Suture, Needles, and Staples

Suture

any material that holds tissue together

Multifilament suture

very strong, reactions, can harbor bacteria

Monofilament suture

Prevents wicking, lower infection; poor knotting, significant memory

Sizes of sutures

11-0 is smallest, increases as the #-0 decreases, size increases as whole numbers go up

What is 0-4-0 suture used most for?

Routine type surgeries

What is 5-0 to 7-0 suture used most for?

Delicate Vascular work

What is 8-0 to 10-0 suture used most for?

Ophthalmic surgery

Chromic Gut suture

Absorbable suture; absorbs in 10-15 days; easy to work with and inexpensive

Synthetic Absorbable Suture Options

PDS, Polyglecaprone-Monocryl, PLA (Vicryl), PGA (Dexon), Polyglyconate-Maxon, Polysorb, GLycomer 631-Biosyn

How is synthetic absorbable suture material broken down?

Hydrolysis

How long does synthetic absorbable suture material take to absorb?

40-60 days

Organic Nonabsorbable Suture

Silk is most common

Silk suture use

Cardiovascular, ophthalmic, GI, vessel ligation, PU

Silk Suture

twisted or braided; wicking, avoid in contaminated sites; can cause inflammation;

Synthetic Nonabsorbable Materials

less irritating than silk; very strong; not inclined to harbor bacterial growth

Metallic Sutures

Usually stainless steel; monofilament wire or twisted multifilament wire; minimal tissue reaction; knot ends evoke an inflammatory reaction; stable in contaminated wounds

Swaged Needle

atraumatic; suture already attached to the needle

Eyed needle

reusable; suture must be threaded through eye, have to drag not through

Tapered needles

atraumatic; suited to soft tissue; dilates rather than cuts

What are taper needles used for?

Intestine, SQ tissues, fascia

Cutting needle

very sharp, cuts rather than dilates, creates weakness allowing suture to tear out; end triangle in shape (three cutting edges)

Reverse cutting needle

Very sharp, ideal for skin, cuts rather than dilates; Upside-down triangle

What is a cutting needle used for?

skin, eye tissues and facial tissue; not for areas needling seel

What are reverse cutting needles used for?

suturing most hollow organs

Taper-cutting

ideal in tough or calcified tissues

Metal Clips and Staples

used to ligate small blood vessels, pull wound edges together