sutures

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slide 1 jesil mary john intern sutures introduction suture means to ‘sew’ or seam act of sewing or bringing tissue together and holding them in apposition until healing has taken place what’s it used for? to bring tissue edges together and speed wound healing( + tissue apposition) to help stabilizing the joints- ligament repair ligate vessels or tissues suture material is a strand of fibre used to keep wound together until they hold sufficiently well by themselves by natural fibre(collagen) which is synthesized and woven into a stronger scar. 4 ideal suture material easy to handle predictable behaviour in tissues predictable tensile strength sterile glides through tissues easily secure knotting ability inexpensive minimal tissue reaction non-allergenic non-carcinogenic non-electrolytic non-shrinkage suture material source structure fate coating natural monofilament absorbable coated synthetic multifilament non-absorbable uncoated metallic monofilament single strand of suture material minimal tissue trauma smooth tying but more knots needed harder …

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absorbable stronger than gut: retains strength 3 weeks broken down by enzymes(hydrolysis), not phagocytosis break-down products inhibit bacterial growth minimal tissue reactivity .can use in contaminated wounds, unlike other multifilaments absorption : 35 – 42 days dexon / pga polymer of glycolic acids braided, synthetic, absorbable broken down by enzymes(hydrolysis) it is stronger than gut non absorbable- natural surgical silk black, derived from the cocoon of the silk worm larvae ease of handling. good knot security cost effective undergoes proteolysis used in ligating major blood vessels. other eg: virgin silk, cotton, linen surgical steel natural, monofilament/multifilament, non absorbable alloy of nickel, iron and chromium difficult to handle and tendency to cut through tissues very hard to tie used in abdominal wall and skin closure, hernia repair, sterna closure and orthopaedic procedure including cerclage & tendon repair. skin staples very common in modern medicine expensive very easy very secure very little …

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al suture. suture needles classified according to shape and type of point curved or straight swaged or eyed tapered point, cutting or reverse cutting made up of either ss or carbon steel 2 basic configurations for curved needles cutting: cutting edge can cut through tough tissue, such as skin tapered: no cutting edge; used for softer tissue inside the body surgical needles cutting tapered www.emedicine.medscape.com www.emedicine.medscape.com needle anatomy term chord linear distance between eye and tip diameter gauge or thickness of the metal wire out which the needle is made length of needle distance betw eye and tip following the curvature radius distance of the body of the needle from the center of the circle eyed require threading prior to use, resulting in pulling a double strand through tissue tying the suture to the eye increases the bulk of suture material drawn through the tissues - ‘traumatic needles’ swaged needles …

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slide 1 jesil mary john intern sutures introduction suture means to ‘sew’ or seam act of sewing or bringing tissue together and holding them in apposition until healing has taken place what’s it used for? to bring tissue edges together and speed wound healing( + tissue apposition) to help stabilizing the joints- ligament repair ligate vessels or tissues suture material is a strand of fibre used to keep wound together until they hold sufficiently well by themselves by natural fibre(collagen) which is synthesized and woven into a stronger scar. 4 ideal suture material easy to handle predictable behaviour in tissues predictable tensile strength sterile glides through tissues easily secure knotting ability inexpensive minimal tissue reaction non-allergenic non-carcinogenic non-electrolytic non...

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