Download - Suture material
![Page 1: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/1.jpg)
Suture MaterialM. Jude Nilshan Fernando
![Page 2: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/2.jpg)
Classifications
• Absorbabale vs non-absorbable
• Natural vs synthetic
• Monofilament vs polyfilament
![Page 3: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/3.jpg)
Absorbable
Absorbable
Natural
Monofilament Braided
Synthetic
Monofilament Braided
JMJ 3
Plain CatgutChromic catgut
Polydiaxanone -PDS
Polyglycolic acid-DexonPolyglactin - Vicryl
![Page 4: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/4.jpg)
Non -Absorbable
Non-Absorbable
Natural
Monofilament Braided
Synthetic
Monofilament Braided
JMJ 4
SilkLinen
Wire – steelNylone – EthilonPolypropylene -prolene
Expanded polytetrafluoroethylene (ePTFE) – expanded monofilament
![Page 5: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/5.jpg)
Absorbable vs Non- absorbable
• Strength of absorbable sutures are less
• Non-absorbable sutures
• retain strength indefinitely and are used
• where strength is needed until repair is completed naturally (abdominal incision and hernia repair)
JMJ 5
![Page 6: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/6.jpg)
Natural vs Synthetic
Natural
• Catgut
• Silk
• Linen (strong inflammatory reaction)
Synthetic
• Dexon
• Vicryl
• PDS
• Nylon
• Polypropylene
• ePTFE
JMJ 6
![Page 7: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/7.jpg)
Monofilament vs Braided
Monofilament
• Catgut
• Polydiaxanone
• Wire
• Polypropylene
• Nylon
Braided
• Polyglycolic acid
• Polyglactil
• Silk
• Nylon
• Linen
JMJ 7
They are smooth
Pass easily through tissue
Cause less tissue reaction
Handle well
More risk of infection
![Page 8: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/8.jpg)
Features of a ideal suture material
• Adequate tensile strength
• Good knot holding property
• Should be least reactive
• Easy handling property
• Should have less memory
• Should be easily available and costeffective
JMJ 8
![Page 9: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/9.jpg)
JMJ 9
![Page 10: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/10.jpg)
JMJ 10
![Page 11: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/11.jpg)
JMJ 11
![Page 12: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/12.jpg)
Absorbable Suture Materials
JMJ 12
![Page 13: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/13.jpg)
Plain catgut
• Absorbed by inflammatory reaction and phagocytosis
• Absorption time – 7 days
• Used for• Subcutaneous tissue
• Muscle
• Circumcision in children
JMJ 13
![Page 14: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/14.jpg)
Chromic catgut • Catgut with chromic acid salt
• Brown in colour
• Absorption time 21 days
• Used for• Suturing muscles• Fascia• External oblique aponeurosis• Ligating pedicles
JMJ 14
![Page 15: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/15.jpg)
Vicryl – Polyglactic acid• Absorbed in 90 days
• Absorption is by hydrolysis
• Violet in colour (braided)
• Polyfilament and braided
• Used for• Bowel anastomosis• Suturing muscles• Closure of peritoneum
JMJ 15
![Page 16: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/16.jpg)
Dexon – Polyglycolic acid
• Creamy yellow in colour
JMJ 16
PDS- Poly Dioxanone Suture Material• Costly
• But better than vicryl
![Page 17: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/17.jpg)
Uses in absorbable suture materials
• Bowel anastomosis (gastrojejunostomy, resection & anastomosis)
• Vicryl
• In cholecystojejunostomy, choledechojejunostomy
• Vicryl
• In suturing muscle, fascia, peritoneum, sub cutaneous tissue, mucosa
JMJ 17
![Page 18: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/18.jpg)
Uses of absorbable suture materials
• Ligation of pedicles during hysterectomy• 1-zero chromic catgut• Vicryl
• In circumcision • 3-zero plain or chromic catgut
• Absorbable suture materials should not be used for• Suturing tendons• Nerves• Vessels (vascular anastomosis)
JMJ 18
![Page 19: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/19.jpg)
Non-Absorbable Suture Materials
JMJ 19
![Page 20: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/20.jpg)
Silk
• Black colour
• Coated material to reduce capillary action
JMJ 20
![Page 21: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/21.jpg)
Polypropelene
• Blue in colour
• Got high memory
JMJ 21
MEMORY – is recoiling tendency after removal from the packet. Ideally suture material should have low memory
![Page 22: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/22.jpg)
Uses of non- absorbable suture materials
• In herniorraphy for repair
• For closure of abdomen after laparotomy
• For vascular anastomosis (6-zero), nerve suturing, tendon suturing
• For tension suturing in the abdomen
• For suturing of skin
JMJ 22
![Page 23: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/23.jpg)
TYPES OF SUTURING
JMJ 23
![Page 24: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/24.jpg)
Simple continuous suture
![Page 25: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/25.jpg)
Interrupted simple suturing
Increase risk of infection
Easy when need of draining
![Page 26: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/26.jpg)
Interrupted mattress suturing
![Page 27: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/27.jpg)
Subcuticular suturing
Good cosmetic results
![Page 28: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/28.jpg)
Suture Removal
• Face and neck 3-4 days
• Scalp 5-7 days
• Limbs 5-7 days
• Hands and feet 10-14 days
• Abdomen 8-10 days
JMJ 28
![Page 29: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/29.jpg)
TYPES OF KNOTS
JMJ 29
![Page 30: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/30.jpg)
![Page 31: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/31.jpg)
NEEDLES
JMJ 31
![Page 32: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/32.jpg)
![Page 33: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/33.jpg)
Needles
Cutting edge
• Triangular in cross section
• Skin
• Tendon
• Breast tissue
Round body
• Oval or round in cross section
• GI tract
• Vascular anastamosis
JMJ 33
![Page 34: Suture material](https://reader034.vdocument.in/reader034/viewer/2022042513/587f7ddf1a28ab3f4e8b64ad/html5/thumbnails/34.jpg)
THANK YOU!
JMJ 34