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ETHICON | STRATAFIX Flashcards

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1
Q

STRATAFIX Spiral MONOCRYL Plus device with Bidirectional design (Spiral family) - basics

(Polymer, color, absorption profile, tensile strength, antimicrobial (or no), design features)

A

Polymer: Monocryl (glycolide + epsilon=caprolacton)
Color: Undyed
Absorption profile: 90-120 days
Tensile strength: 1-2 weeks
Antimicrobial coating: No
Design Features: Bidirectional anchors in a 360 degree spiral pattern, 2 needles, transition zone for fixation

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2
Q

STRATAFIX Spiral MONOCRYL Plus device with Unidirectional design (Spiral family) - basics

(Polymer, color, absorption profile, tensile strength, antimicrobial (or no), design features)

A

Polymer: Monocryl (glycolide + epsilon-caprolactone)
Color: Undyed
Absorption profile: 91 days
Tensile strength: 7-21 days
Antimicrobial coating: Yes - IRGACARE MP (triclosan)
Design Features: Unidirectional anchors in a 360 degree spiral pattern, 1 needle, adjustable fixation loop

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3
Q

STRATAFIX Spiral MONOCRYL Plus with Bidirectional design (Spiral family) - what are notable features (2-3) of this suture’s advantages?

A

1) polymer provides strength for a shorter period of time and then absorbs quickly into the body
2) bidirectional anchors eliminate the needs for knots
3) Best used for superficial layers (like skin)

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4
Q

STRATAFIX Spiral MONOCRYL Plus with Bidirectional design (Spiral family) - Indications (when used and in what specialty)

A

Device is intended for use on soft tissue approximation where use of absorbable sutures is appropriate

Examples: Plastic surgery, Orthopedic surgery

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5
Q

STRATAFIX Spiral MONOCRYL Plus with Bidirectional design (Spiral family) - contraindications (when and how not to use)

A

Device should NOT be used where extended approximation of tissue under stress is required

Device should not be used in conjunction with or for fixation of prosthetic devices that are non absorbable in nature (heart valves, synthetic grafts)

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6
Q

STRATAFIX Spiral MONOCRYL Plus with Bidirectional design (Spiral family) - design details (Needle)

A

Needles: Two, one on each end (bidirectional)

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7
Q

STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - design details (Needle)

A

Needles: One needle (unidirectional)

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8
Q

STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - design details (Needle)

A

Needles: One needle (unidirectional)

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9
Q

STRATAFIX Spiral Polypropylene with Unidirectional design (Spiral family) - design details (Needle)

A

Needles: One needle (unidirectional)

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10
Q

STRATAFIX Spiral MONOCRYL Plus with Unidirectional design (Spiral family) - what are notable features (2-3) of this suture’s advantages?

A

1) one of the first STRATAFIX spiral knotless tissue control devices to have an antimicrobial coating

2) provides strength and stability primary for skin (subcuticular) and fat (subcutaneous) layers

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11
Q

STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - design details (anchors)

A

Anchors: Placed in a unidirectional symmetric pattern; 5 anchors / cm; maintains the core of the device

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12
Q

STRATAFIX Spiral MONOCRYL Plus with Unidirectional design (Spiral family) - Indications (when used and in what specialty)

A

Device is intended for use on soft tissue approximation where use of absorbable sutures is appropriate

Examples: Plastic surgery, Orthopedic surgery, Gynecology, Urology, General surgery

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13
Q

STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - design details (fixation tab)

A

Fixation tab: Secures the device without the need for tying a knot; dimensions (0.2” x 0.1”)

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14
Q

STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - design details (leader length)

A

Leader length (~1.9 cm): recommended area where to grab the suture so as not to damage the anchors; part between the needle and the anchor; allows the surgeon to “back out” of the initial bite

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15
Q

STRATAFIX Spiral Polypropylene with Unidirectional design (Spiral family) - design details (leader length)

A

Leader length (~35 mm): recommended area where to grab the suture so as not to damage the anchors; part between the needle and the anchor; allows the surgeon to “back out” of the initial bite

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16
Q

STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - Indications (when used and in what specialty)

A

Device is intended for use on soft tissue approximation where use of absorbable sutures is appropriate

only device appropriate for high tension areas such as deep fascia

Examples: Plastic surgery, orthopedic surgery, gynecology, General Surgery, bariatric surgery

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17
Q

STRATAFIX Spiral Polypropylene with Unidirectional design (Spiral family) - design details (anchors)

A

Anchors: Placed in a 360 degree spiral pattern; 20 anchors / inch (8/cm); anchor depth ~30% into core; anchor angle ~15-20 degrees

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18
Q

STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - what are notable features of this suture’s advantages?

