Sutures

Front 1

Ideal suture material

Back 1

✔ maintains adequate tensile strength

✔ nonelectrolytic, noncapillary, nonallergenic, noncarcinogenic

✔ comfortable to use

✔good knot security

✔ stimulate little tissue reaction

✔ non corrosive/ toxic

✔ doesn't create situation favorable for bacterial growth

Front 2

General classification of suture materials

Back 2

✔ absorbable

✔ non absorbable

Front 3

TRUE OR FALSE. Absorbable sutures are those that undergo degeneration and rapid loss of tensile strength is 60 days

Back 3

True

Front 4

Further classification of absorbable sutures

Back 4

✔synthetic

✔ natural

Front 5

Examples of natural fiber absorbable suture materials

Back 5

◾surgical gut (catgut)

◾collagen

Front 6

Examples of synthetic absorbable suture materials

Back 6

◾ polyglycolic acid

◾ polyglactin 910

◾ polydioxanone

◾ polyglyconate

◾ poliglecaprone 25

Front 7

Examples of natural fiber nonabsorbable suture materials

Back 7

◾ silk

◾ cotton

◾ stainless steel

◾ tantalum

Front 8

Examples of synthetic nonabsorbable suture materials

Back 8

◾ polyamides (nylon, polymerized caprolactum)

◾ polyester (including polybutester)

◾ polyolefin plastics (polypropylene, polyethylene)

Front 9

Surgical gut (catgut) is made from _____.

Back 9

✔ submucosa of sheep

✔ serosal layer of cattle SI

Front 10

TRUE OR FALSE. Catgut is essentially composed formaldehyde-treated collagen

Back 10

True

Front 11

This suture material is a capillary multifilament suture that is machine ground and polished to yield a relatively smooth surface resembling a monofilament material

Back 11

Surgical gut (catgut)

Front 12

Absorption of catgut through ___.

Back 12

Phagocytosis

Front 13

TRUE OR FALSE. Medium chromic gut loses 33% of its original strength after 7 days of implantation and 67% after 28 days

Back 13

True

Front 14

Forms of surgical gut

Back 14

✔ plain

✔ chromic

Front 15

TRUE OR FALSE. Plain catgut produces severe tissue reaction and loses tensile strength rapidly

Back 15

True

Front 16

TRUE OR FALSE. Chromic catgut has increased tensile strength, resistant to digestion and decreased tissue reaction

Back 16

True

Front 17

Disadvantages of surgical gut suture

Back 17

✔ swells, weakens and exhibits poor knot security when wet

✔ intense inflammatory reaction

✔ capillarity

✔ sensitivity reaction (primarily seen in cats)

Front 18

This is a multifilament suture material that is processed from bovine flexor tendon and treated with formaldehyde and/or chromium salts

Back 18

Collagen

Front 19

Collagen sutures are only used in ____.

Back 19

Opthalmic surgery

Front 20

This is a braided multifilament polymer of glycolic (hydroxyacetic) acid

Back 20

Polyglycolic acid

Front 21

Absorption of polyglycolic acid through _____.

Back 21

Hydrolysis

Front 22

TRUE OR FALSE. Hydrolysis of polyglycolic acid proceeds more rapidly in alkalinic environment

Back 22

True

Front 23

Absorption of polyglycolic acid (days)

Back 23

✔ 14 days after implantation

✔ 120 days (complete)

Front 24

TRUE OR FALSE. PGA suture is recommended to be used in urinary bladder

Back 24

False

Front 25

This suture material is similar to pilyglactin 910 & monofilament nylon, and is relatively strong and ductile.

Back 25

Polyglycolic acid

Front 26

Loss of tensile strength of PGA

Back 26

✔ 33% by 7 days of implantation

✔ 80% within 14 days

Front 27

Disadvantages of PGA

Back 27

✔ tends to drag through tissues

✔ tends to cut friable tissues

✔ relatively poor knot security

Front 28

This suture material is braided synthetic fiber composed of glycolic and lactic acid (9:1)

Back 28

Polyglactin 910

Front 29

This suture material is more hydrophobic, and more resistant to hydrolysis than PGA

Back 29

Polyglactin 910

Front 30

Absorption of polyglactin through ____.

