FINAL SUTURE, NEEDLES, AND STAPLES

Why is a cutting needle used for skin closure?

Cuts through tissue easily because if it’s triangle sharp tip

Which type of suture needle would be best for fireable tissue like liver or kidney and why?

Blunt needle, It won’t puncture it

why are interrupted sutures, preferred, in infected wounds

Reduces the spread of infection/easier to remove infected area if infection occurs

what does it mean when the suture is labeled “plus”

Antibacterial coating

which stapler is commonly used to create a circular anastomosis in the colon

Intraluminal stapler

How does a linear stapler differ from a GIA stapler

• Linear: Used to divide tissue

• GIA: Creates anastomosis between two bowel segments

What is the purpose of an Endo-GIA stapler in laparoscopic procedures?

• Same principle as GIA but sized for minimally, invasive surgeries

• Laparoscopic anastomosis

What are the advantages of skin stapler over traditional suture closure

Good for long incisions/faster closing

What is the purpose of auntie antibacterial sutures?

To reduce infection risk

What does an intraluminal stapler (EEA, ILS, “ Circular staple”) do?

• Fires a circular double row of staples

• Used to reanastomose tubular structures, like the colon esophagus or rectum

What does a linear stapler (TA, “thoracoabdominal” or “ Linear cutter”) Do?

• Fires two straight parallel rows of stapler

• Used to divide tissue such as bowel or lung tissue

• Often applied across the stomach or intestines

What does a linear cutter stapler ( GIA - Gastrointestinal anastomosis Stapler) Do?

• Fire is two double rows of staples and cuts between them

• Create a secure stapled anastomosis between two bowel segments during resections

What does a skin stapler do?

• Places, external staples to close skin incision

• Provides rapid closure of long incisions

Natural sutures

• Plain gut

• Chromic gut

• Silk

Synthetic sutures

• Monocryl/polygecaprone

• PDS/ polydioxanone

• Ethilon/ nylon

• Prolene/ polypropylene

• Vicryl/ polyglactin 910

• Ethibond/ polyester

Plain gut

• Absorbable

• Monofilament

• Collagen from serosa of beef intestine or submucosa of sheep intestine

• Color:yellow

• Use:subcutaneous, ligating superficial blood vessels

• Packaged in alcohol

Chronic gut

• Absorbable

• Monofilament

• Collagen from serosa of beef intestine or submucosa of sheep intestine

• Plain gut treated with chromium salt solution to prolong absorption rate

• Color: tan

• Use: subcutaneous, ligating superficial blood vessels

• Packaged in alcohol

Silk

• Non absorbable, “slow absorbing”, breaks down in tissue and is undetectable after 2 years

• Natural fiber from silkworm cocoons

• Color: black

• Use: serosa of GI tract, fascia, suture ligatures

• Must be kept dry!

Monocryl/ polyglecaprone

• Absorbable

• Monofilament

• Color: undyed, violet

• Use: soft tissue approximation and/ or ligation

• Good knot security

PDS/ polydioxanone

• Absorbable

• Monofilament

• Color: clear, blue, violet

• Use: soft tissue approximation, including orthopedics, gynecology, eye, plastic, digestive, and pediatric CV

• Little memory

Ethilon/ nylon

• Non absorbable

• Monofilament

• Color: undyed, black, blue, green

• Use: soft tissue approximation and/ or ligation, including eye, CV, and neural tissues, microsurgery

• Memory requires more knots

Prolene/ polypropylene

• Non absorbable

• Monofilament

• Color: clear, blue

• Use: general, orthopedic, plastic, CV, and neurologic surgery, vascular anastomosis

• Especially useful in contaminated wounds and in presence of infection

• Commonly used as mesh for tissue reinforcement

Vicryl/ polyglactin 910

• Absorbable

• Multifilament

• Color: undyed, violet

• Use: soft tissue approximation and/ or ligation, eye procedures

• Good knot security

• No memory

Ethibond/ polyester

• Non absorbable

• Multifilament

• Color: undyed, green

• use: soft tissue approximation and/ or ligation, commonly used to close incisions of the heart, tendon repair, eye and neurologic surgery

• Braided