Suture Characteristics:
Memory
Memory is the capacity to take back former shape after being tied
Suture Characteristics:
Coefficient of Friction
Coefficient of Friction is the ability to glide through tissue and retain a knot
Suture Characteristics:
Capillarity
Capillarity is the ability to soak up fluid along a strand
Suture Characteristics:
Pliability
Pliability is the ability to bend easily
Suture Characteristics:
Knot tensile strength
Knot tensile strength is the force, measured in pounds, that the suture strand can withstand before it breaks when knotted
Suture Characteristics:
Elasticity
Elasticity is the ability to regain original form and length after being stretched.
If a natural absorbable suture starts to dry during a procedure…
If a natural absorbable suture starts to dry during a procedure, the material may be restored by quickly immersing in sterile water or NS solution that is not above 98.6 F. it should NOT be soaked.
Natural Absorbable Suture:
Plain catgut (type A) is used for…
Plain catgut (type A) is used for
- Ligation of small vessels
- To suture subQ fat
- To suture tissue under tension while healing.
Natural Absorbable Suture:
Chromic gut (type C) is used for…
Chromic gut (type C) is used for
- Infected tissues and slow-healing tissue
- Ligation of larger vessels, biliary, urinary tracts
- Muscle and fascia closure
Synthetic Absorbable Suture (made of POLYmers):
Polydioxanone sutures (eg PDS) are used for…
Polydioxanone sutures (eg PDS) are used for
- Abdominal and thoracic closure
- SubQ tissue
- Colorectal surgery
Synthetic Absorbable Suture (made of POLYmers):
Polyglyconate sutures (eg Maxon) are used for…
Polyglyconate sutures (eg Maxon) are used for * Soft tissue except cardiovascular neural and ophthalmic tissues
Synthetic Absorbable Suture (made of POLYmers):
Polyglactin 910 sutures (eg Vicryl) are used for…
Polyglactin 910 sutures (eg Vicryl) are used for
- Ophthalmic procedures
- When absorption is desired
Synthetic Absorbable Suture (made of POLYmers):
Polyglycolic acid sutures (eg Dexon) are used for…
Polyglycolic acid sutures (eg Dexon) are used for
* Peritoneal, fascial, and subQ closure
Natural Absorbable Suture:
Collagen suture is used for…
Collagen suture is used for
* Opthalmalogic surgery
General characteristics of natural absorbable sutures include:
General characteristics of natural absorbable sutures include:
- Pkg’d in fluid which may be irritating
- Open over a small basin to prevent splashing
- Don’t open until needed (lose pliability when dry)
- For eye procedures, rinse but don’t soak
- If starting to dry, quickly immerse in sterile water or NS but don’t soak.
- Unwind carefully & gently. Excessive handling weakens and damages the material
General characteristics of synthetic absorbable sutures include:
General characteristics of synthetic absorbable sutures include:
- Use dry
- Don’t soak or dip in H2O/NS - causes hydrolysis
- They retain pliability & are soft / smooth.
General characteristics of natural nonabsorbable sutures include:
General characteristics of natural nonabsorbable sutures include:
- Made of silk, surgical cotton, linen or stainless steel
- 3 types of silk - dermal, virgin and surgical. Used dry.
- Surgical cotton is used for ligating and suturing. Gains strength when wet.
- Linen is used for GI surgery and has inferior tensile strength compared to other nonabsorbables.
- Stainless steel is used for closure of abd wall or sternum, retention sutures, secondary repairs, respiratory tract, orthopedics and neuro.
Natural nonabsorbable suture:
Stainless Steel
Stainless steel is used for
- closure of abd wall or sternum,
- retention sutures,
- secondary repairs,
- respiratory tract, orthopedics and neuro.
- Knot tying is painstaking
- Be careful - may cut tissue or gloves
- CAN be used with infection
- CANNOT be used with another alloy like titanium
- only cut with wire scissors
Natural NONAbsorbable Suture:
Surgical silk
Surgical silk suture gives good support during early ambulation and promotes rapid healing;
Used to close fascia when no infection is present
Natural NONAbsorbable Suture:
Virgin silk
Virgin silk is composed of natural fibers and used for ophthalmic surgery.
Natural NONAbsorbable Suture:
Dermal silk
Dermal silk strands are encased in gelatin or protein substances and used for skin sutures.
Natural NONAbsorbable Suture:
Surgical cotton
Surgical cotton is the weakest of the nonabsorbable sutures but gains strength when wet.
Natural NONAbsorbable Suture:
Linen
Linen suture is used for GI surgery and has inferior tensile strength compared to other nonabsorbables.
Synthetic NONabsorbable Suture characteristics:
Synthetic NONabsorbable Suture characteristics:
* made of synthetic polymers
* Advantages - higher tensile strength, less tissue reaction and the material retains its strength in tissue.
Disadvantages – knot tying is hard b/c the material is slick.
* Handle as little as possible - easily damaged, pulled, stretched.
* A special knot is needed for security.