A

1) First STRATAFIX Symmetric knotless tissue control device to have an antimicrobial coating and non-spiral symmetric anchors

2) provides strength and security for high tension areas such as deep fascia

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19
Q

STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - design details (anchors)

A

Anchors: Placed in a 360 degree spiral pattern; 20 anchors / inch (8/cm); anchor depth ~30% into core; anchor angle ~15-20 degrees

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20
Q

STRATAFIX Spiral MONOCRYL Plus with Unidirectional design (Spiral family) - design details (anchors)

A

Anchors: Placed in a 360 degree spiral pattern; 20 anchors / inch (8/cm); anchor depth ~30% into core; anchor angle ~15-20 degrees

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21
Q

STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - design details (adjustable fixation loop)

A

Adjustable fixation loop: secures device without the need for tying a knot

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22
Q

STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - design details (leader length)

A

Leader length (~35 mm): recommended area where to grab the suture so as not to damage the anchors; part between the needle and the anchor; allows the surgeon to “back out” of the initial bite

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23
Q

STRATAFIX Spiral MONOCRYL Plus with Unidirectional design (Spiral family) - design details (leader length)

A

Leader length (~35 mm): recommended area where to grab the suture so as not to damage the anchors; part between the needle and the anchor; allows the surgeon to “back out” of the initial bite

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24
Q

STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - Indications (when used and in what specialty)

A

Device is intended for use on soft tissue approximation where use of absorbable sutures is appropriate

Examples: Plastic surgery, orthopedic surgery, gynecology, General Surgery, urology

