Sutures Chapter 11 (Nicola)

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created 6 years ago by fudgey65
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1

Color: Yellow
Coating: None
NATURAL Strand: Monofilament
Tensile: Maintained 7-10 days
Absorbable: Enzymatic, complete in 70 days

Usage: In presence of infection, superficial hemostasis. Packed in alcohol

Plain Gut

Absorbable (natural) monofilament

2

Color: Beige, Tan
Coating: None
NATURAL Strand: Monofilament
Tensile: Maintained 10-14 days
Absorbable: Complete in 90 days

Usage: Internal Ligation, peritoneum
OTHER: Chrome gut treated with chromium salt

Chromic Gut

Absorbable (natural) monofilament

3

Color: Clear, Blue, Violet
Coating: None
SYNTHETIC Strand: Monofilament
Tensile: 180-240 days by hydrolysis
Absorbable: Slow hydrolysis, complete in 6 mths

Usage: All types soft tissue, ortho, gyne, eye,
Other: Not for use on prosthetic devices

Polydioxanone (PDS II) polyester Polymer

Absorbable (synthetic) monofilament

4

Color: Undyed, Violet
Coating: None
SYNTHETIC Strand: Monofilament
Tensile: 60% of its original strength for 6 weeks
Absorbable: Hydrolysis 183-238 days

Usage: Same as (PDS II) but NO contact with sclera

PDS plus antibacterial

Absorbable (synthetic) monofilament

5

Color: Undyed, violet
Coating: None
SYNTHETIC Strand: Monofilament
Tensile: Undyed 21 days
Tensile: Dyed 28 days
Absorbable: hydrolysis, 91-119 days

Usage: General soft tissue approximation and/or ligation, gyne, urologic, and plastics

Poliglecaprone 25 (monocryl)

Absorbable (synthetic) monofilament

6

Color: Undyed, violet
Coating: None
SYNTHETIC Strand: Monofilament
Tensile: Wound support for 14 days
Absorbable: 91-119 days

Usage: (Same as monocryl) General soft tissue approximation and/or ligation
Other: Shown in vitro to kill bacteria and inhibit bacterial colonization of the suture

Monocryl plus antibacterial

Absorbable (synthetic) monofilament

7

Color: Violet
Coating: None
SYNTHETIC Strand: Multifilament
Tensile: 6-0 & larger 75% at 2wks, 50% at 3wks
Tensile: 7-0 and smaller 40% at 3 weeks
Absorbable: Hydrolysis, complete in 50-60 days

Usage: Tissue that requires long term tensile strength, but an absorbable suture, soft tissue, and/or ligation
Other: Uncoated available for ophthalmic use

Polyglactin 910 (vicryl)copolymer

Absorbable (synthetic) multifilament

8

Color: Undyed, violet
Coating: Yes Polyglactin 370 stearate
SYNTHETIC Strand: Multifilament
Tensile: Progressive loss of tensile strength
Absorbable: 56-70 days

Usage: soft tissue approximation and/or ligation, including use in ophthalmic procedures
Other: surgical suture composed of a copolymer made from 90% glycolide and 10% L-lactide

Polyglactin 910 coated (coated vicryl)

Absorbable (synthetic) multifilament

9

Color: Undyed, violet
Coating: Yes
SYNTHETIC Strand: Multifilament
Tensile: Wound support 4 wks
Absorbable: Hydrolysis, 56-70 days

Usage: soft tissue approximation and/or ligation, CANNOT be use in ophthalmic, neuro or CV procedures

Vicryl plus suture

Absorbable (synthetic) multifilament

10

Color: Undyed, black, blue, green
Coating: None
SYNTHETIC Strand: Monofilament
Tensile: Degrades 15-20% per year
NON-absorbable: N/A

Usage: general soft tissue approximation and/or ligation
Other: Easier to handle when damp, requires more throws in the knot

Nylon

Non-absorbable (synthetic) monofilament

11

Color: Clear, blue
Coating: None
SYNTHETIC Strand: Monofilament
Tensile: Excellent
NON-absorbable: N/A

Usage: Excellent for contaminated wounds, infection, commonly used for mesh
Other: LEAST reactive of all synthetic material

Polypropylene (prolene)

Non-absorbable (synthetic) monofilament

12

Color: White
Coating: None
SYNTHETIC Strand: Monofilament
Tensile: Excellent
Absorbable: N/A

Usage: general soft tissue approximating, bone grafting, soft tissue implants, plastic surgery. Has good knot security, but no memory

Polytetrafluoro - ethylene

Non-absorbable (synthetic) monofilament

13

Color: Silver
Coating: None
SYNTHETIC Strand: Monofilament
Tensile: Indefinite
NON-Absorbable: N/A

Usage: abdominal wound closure, hernia repair, sterna closure and ortho. MOST INERT
Other: Must not be used in presence of other metals, prostheses, implants etc

Stainless steel

Non-absorbable (synthetic) monofilament

14

Color: White
Coating: None
SYNTHETIC Strand:
Tensile: Excellent
NON-absorbable: N/A

Usage: Anastomosis of vascular grafts for vascular access, mitral valve, pelvic floor, robotics

GORE-TEX

Non-absorbable (synthetic) monofilament

15

Color: Undyed, black
Coating: Wax or silicone
NATURAL Strand: Multifilament
Tensile: Loses most in 1 year
NON-Absorbable: Not detected in tissue after 2 years

Usage: Serosa GI tract, fascia, suture ligatures
Other: Must be used dry

Surgical silk

Non-absorbable (natural) multifilament

16

Color: Undyed, black, green
Coating: PTFE, silicaone
SYNTHETIC Strand: Multifilament
Tensile: Excellent strength, but lost over time
NON-Absorbable: N/A

Usage: General soft tissue when continual strength is needed, neurological closures, eye and CV

Nylon

Non-absorbable (synthetic) multifilament

17

Color: Undyed, green
Coating: Polybutilate
SYNTHETIC Strand: Multifilament
Tensile: Excellent - no significant change
NON-absorbable: N/A

Usage: General soft tissue, commonly used to close heart incisions

Polyethylene terephthalate coated with polybutilate

Non-absorbable (synthetic) multifilament

18

Color: Undyed, green
Coating: None
SYNTHETIC Strand: Multifilament
Tensile: Excellent
NON-absorbable: N/A

Usage: General soft tissue, neurological closures, eye, CV, and respiratory tract

Polyethylene terephthalate (mersilene)

Non-absorbable (synthetic) multifilament

19

Color: Undyed, green
Coating: Uncoated or coated
SYNTHETIC Strand: Multifilament
Tensile: Excellent
Absorbable: N/A

Usage: Especially useful in digestive tract, also used in soft tissue

Dacron (polyester fibers)

Non-absorbable (synthetic) multifilament

20

Color: Black
Coating: Silicone
SYNTHETIC Strand:
Tensile: Excellent
Absorbable: N/A

Usage: Ortho, soft tissue, rotator cuff

Fiberwire

Non-absorbable (synthetic) multifilament