You are on page 1of 26

SUTURES, NEEDLES AND SUTURING TECHNIQUES

Nenette C. Almario BSN 4B

Suture
Definition

Purpose

A suture is a piece of thread-like material used to stitch or approximate tissues, and hold the wound together until healing takes place. any strand of material used to ligate bleeders or used to approximate tissue. any materials used to sew, sick or hold tissue together until healing process occurs.

to hold a wound together in good apposition until such time as the natural healing process is sufficiently well established to make the support from the suture material unnecessary and redundant.

The SUTURE Labels .

Classification of Suture Material Absorbable Capable of being absorbed by living mammalian tissue. through processes of hydrolysis or enzymatic digestion  .

externally  . or need to be removed.Classification of Suture Material Non Absorbable Effectively resist enzymatic digestion in living tissue and are enacapsulated or “walled off” by the body internally.

Kinds of Suture Monofilament  Multifilament  Made of single strand of material Made of several strands of suture that are twisted or braided together .

Suture Tissue Absorbab Reaction le/Non Absorbab le Braided Non Braided Suture Strength Primary indication Chromic Catgut Nylon Last 3 – 4 weeks the most Loses 20% per year Lasts 4 – 6 months Lasts about 1 month Polydioxanon e Polyglycolic acid (Dexon) Prolene Lasts a long time Loses strength within one Silk .

also available undyed Strong absorbable suture during the critical wound healing period Indicated for use in general soft tissue for approximation or ligation. fascia or contaminated areas Not to be used on urinary or biliary tract (could cause stone .Suture Material Biosyn Absorbable Description Color: Violet. to increase visibility. as well as in ophthalmic surgery but not for use in cardio or neuro surgery Chromic Gut Derived form the serosal layer of beef (bovine) treated with chromic salt solution AVOID opening packet until use (will dry out and break) Used for internal ligation Not used on peritoneum.

Suture Material Polyglycolic Acid (Dexon) Absorbable Description Available in the undyed natural beige color. voilet or bicolor Applications on tissues that require long term tensile strength such as stomach and vascular procedures Smaller sizes are used in ophthalmic surgery Plain Gut Derived form the serosal layer of beef (bovine) intestines Packaged in a solution of 89% isopropanol. green. 10% water and 1%triethanolamine Fast absorption Used on hemostasis Ligation of small vessels .

also available undyed Strong absorbable suture during the critical wound healing period Indicated for use in general soft tissue for approximation or ligation. as well as in ophthalmic surgery but not for use in cardio or neuro surgery Chromic Gut Derived form the serosal layer of beef (bovine) treated with chromic salt solution AVOID opening packet until use (will dry out and break) Used for internal ligation Not used on peritoneum. fascia or contaminated areas Not to be used on urinary or biliary tract (could cause stone .Suture Material Biosyn Absorbable Description Color: Violet. to increase visibility.

SURGICAL NEEDLES Definition. Classification and Characteristics .II.

Surgical Suture Needles Needed to carry the suture material through tissue with the least amount of trauma .

Classifications of a Surgical Needle Traumatic  Atraumatic  Needles with holes or eyes which are separate from their suture thread. as it is done at home. . Comprised of an eyeless needle attached to a specific length of suture thread. The suture must be threaded on site.

Ideal Characteristics of a Needle .

Usage is based thread.tissue the needle will needle to the surgical on the be used to penetrate. . needlesthe of the entire several point Parts:Refers Body and Swage in needle Body: Attachment at are available types.Anatomy of a Surgical Needle Point: Surgicalto the shape end that connects the Swage: Point.

characteristically they are rounded and produce the smallest hole minimizing trauma .Needle Tips Tapered  These tips are used for soft tissues.

. triangular in shape and useful in puncturing tough tissue but produces a larger hole than tapered tips.Needle Tips Cutting  These tips are used for skin repair. Cutting tips are not used intra-abdominally due to the risk of blood vessel or delicate tissue damage.

Needle Tips Blunt  These needle tips have no cutting edge and are used for friable tissues such as the liver where cutting and piercing would be detrimental .

GI. and respiratory surgeries) . nasal surgery). as for skin the suturing ¼ without requiring the use of the half curved (used long as closure. ½ circle (skin closure.area offers (microsurgery and ocular procedures). rare). can be used for suturing configurations. ½ and 5/8 (cardiovascular. 3/8. this includes a needle holder. oral and good visibility. GU.Needle Shapes Curved: Used for skin used surgical needles. curved needle are made in several Straight: Most commonly closure in some surgeries.

COMMON SUTURING TECHNIQUES .

such as the peritoneum. May also be used in skin or blood vessels. However. and accommodation of edema during the wound healing process. . there is a greater potential for malapproximation of wound edges than with the interrupted stitch.Running or Continuous Stitch The "Running" stitch is made with one continuous length of suture material. Used to close tissue layers which require close approximation. The advantages of the running stitch are speed of execution.

More exact approximatio n of wound edges can be achieved with this technique than with the running stitch. . May be used in skin or underlying tissue layers.Interrupted Stitch Each stitch is tied separately.

.Mattress Stitch A double stitch that is made parallel (horizontal mattress) or perpendicular (vertical mattress) to the wound edge. each stitch penetrates each side of the wound twice. Chief advantage of this technique is strength of closure. and is inserted deep into the tissue.

. such as a hernia or an appendiceal stump. The wound edges are inverted when tied.Purse String A continuous stitch paralleling the edges of a circular wound. Commonly used to close circular wounds.

Smead Jones or Far and Near A double loop technique alternating near and far stitches. Commonly used for approximatin g fascial edges .

Continuous Locking or Blanket Stitch A selflocking running stitch .

8.5503/.073. 5.0790/03 90/  42243 :80/94.7. .:.:.74:3/  %04:3/ 0/08.0390 0/0841.0.4393:4:8 899.70 3.!:780$973 .7. . 89:25 .480 .3 .47 .7 4:3/8 8:.7.

08  42243 :80/147 .93 30.7. 0/08 .3/1.36:0 ../ 430847.93 1.3/0.7 /4:-0445 90.$20.7.55742.8.7 899.9073.

347.309$99.3 7:333899. . 801 4.4393:4:84.