to luminal contents reduces wicking from lumen

20

What are the advantages of a full thickness suture?

better apposition suture holding layer engaged

21

What is the most important layer in a suture?

submucosa - as this keeps the tensile strength

22

What are the advantages of a two layer closure?

more accurate apposition more watertight ? easier in some tissues stronger?

23

What is this?

one layer closure

24

What is this?

two layer closure

25

What is this?

1 layer, partial thickness

26

What is this?

1 layer, full thickness

27

What is this?

2 layers, partial thickness

28

What is this?

2 layers, full thickness and partial thickness

29

What are the features of a simple interrupted suture? Examples?

 

secure anatomical closure precise adjustment of tension possible easily applied (inversion if tight) EXAMPLES - skin, GIT, fascia

30

What are the features of an intradermal/subcuticular suture?

upside down simple interrupted (i.e. buried knot) EXAMPLE - intradermal/subcuticular closure

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