Back 30

Hydrolysis

Front 31

Polyglactin 910 stronger than PGA ___

Back 31

21 days after implantation

Front 32

Suture material that is made from a polymer of paradioxanone available as a monofilament

Back 32

Polydioxanone

Front 33

Absorption of polydioxanone through ___.

Back 33

Hydrolysis

Front 34

Advantages of polydioxanone

Back 34

✔ exhibits less tissue drag

✔ has acceptable handling characteristics

Front 35

Polydioxanone loses tensile strength in (days)

Back 35

◾ 26% after 14 days

◾ 42% after 28 days

◾ 84% after 56 days

◾ completed 182 days after implantation

Front 36

A monofilament suture that is a copolymer of glycolic acid and trimethylene carbonate

Back 36

Polyglyconate

Front 37

TRUE OR FALSE. Absorption of polyglyconate through the action of macrophages between 6-7mo after implantation

Back 37

True

Front 38

It is a monofilament synthetic suture that has high initial tensile strength, excellent pliability, and relative rapid loss of tensile strength.

Back 38

Poliglecaprone 25

Front 39

Poliglecaprone 25 loses its its tensile strength (days)

Back 39

◾75% at 14 days

◾ 100% after 21 days

Front 40

This nonabsorbable suture material is made from the cocoon of silkworm, and is available as braided or twisted multifilament

Back 40

Silk

Front 41

TRUE OR FALSE. Silk is absorbed within 2 years after implantation

Back 41

True

Front 42

This suture material is introduced as a replacement for silk during WWII

Back 42

Cotton

Front 43

Disadvantages of cotton

Back 43

✔ capillarity

✔ tissue reactivity

✔ inferior handling activity due to electrostatic properties

✔ ability to potentiate infection

Front 44

This suture material is biologically inert, noncapillary as monofilament, and easily sterilized by autoclaving.

Back 44

Stainless steel

Front 45

This suture material has highest tensioe strength and great knot security of all suture materials, and maintains its strength on implantation on tissues

Back 45

Stainless steel

Front 46

Disadvantages of stainless steel suture

Back 46

✔ tendency to cut tissues

✔ poor handling characteristics

✔ diminished ability to withstand repeated bending without breaking

Front 47

Metallic suture used for hernia repair, and for ligating clips

Back 47

Tantalum

Front 48

It is an amine-containing thermoplastic, and is available as monofilament or multifilament suture

Back 48

Nylon

Front 49

TRUE OR FALSE. Nylon has minimal tissue reaction even in canine tendon

Back 49

True

Front 50

Disadvantages of nylon

Back 50

✔ poor handling characteristic

✔ poor knot security

Front 51

This suture is one of the strongest nonmetallic suture material

Back 51

Polyester fibers

Front 52

TRUE OR FALSE. Suture should be as strong as the normal tissue to which they are placed

Back 52

True

Front 53

TRUE OR FALSE. Visceral tissue heal rapidly, attaining strength in 14-21 days

Back 53

True

Front 54

TRUE OR FALSE. Monofilament sutures can withstand infection than multifilament

Back 54

True

Front 55

Principles of selecting suture materials

Back 55

Front 56

Suture characteristics

Back 56

1. Easy to handle

2. Reacts minimally on the tissue

3. Inhibit bacterial growth

4. Holds securely when knotted

5. Resist shrinking in tissue

6. Non-allergenic and non-carcinogenic

7. Absorb with minimak reaction after the tissue has healed

Front 57

TRUE OR FALSE. Stainless steel suture incites little to no inflammatory reaction

Back 57

True

Front 58

Uses of stainless steel suture

Back 58

✔ for suturing tissues that heal slowly

✔ for contaminated and infected wounds