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25
STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - what are notable features of this suture's advantages?
1) First STRATAFIX Spiral knotless tissue control device to have an antimicrobial coating 2) provides strength and security for a longer period of time, making it useful for deeper layers (EXCEPT for high tension areas such as deep fascia)
26
STRATAFIX Spiral MONOCRYL Plus with Unidirectional design (Spiral family) - design details (adjustable fixation loop)
Adjustable fixation loop: secures the device without need for typing a knot
27
STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - device basics (Polymer, color, absorption profile, tensile strength, antimicrobial (or no), design features)
Polymer: PDS (polyester + p-dioxanone) Color: Violet Absorption profile: 210 days Tensile strength: 4-6 weeks Antimicrobial coating: Yes - IRGACARE MP (triclosan) Design Features: Unidirectional anchors in a non spiral, symmetric pattern, 1 needle, fixation tab
28
STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - contraindications (when and how not to use)
Device should NOT be used where approximation of tissue under stress beyond 6 weeks is required Device should not be used in patients with known allergic reactions to IRGACARE MP (triclosan) Device should not be used in conjunction with or for fixation of prosthetic devices that are non absorbable in nature (heart valves, synthetic grafts)
29
STRATAFIX Spiral MONOCRYL Plus with Unidirectional design (Spiral family) - contraindications (when and how not to use)
Device should NOT be used where extended approximation of tissue under stress is required (i.e. fascia) Device should NOT be used with nonabsorbable prosthetic devices Device should NOT be used in patients with known allergic reactions to IRGACARE MP (triclosan)
30
STRATAFIX Spiral Polypropylene with Unidirectional design (Spiral family) - what are notable features (2-3) of this suture'?
1) Uses a non absorbable polymer to provide permanent support (i.e. organ tissue) 2) NOT appropriate for closure of the epidermis
31
STRATAFIX Spiral Polypropylene with Unidirectional design (Spiral family) - Indications (when used and in what specialty)
Device is intended for use on soft tissue approximation excluding closure of the epidermis Examples: Plastic surgery, General surgery
32
STRATAFIX Spiral Polypropylene with Unidirectional design (Spiral family) - contraindications (when and how not to use)
Device should not be used for surface closures through the epidermis (because removal is unfeasible)
33
STRATAFIX Spiral MONOCRYL Plus with Unidirectional design (Spiral family) - design details (Needle)
Needles: One needle (unidirectional)
34
STRATAFIX Spiral PDS Plus with Bidirectional design (Spiral family) - design details (Needle)
Needles: Two, one on each end (bidirectional)
35
STRATAFIX Spiral Polypropylene with Bidirectional design (Spiral family) - design details (Needle)
Needles: Two, one on each end (bidirectional)
36
STRATAFIX Spiral MONOCRYL Plus with Bidirectional design (Spiral family) - design details (anchors)
Anchors: Placed in a 360 degree spiral pattern; 20 anchors / inch (8/cm); anchor depth ~30% into core; anchor angle ~15 degrees
37
STRATAFIX Spiral Polypropylene device with Unidirectional design (Spiral family) - basics (Polymer, color, absorption profile, tensile strength, antimicrobial (or no), design features)
Polymer: Polypropylene Color: Undyed Absorption profile: None; permanent polymer Tensile strength: Permanently Antimicrobial coating: No Design Features: Unidirectional anchors in a 360 degree spiral pattern, 1 needle, adjustable fixation loop
38
STRATAFIX Spiral MONOCRYL Plus with Bidirectional design (Spiral family) - design details (transition zone)
Transition zone: Marks the midpoint of the device and is where anchors change direction; anchors the device while suturing (~2 mm long)
39
STRATAFIX Spiral Polypropylene with Bidirectional design (Spiral family) - design details (leader length)
Leader length (~35 mm): recommended area where to grab the suture so as not to damage the anchors; part between the needle and the anchor; allows the surgeon to "back out" of the initial bite
40
STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - device basics (Polymer, color, absorption profile, tensile strength, antimicrobial (or no), design features)
Polymer: PDS (polyester + p-dioxanone) Color: Violet Absorption profile: 210 days Tensile strength: 4-6 weeks Antimicrobial coating: Yes - IRGACARE MP (triclosan) Design Features: Unidirectional anchors in a 360 degree spiral pattern, 1 needle, adjustable fixation loop
41
STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - contraindications (when and how not to use)
Device should NOT be used where approximation of tissue under stress beyond 6 weeks is required Device should not be used in patients with known allergic reactions to IRGACARE MP (triclosan) Device should not be used in conjunction with or for fixation of prosthetic devices that are non absorbable in nature (heart valves, synthetic grafts)
42
STRATAFIX Spiral Polypropylene with Bidirectional design (Spiral family) - design details (anchors)
Anchors: Placed in a 360 degree spiral pattern; 20 anchors / inch (8/cm); anchor depth ~30% into core; anchor angle ~15 degrees
