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46 Cards in this Set
- Front
- Back
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What is a suture? |
Any strand of material used to ligate blood vessels or to approximate tissues |
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How are sutures sized? |
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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Which is thicker, 1-O suture or 3-O suture? |
1-O suture (pronounced "one oh")
The higher the number of O’s, the smaller the diameter |
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What are the two most basic suture types? |
Absorbable and nonabsorbable |
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What is an absorbable suture? |
Suture that is completely broken down by the body (dissolving suture) |
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What is a non-absorbable suture? |
Suture is not broken down (permanent suture) |
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What are the "catgut" sutures made of? |
Purified collagen fibers from the intestines of healthy cows or sheep (sorry, no cats) |
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What are the two types of "catgut" sutures? |
Plain and chromic |
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What is the difference between plain and chromic "catgut" sutures? |
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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What are "Vicryl" sutures? |
Absorbable, braided, multifilamentous copolymer of lactide and glycoside |
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How long does a "Vicryl" suture retain its strength? |
60% at 2 weeks, 8% at 4 weeks |
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Should you ever use PURPLE-colored "Vicryl" sutures for skin closure? |
No - it may cause purple tattooing |
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What are "PDS" sutures? |
Absorbable, monofilament polymer of polydioxanone (absorbable fishing line) |
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How long do "PDS" sutures maintain their tensile strength? |
- 70% to 74% at 2 weeks - 50% to 58% at 4 weeks - 25% to 41% at 6 weeks |
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How long does it take to complete absorption of "PDS" sutures? |
180 days (6 months) |
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What is silk? |
Braided protein filaments spun by the silkworm larva; known as a nonabsorbable suture |
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What is Prolene? |
Nonabsorbable suture (used for vascular anastomoses, hernias, abdominal fascial closure) |
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What is nylon? |
Nonabsorbable "fishing line" |
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What is monocryl? |
Absorbable monofilament |
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What kind of suture should be used for the biliary tract or the urinary tract? |
ABSORBABLE—otherwise the suture will end up as a nidus for stone formation! |
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What is the purpose of a suture closure? |
To approximate divided tissues to enhance wound healing |
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What are the three types of wound healing? |
1. Primary closure (intention) Closure = DPC) |
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What is primary intention? |
When the edges of a clean wound are closed in some manner immediately (e.g., suture, Steri-Strips, staples) |
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What is secondary intention? |
When a wound is allowed to remain open and heal by granulation, epithelization, and contraction—used for dirty wounds, otherwise an abscess can form |
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What is tertiary intention? |
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) |
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What is another term for tertiary intention? |
DPC = Delayed Primary Closure |
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Classic time to wait before closing an open abdominal wound by DPC? |
5 days |
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What rule is constantly told to medical students about wound closure? |
“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 |
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What is a taper-point needle? |
Round body, leaves a round hole in tissue (spreads without cutting tissue) |
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What is a taper-point needle used for? |
Suturing of soft tissues other than skin (e.g., GI tract, muscle, nerve, peritoneum, fascia) |
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What is a conventional cutting needle? |
Triangular body with the sharp edge toward the inner circumference; leaves a triangular hole in tissue |
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What are the uses of conventional cutting needles? |
Suturing of skin |
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What is a simple interrupted stitch? |
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What is a vertical mattress stitch? |
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 |
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What is the vertical mattress stitch also known as? |
Far-far, near-near stitch - oriented perpindicular to the wound |
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What is the vertical mattress stitch used for? |
Difficult-to-approximate skin edges; everts tissue well |
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What is a horizontal mattress stitch? |
Simple stitch is made, the needle is reversed, and the same size bite is taken again—oriented parallel to wound |
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What is a simple running (continuous) stitch? |
Stitches made in succession without knotting each stitch |
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What is a subcuticular stitch? |
Stitch (usually running) placed just underneath the epidermis, can be either absorbable or nonabsorbable (pull-out stitch if nonabsorbable) |
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What is a pursestring suture? |
Stitch that encircles a tube perforating a hollow viscus (e.g., gastrostomy tube), allowing the hole to be drawn tight and thus preventing leakage |
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What are the metallic skin staples? |
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What is a staple removal device? |
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What is a gastrointestinal anastomosis (GIA) device? |
Stapling device that lays two rows of small staples in a hemostatic row and automatically cuts in between them |
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What is a suture ligature (aka stick tie)? |
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 |
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What is a retention suture? |
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 |
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What is a pop-off suture? |
Suture that is not permanently swaged to the needle, allowing the surgeon to “pop off” the needle from the suture without cutting the suture |
