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Types of Synthetic Absorbable Polymers1.Dexon – has a minimal absorption in 30 day 2.

VicrylNon-Absorbable Sutures These sutures are made from various materials that are not affected by the digesting enzymes. Theyremain encapsulated when buried in tissues and in removed post-operatively when used as skin suture.1. Silk • Not a true non-absorbable material • Loss much of its tensile strength after about 1 year and usually disappear after 1-2 or more years. • Gives good support to wound during early ambulation and generally promotes healing alittle more rapidly than surgical gut. • Used frequently in serosa of the gastrointestinal tract and close fascia in the absence of infection. • May be used in anastomosing major vessels, especially in your children. • Kinds:1. surgical silk2. virgin silk3. derma silk • Loss its tensile strength if wet, therefore do not moisten before use. • Black color 2.Surgical Cotton a. One of the weakest the non-absorbable material, but gains tensile strength when wet. Therefore,moisten it before handling to the surgeon. Tensile strength is increased by 10% by moisture. Moisture preventsclinging to the surgeon’s gloves .b. May be used in most body tissue for ligating and suturing but it offers no advantages over silk. 3.Dacron4.Nylon5.Polythylene6.Li-cron7.Havdek8.Stainless steelFactors Influencing the Choice of the Types of Suture 1.Desired length of time the sutures are to remain in place.2.Type of tissue to be sutured. Some tissue absorb suture faster than others.3.Nutritional status of the patient. The absorbable suture will faster in a malnourished, older, anemic or obese patient.4.Disease condition rate in increased when infection is present. Common Suturing Technique 1.Continuous – a running stitch that is tied only at the end of incision. This is used to close theperitoneum, muscle, fascia, subcutaneous tissue.2.Interrupted – each stitch is taken and tied up separately.3.Purse String – a continuous suture is placed around a lumen and tightened, drawstring fashion toclose the lumen. This is used when inverting the stump of the appendix.4.Subcuticular – a continuous suture is placed beneath the epithelial layer of the skin in short lateralstitched. It leaves a minimal scar.

5.Traction – may be used to retract a structure to the side of the operative field, out of the way.6.Mattress – a variation of the simple interrupted stitch, and is made by taking a second bite with theneedle through the tissue. Manner of Threading Sutures • Certain lengths have been found to be advantageous for various types of stitching. A suture strand thatis too long is difficult to handle. Excessive length offers greater opportunity for contamination of thisstrand as it can be dragged across the operative field. If the suture strand is too short. It may slip fromthe eye of the needle or it may be difficult to knot.a. Single – one length of suture is threaded on needle, one long end and one short end. Theshort end is 1/3 of the long one.b. Double – both end of the suture is the same in length. • Varieties of Ligature1.Free tie2.Tie on the carries or carrier tie3.Tie on the spool, winder, or reels Points to Remember in Suture Technique • There should be a suture routine in each operating room; an allowance must be made for changesaccording to the need soft the surgeon. • Prepare ligatures first according to their use. Then prepare the others sutures in the order in which theywill be used, in so far as possible. • Be conservative and economical. • Handle suture materials as little as possible. • Know the size of the suture that is handed to the surgeon and keep a close eye on the surgery toanticipate the number and length of the additional suture the surgeon will used. • Be ready with suture scissors or a clamp depending on whether the surgeon will cut or hold the suturewith a clamp, after the suture is past. • Checks each suture for knots before handling to the surgeon. A knot can destroy a line of an importantanastomosis by widening the aperture through which the suture has passed. •

Regular eyed – threaded like ordinary sewing needleb. one should always keep the suture book always closed. Be certain of receiving the empty needle back before handlinganother to the surgeon. 3. N o n . • Appropriate in shape and size for the type condition and accessibility of the tissue to be sutured. Curved – used inside for quickly recovery of the point of needle.-used for tough tissues that a round needle cannot well go through such as tendon. • Straight needles are not used on needle holders • Select a needle strong enough and large enough for tissue in which it is to be used • If the needle breaks. peritoneum.c u t t i n g – these are rounded bodied and are use on tissue that offers a small amount of resistance tothe needle as it passes thru. When the surgeonworks deep inside the abdomen. a longer needle holder will be needed then onsuperficial areas .According to Shape. • Approximately the same diameter as the suture material it carries to minimize trauma in passagethrough tissue. Eyeless or swayed – atraumatic. • Account for each used by the surgeon. The suture ends should behanging at the back of the palm. breakage. locate both pieces. • Sharp enough to penetrate tissue with minimal resistance.Hand the suture and holder to the surgeon in each functional position. cutting or non-cutting a . atrolooc. Needle Care After the Operation • All needles (used. thread another one of the same kind immediately. • Place strands in suture book with ends extended for enough for rapid extraction. . Straight – used primarily for skin closuresb. • Free from corrosion and burns to prevent and tissue trauma. • After all the needles have been accounted for: • Make sure that all needles have been removed from the suture hook before discarding into the soiledlinen hamper.fascia. unused. French or Spring Eye – there is slit from the end of the needle to the eye. • After handling a suture with needle to the surgeon. also known as dulex.According to Shaft or Body a. • Select a needle holder with appropriate size jaws for the size needle to be used. broken) must be accounted for after each operation. completely free from the handle of the holder. Needle Care During the Operation • In order to keep or prevent losses of needle.used to suture the viscera. and the suture tends to cut it a little more. the needle holder should be placed approximately 1/3 of the distancefrom the eye. chest or pelvic cavity. subcutaneous and skin. • Select an appropriate length needle holder for the area of the tissue to be sutured. yet not stronger than the tissue it penetrates. 2. through which is the sutureis drawn to thread it. The needle should be near the end of the needle holder. peritoneum. Characteristics of a Good Needle • Strong enough so it does not break easily • Rigid enough to prevent excessive binding yet flexible enough to prevent breaking after binding. musclea . Points to Remember in Using Surgical Needles • Thread needle from inside curve towards outside. • To prevent needle. Classification of Needles1. C u t t i n g – these make a slight tear in tissue. of shaft. An extremely smallneedle requires a needle holder with very fine tipped jaw.According to the Eye a.