43
STRATAFIX Spiral Polypropylene with Bidirectional design (Spiral family) - design details (transition zone)
Transition zone: Marks the midpoint of the device and is where anchors change direction; anchors the device while suturing (~2 mm long)
44
STRATAFIX Spiral MONOCRYL Plus with Bidirectional design (Spiral family) - design details (leader length)
Leader length (~35 mm): recommended area where to grab the suture so as not to damage the anchors; part between the needle and the anchor; allows the surgeon to "back out" of the initial bite
45
STRATAFIX Spiral PDS Plus with Bidirectional design (Spiral family) - design details (anchors)
Anchors: Placed in a 360 degree spiral pattern; 20 anchors / inch (8/cm); anchor depth ~30% into core; anchor angle ~15 degrees
46
STRATAFIX Spiral PDS Plus with Bidirectional design (Spiral family) - design details (transition zone)
Transition zone: Marks the midpoint of the device and is where anchors change direction; anchors the device while suturing (~2 mm long)
47
STRATAFIX Symmetric PDS Plus with Unidirectional design (Symmetric family) - design details (Antibacterial protection)
Contains IRGACARE MP (Triclosan), a broad spectrum antibiotic Animal studies demo inhibition of bacterial colonization of the device after direct in vivo challenge with bacteria CDC, WHO, ACS endorse the use of triclosan-coated sutures to help reduce the risk of SSI
48
STRATAFIX Spiral PDS Plus with Bidirectional design (Spiral family) - design details (leader length)
Leader length (~35 mm): recommended area where to grab the suture so as not to damage the anchors; part between the needle and the anchor; allows the surgeon to "back out" of the initial bite
49
STRATAFIX Spiral PDS Plus with Bidirectional design (Spiral family) - device basics (Polymer, color, absorption profile, tensile strength, antimicrobial (or no), design features)
Polymer: PDS (polyester + p-dioxanone) Color: Violet Absorption profile: 120-180 days Tensile strength: 4-6 weeks Antimicrobial coating: No Design Features: Bidirectional anchors in a 360 degree spiral pattern, 2 needles, transition zone for fixation
50
STRATAFIX Spiral PDS Plus with Bidirectional design (Spiral family) - Indications (when used and in what specialty)
Device is intended for use on soft tissue approximation where use of absorbable sutures is appropriate Examples: Plastic surgery, orthopedic surgery, gynecology
51
STRATAFIX Spiral PDS Plus with Bidirectional design (Spiral family) - what is a notable feature of this suture's advantages?
1) Uses a polymer which provides strength and support to maintain tension for 4-6 weeks
52
STRATAFIX Spiral PDS Plus with Bidirectional design (Spiral family) - contraindications (when and how not to use)
Device should NOT be used where extended approximation of tissue under stress beyond 6 weeks is required Device should not be used on the skin Device should not be used in conjunction with or for fixation of prosthetic devices that are non absorbable in nature (heart valves, synthetic grafts)
53
STRATAFIX Spiral Polypropylene device with Bidirectional design (Spiral family) - basics (Polymer, color, absorption profile, tensile strength, antimicrobial (or no), design features)
Polymer: Polypropylene Color: Undyed Absorption profile: None; permanent polymer Tensile strength: indefinite Antimicrobial coating: No Design Features: Bidirectional anchors in a 360 degree spiral pattern, 2 needles, transition zone for fixation
54
STRATAFIX Spiral Polypropylene with Bidirectional design (Spiral family) - what are notable features (2-3) of this suture'?
1) Uses a non absorbable polymer to provide permanent support (i.e. organ tissue) 2) NOT appropriate for closure of the epidermis
55
STRATAFIX Spiral Polypropylene with Bidirectional design (Spiral family) - Indications (when used and in what specialty)
Device is intended for use on soft tissue approximation excluding closure of the epidermis Examples: Plastic surgery, General surgery
56
STRATAFIX Spiral Polypropylene with Bidirectional design (Spiral family) - contraindications (when and how not to use)
Device should not be used for surface closures through the epidermis (because removal is unfeasible)
57
STRATAFIX Spiral PDS Plus with Unidirectional design (Spiral family) - design details (Antibacterial protection)
Contains IRGACARE MP (Triclosan), a broad spectrum antibiotic Animal studies demo inhibition of bacterial colonization of the device after direct in vivo challenge with bacteria CDC, WHO, ACS endorse the use of triclosan-coated sutures to help reduce the risk of SSI
58
How do STRATAFIX Knotless Tissue Control Devices provide more security?
No knot related complications (when compared to interrupted suturing) Provides strength and security of interrupted closure without knots Cutting the knotless tissue control device did not result in tissue separation in preclinical ex vivo trials Superior tissue holding strength when compared to interrupted technique
59
How do STRATAFIX Knotless Tissue Control Devices provide more consistency?
Easily manage tension and control approximation during closure (as compared to traditional sutures)
60
How do STRATAFIX Knotless Tissue Control Devices provide more efficiency?
