Post on 14-Dec-2015
Suture, Needles, Staplers, Wound Closure Techniques, &
Wound Closure DevicesST230
Concorde Career College
Objectives
• Define the term suture as a noun and as a verb.
• List the specifications for suture material and describe the importance of each.
• Describe the suture selection process.
Objectives
• List and describe the ideal characteristics for suture material and surgical needles.
• Identify the types and sizes of suture material, provide examples of each, and describe the type of tissue usage appropriate for each type.
Objectives
• Identify the types and sizes of surgical needles, provide examples of each, and describe the type of tissue usage appropriate for each type.
• Describe suture packaging, list the information found on the suture package, and explain its importance.
Objectives
• Identify types of stapling and ligating devices and provide examples of when each may be utilized.
Objectives
• Identify types of alternative wound closure materials, tissue adhesives, and tissue repair and replacement materials and provide examples of when each may be utilized.
Brief Suture History
• 3000 BCE - Linen strips and animal sinew (tendon) were used to close wounds with needles made of bone
• 600 BCE - Cotton, leather, horsehair, and bark fiber from trees was used to close wounds
Brief Suture History
• Lister (late 1800s) was the first to use a bacteriocide (carbolic acid) on suture
• Suture manufacture and sterilization started in the early 20th Century
• First synthetic absorbable suture was produced in the 1960s
Specifications for Suture Material
• Must be sterile and sterile technique must be used when handling
• Uniform tensile strength• Uniform size• Appropriate diameter for tissue type• Provide knot security• Cause minimal foreign body tissue reaction
Suture Selection
• Characteristics of the suture material
• Age• Weight• Allergy status• General tissue condition
• Surgical site disease• Comorbid condition(s)• Surgeon preference• Suture availability• Cost• Mentor influence
Ideal Suture Characteristics
• Pliable• Easy to tie secure knots• Tensile strength (will not fray or break)• Glide through tissue effortlessly• Inert• Nonallergenic• Inexpensive
Tensile Strength
Tensile strength of absorbable and non-absorbable sutures is critical both during and after surgical procedures. Breaking strength and elongation can be measured using either a "straight pull" test or a "knot pull" test.
Types of Suture Material
• Natural
• Absorbable
• Monofilament
• Synthetic
• Nonabsorbable
• Multifilament
Suture Sizes
Ideal Needle Characteristics
• Stainless steel (corrosion resistant)• Slim without compromising strength• Stable in the needle holder• Carries suture through tissue with minimal tissue
trauma• Sharp• Sterile• Inexpensive
Needle Sizes & Types
Needle Points
– Taper – most internal tissues
– Cutting – Skin and other tough tissues
– Reverse Cutting – Tendon sheath, bone, cornea, other tough tissues
– Blunt – Liver and other friable tissues
Commonly Used Needle Codes (Ethicon)
• CP• CT• CTX• CV• FS• FSL• FSLX• KS
• MO• SH• TF• OS• UR• PS• RB• S
Suture Handling
Needle holder is clamped onto the
needle approximately 1/3 the distance from the swage to the point
Tie Terms
• Free-tie – Place a suture (no needle) into the surgeons
hands• Stick-tie
– Suture on a needle (use a needle holder)• Tie on a pass
– Place the suture (no needle) on an instrument (tonsil/right angle)
• Ligate– To tie