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Section I, Surgical Recall Sixth Edition > Sutures and Stitches Chapter7 P53-60 > Flashcards

Sutures and Stitches Chapter7 P53-60 Flashcards

(46 cards)

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1
Q

GENERAL INFORMATION
1. What is a suture?
P53

A

Any strand of material used to ligate blood vessels or to approximate tissues

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2
Q
  1. How are sutures sized?

P53

A

By diameter; stated as a number of O’s: the higher the number of O’s, the smaller the diameter (e.g., 2-O suture has a larger diameter than 5-O suture)

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3
Q
  1. Which is thicker, 1-O suture or 3-O suture?

P53

A

1-O suture (pronounced “one oh”)

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4
Q

CLASSIFICATION
1. What are the two most basic suture types?
P53

A

Absorbable and nonabsorbable

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5
Q
  1. What is an absorbable suture?

P53

A

Suture that is completely broken down by the body (dissolving suture)

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6
Q
  1. What is a nonabsorbable suture?

P53

A

Suture is not broken down (permanent suture)

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7
Q

SUTURES
1. Catgut
a) What are “catgut” sutures made of?
P54

A

Purified collagen fibers from the intestines of healthy cows or sheep (sorry, no cats)

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8
Q

b) What are the two types of gut sutures?

P54

A

Plain and chromic

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9
Q

c) What is the difference between plain and chromic gut?

P54

A

Chromic gut is treated with chromium salts (chromium trioxide), which results in more collagen crosslinks, making the suture more resistant to breakdown by the body

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10
Q
  1. Vicryl® Suture
    a) What is it?
    P54
A

Absorbable, braided, multifilamentous copolymer of lactide and glycoside

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11
Q

b) How long does it retain its strength?

P54

A

60% at 2 weeks, 8% at 4 weeks

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12
Q

c) Should you ever use PURPLE-colored Vicryl® for skin closure?
P54

A

NO—it may cause purple tattooing

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13
Q
  1. PDS®
    a) What is it?
    P54
A

Absorbable, monofilament polymer of polydioxanone (absorbable fishing line)

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14
Q

b) How long does it maintain its tensile strength?

P54

A

70% to 74% at 2 weeks, 50% to 58% at 4 weeks, 25% to 41% at 6 weeks

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15
Q

c) How long does it take to complete absorption?

P54

A

180 days (6 months)

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16
Q

d) What is silk?

P55

A

Braided protein filaments spun by the silkworm larva; known as a nonabsorbable suture

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17
Q

e) What is Prolene?

P55

A

Nonabsorbable suture (used for vascular anastomoses, hernias, abdominal fascial closure)

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18
Q

f) What is nylon?

P55

A

Nonabsorbable “fishing line”

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19
Q

g) What is monocryl?

P55

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A

Absorbable monofilament

20
Q

h) What kind of suture should be used for the biliary tract
or the urinary tract?
P55

Study These Flashcards
A

ABSORBABLE—otherwise the suture will end up as a nidus for stone formation!

21
Q

WOUND CLOSURE
GENERAL INFORMATION
1. What is the purpose of a suture closure?
P55

Study These Flashcards
A

To approximate divided tissues to enhance wound healing

22
Q
  1. What are the three types of wound healing?

P55

Study These Flashcards
A
  1. Primary closure (intention)
  2. Secondary intention
  3. Tertiary intention (Delayed Primary Closure DPC)
23
Q
  1. What is primary intention?

P55

Study These Flashcards
A

When the edges of a clean wound are closed in some manner immediately (e.g., suture, Steri-Strips®, staples)

24
Q
  1. What is secondary intention?

P55

Study These Flashcards
A

When a wound is allowed to remain open and heal by granulation, epithelization, and contraction—used for dirty wounds, otherwise an abscess can form

25
5. What is tertiary intention? | P55
When a wound is allowed to remain open for a time and then closed, allowing for débridement and other wound care to reduce bacterial counts prior to closure (i.e., delayed primary closure)
26
6. What is another term for tertiary intention? | P55
DPC = Delayed Primary Closure
27
7. Classic time to wait before closing an open abdominal wound by DPC? P56
5 days
28
8. What rule is constantly told to medical students about wound closure? P56
“Approximate, don’t strangulate!” Translation: If sutures are pulled too tight, then the tissue becomes ischemic because the blood supply is decreased, possibly resulting in necrosis, infection, and/or scar
29
SUTURE TECHNIQUES 1. What is a taper-point needle? P56 (pictures)
Round body, leaves a round hole in tissue | spreads without cutting tissue
30
2. What is it used for? | P56
Suturing of soft tissues other than skin | e.g., GI tract, muscle, nerve, peritoneum, fascia
31
3. What is a conventional cutting needle? | P56 (pictures)
Triangular body with the sharp edge toward the inner circumference; leaves a triangular hole in tissue
32
4. What are its uses? | P56
Suturing of skin
33
5. What is a simple interrupted stitch? | P56 (pictures)
see picture
34
6. What is a vertical mattress stitch? | P57 (pictures)
Simple stitch is made, the needle is reversed, and a small bite is taken from each wound edge; the knot ends up on one side of the wound
35
7. What is the vertical mattress stitch also known as? | P57
Far-far, near-near stitch—oriented perpendicular to wound
36
8. What is it used for? | P57
Difficult-to-approximate skin edges; everts tissue well
37
9. What is a horizontal mattress stitch? | P57 (pictures)
Simple stitch is made, the needle is reversed, and the same size bite is taken again—oriented parallel to wound
38
10. What is a simple running (continuous) stitch? | P57 (pictures)
Stitches made in succession without knotting each stitch
39
11. What is a subcuticular stitch? | P58 (picture)
Stitch (usually running) placed just underneath the epidermis, can be either absorbable or nonabsorbable (pull-out stitch if nonabsorbable)
40
12. What is a pursestring suture? | P58 (picture)
Stitch that encircles a tube perforating a hollow viscus (e.g., gastrostomy tube), allowing the hole to be drawn tight and thus preventing leakage
41
13. What are metallic skin staples? | P58 (picture)
see picture
42
14. What is a staple removal device? | P59 (pictures)
see picture
43
15. What is a gastrointestinal anastomosis (GIA) device? | P59 (pictures)
Stapling device that lays two rows of small staples in a hemostatic row and automatically cuts in between them
44
16. What is a suture ligature (a.k.a. stick tie)? | P60 (pictures)
Suture is anchored by passing it through the vessel on a needle before wrapping it around and occluding the vessel; prevents slippage of knot-use on larger vessels
45
17. What is a retention suture? | P60 (pictures)
``` Large suture (#2) that is full thickness through the entire abdominal wall except the peritoneum; used to buttress an abdominal wound at risk for dehiscence ```
46
18. What is a pop-off suture? | P60
Suture that is not permanently swaged to the needle, allowing the surgeon to “pop off” the needle from the suture without cutting the suture

Section I, Surgical Recall Sixth Edition (33 decks)

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