No need for knot tying No need for an assistant to follow the suture line (or hold tension after each bite) Potentially less time under anesthesia
61
What STRATAFIX Knotless Tissue Control Device can be used in high tension areas such as fascia?
STRATAFIX Symmetric PDS Plus knotless tissue control device
62
What STRATAFIX Knotless Tissue Control Device can be used to close skin?
STRATAFIX Spiral MONOCRYL Plus
63
What STRATAFIX Knotless Tissue Control Device can be used on hernia mesh?
STRATAFIX Spiral Polypropylene
64
How much (length) should be retained for completing reverse stitching to secure the terminal end when using STRATAFIX Symmetric PDS Plus Knotless Tissue Control device during closure?
Approximately 3" (8 cm)
65
What are two benefits of the STRATAFIX Spiral Bidirectional Knotless Tissue Control Devices?
Management of tension from the middle of the incision for greater control over tissue approximation Facilitates management of wound closure in challenging conditions (non linear incisions, larger, open wounds)
66
What are three benefits of the STRATAFIX Spiral Unidirectional Knotless Tissue Control Devices?
Can be used in a continuous suture pattern for quick learning and mastery No need for knot tying, clips or staplers Ideal for minimally invasive procedures (easy to use adjustable loop)
67
Which STRATAFIX Spiral Knotless Tissue Control Device uses a non absorbable suture without Plus antibacterial technology?
STRATAFIX Spiral Polypropylene
68
Which two STRATAFIX Spiral Knotless Tissue Control Devicea use absorbable suture with Plus antibacterial technology?
STRATAFIX Spiral MONOCRYL Plus and Spiral PDS Plus
69
TRUE or FALSE: STRATAFIX Unidirectional devices (both Spiral and Symmetric) have the same size/strength relationship as the traditional suture of the same polymer?
TRUE
70
TRUE or FALSE: STRATAFIX Bidirectional devices have the same size/strength relationship as the traditional suture of the same polymer?
FALSE (anchor creation process changes the relationship)
71
What organisms (bacteria) has STRATAFIX with triclosan proved effective against (that are associated with SSIs)?
S.aureus, S.epi, K.pneumoniae, E.coli, MRSA, MRSE
72
What are the three key limitations of interrupted closure with traditional suture?
1) Inconsistent distribution of tension 2) Knot related complications 3) Time consuming
73
What are the key limitations of continuous closure with traditional suture?
Strength and security can be compromised with a break in the suture
74
TRUE or FALSE The unidirectional design for the STRATAFIX Spiral KTCD portfolio is NOT to be used in high tension deep fascia
TRUE. It is suitable for multiple soft tissues but not for high tension deep fascia
75
TRUE OR FALSE STRATAFIX Spiral PDS Plus Knotless Tissue Closure Devices is the only polymer that can be used in high tension deep fascia
FALSE, STRATAFIX Symmetric PDS Plus is the only Knotless Tissue Closure Devices designed specifically for high tension deep fascia
76
Name the STRATAFIX Knotless Tissue Closure Devices which have antibacterial technology
All synthetic absorbable STRATAFIX devices contain antibacterial technology: Spiral MONOCRYL Plus Spiral PDS Plus Symmetric PDS Plus
77
TRUE or FALSE STRATAFIX Spiral MONOCRYL Plus Device is most appropriate / best suited for superficial tissues such as the skin, fat and subcu layer
TRUE Ideally suited for a subcuticular layer of an abdominoplasty (for example) to achieve proper cosmesis while maintaining security
78
TRUE or FALSE STRATAFIX Spiral Devices are ideally suited for use in deep fascia
FALSE. STRATAFIX Symmetric PDS Plus was designed specifically for high tension areas such as fascia. Spiral Devices should NOT be used in fascia
79
What are the techniques for closure of the Bidirectional Spiral family? (there are 3)
1) running closure (continuous) 2) deep helical closure 3) dual-layer closure
80
What is the technique for closure of the Unidirectional Spiral family? (there is 1)
Running closure (continuous)
81
What is the technique for closure of the Unidirectional Symmetric family? (there is 1)
Running closure (continuous)
82
The Dual Layer Closure technique differs from the other Bidirectional Design techniques in what way(s)?
It closes two layers of tissue with one device. Surgeons must start at one end of a wound/incision Then close the deeper layer first, and then close the superficial layer
83
What do surgeons want at the skin layer?
Cosmesis
84
What do surgeons want at the fascial layer?
Strength (rupture reduction) Infection protection
85
What do surgeons want in the organ space?
Tissue health Precision Infection protection (also strength and security)
86
What are 3 limitations of interrupted closure with traditional suture?
Inconsistent distribution of tension Knot related complications Time consuming
87
What is the limitation of continuous closure with traditional suture?
Strength and security can be compromised with a break in the suture
88
Which STRATAFIX knotless tissue control device is ideal for skin?
Spiral MONOCRYL Plus
89
Which STRATAFIX knotless tissue control device is ideal for fat?
Spiral PDS Plus
90
Which STRATAFIX knotless tissue control device is ideal for fascia?
Symmetric PDS Plus
91
Which STRATAFIX knotless tissue control device is ideal for the organ layer?
Spiral PDS Plus
Ethicon sutures
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