Beruflich Dokumente
Kultur Dokumente
FKH UB
2018
Can be used in any tissue
Easy to handle
Good knot security
Minimal tissue reaction
Unfriendly to bacteria
Cheap
Physical characteristic
Physical configuration : mono or multifilament
Capillarity : ability to soak up fluid along the
strand
Fluid absorption ability
Diameter : in milimeters, expressed in USP sizes
with zeroes (0)
Tensile strenght : amount of weight (Breaking
load) necessary to break a suture (Breaking
strenght)
Handling characteristics
Pliability : the material ability to bend
Coefficient of friction : the material ability to slip
through tissues & ties
Knot Strenght : force necessary to cause a given
type of knot to slip, partially or completely
Tissue reaction characteristics :
Inflammatory and fibrous tissue reaction
Absorption
Potention of infection
Allergic reaction
To bring tissue edges together and speed
wound healing (=tissue apposition)
Origin
Synthetic
Absorbable
SUTURES Absorption
Nonabsorbable
Multifilament
Fiber
construction
Monofilament
Absorbable Vs. Nonabsorbable
Natural or Synthetic
Internal organs
Intradermal/ subcuticular
Rarely on skin
Primarily Skin
– Needs to be removed later
Mechanism
Natural Lysosomal enzyme attack & break down strands
Synthetic water gradually penetrate
Hydrolyzed
Multifilament
Breaks down by
phagocytosis:
inflammatory reaction
common
Chromic: tanned, lasts
longer, less reactive
Easy handling
VERY reactive,
absorbable
Ophthalmic surgery
only
Synthetic absorbable suture that is
copolymer of lactide and gycolide
Similar use and attributes to PGA exept that
may be braided or monofilament
Maintain tensile strength for about 3 weeks
and is absorbed within 90 days by hydrolisis
Braided, synthetic, absorbable
Stronger than gut: retains strength 3 weeks
Broken down by enzymes, not phagocytosis
Break-down products inhibit bacterial growth
– Can use in contaminated wounds, unlike other
multifilaments
Woven from fine filementous threads extracted
from hydroacetic acid
Suture size is determine by the number of
woven strands
Handle well, but the knot tend to slip
High coefficient of friction and tens to cut friable
tissue
Uniformly absorbed in 40-60 days
Less reactive than surgical gut with similar
indication
Don’t use in tissue that heal slowly or in
mucosa of urinary bladder or urethra
(prematurely absorbed in urine)
Polymer of glycolic acids
Braided, synthetic, absorbable
Broken down by enzymes
Both PGA and dexon have increased tissue
drag, good knot security
Both are stronger than gut
Synthetic monofilament absorbable suture
Less drag in tissue and may be used more
effestively in friable tissues
Safe in use in urologic surgery
LA : 0 through 3
Stainless Steel
– In gauges (like needles)
▪ Smaller gauge = bigger, stronger
▪ Larger gauge= smaller, finer
– 26 gauge = “ought”
– 28 gauge = 2-0
Generally 4 “throws” for >90% knot security
(nylon may need 5)
– Less “throws” = more likely to untie itself
Little strength