Surgery Book

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Suture MaterialAka: Suture Needle, Suture Removal Timing, Suture Selection, Suture

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  1. Suture Characteristics
    1. Tensile Strength
      1. Related to suture size (see below)
      2. Related to weight required to break a suture
    2. Knot strength
      1. Force required for a knot to slip
    3. Configuration
      1. Monofilament (less risk of infection)
      2. Braided multifilament (easier to handle and tie)
    4. Elasticity
      1. Degree suture stretches and return to original length
    5. Memory or suture stiffness
      1. High memory: Suture stiff, difficult handling, unties
    6. Tissue reactivity (inflammatory response to suture)
      1. Reaction peaks in first 2 to 7 days
  2. Needles
    1. Curvature
      1. Straight needle
      2. Curved 2/8 of circle
      3. Curved 3/8 of circle (preferred needle in most cases)
      4. Curved 4/8 of circle
      5. Curved 5/8 of circle
    2. Needle Tip
      1. Tapered (used in vascular sutures)
      2. Conventional cutting needle
      3. Reverse cutting needle (preferred in most cases)
  3. Suture types recommended for skin closure
    1. Deep (dermal or buried) Absorbable Sutures
      1. Polyglecaprone 25 (Monocryl)
      2. Polydioxanone (PDS)
      3. Polyglactin-910 (Vicryl)
      4. Polyglycolic acid (Dexon)
    2. Superficial, monofilament Nonabsorbable Sutures
      1. Nylon (Ethilon)
      2. Polypropylene (Prolene)
  4. Suture Size (See suture types above)
    1. General
      1. Superficial facial lesions: 6-0 nylon
      2. Other superficial skin lesions
        1. Low skin tension areas: 5-0 nylon
        2. Higher skin tension areas: 4-0 nylon
    2. Annotation for suture size indications below
      1. Skin: Superficial monofilament Nonabsorbable Suture
      2. Deep: Dermal Absorbable Sutures
    3. Size O: Largest suture
    4. Size 2-O
    5. Size 3-O
      1. Skin: Foot
      2. Deep: Chest, Abdomen, Back
    6. Size 4-O
      1. Skin: Scalp, Chest, Abdomen, Foot, Extremity
      2. Deep: Scalp, Extremity, Foot
    7. Size 5-O
      1. Skin: Scalp, Brow, Oral, Chest, Abdomen, Hand, Penis
      2. Deep: Brow, Nose, Lip, Face, Hand
    8. Size 6-O
      1. Skin: Ear, Lid, Brow, Nose, Lip, Face, Penis
    9. Size 7-O: Smallest Suture
      1. Skin: Eyelid, Lip, Face
  5. Suture indications by location (see suture types above)
    1. Scalp, Torso (chest, back, abdomen), Extremities
      1. Superficial Nonabsorbable Suture: 4-O or 5-O
      2. Deep Absorbable Suture: 3-O or 4-O
    2. Face, Eyebrow, Nose, Lip
      1. Superficial Nonabsorbable Suture: 6-O
      2. Deep Absorbable Suture: 5-O
    3. Ear, Eyelid
      1. Superficial Nonabsorbable Suture: 6-O
    4. Hand
      1. Superficial Nonabsorbable Suture: 5-O
      2. Deep Absorbable Suture: 5-O
    5. Foot or sole
      1. Superficial Nonabsorbable Suture: 3-O or 4-O
      2. Deep Absorbable Suture: 4-O
    6. Penis
      1. Superficial Nonabsorbable Suture: 5-O or 6-O
  6. Suture removal timing
    1. Scalp: 6-8 days
    2. Face, Eyelid, Eyebrow, Nose, Lip: 3-5 days
      1. Follow with papertape or steristrips
    3. Ear: 10-14 days
    4. Chest and abdomen: 8-10 days
    5. Back: 12-14 days
    6. Extremities: 12-14 days
    7. Hand: 10-14 days
    8. Foot and sole: 12-14 days
    9. Penis: 8-10 days
    10. Condition delaying wound healing: 14 to 21 days
      1. Chronic Corticosteroid use
      2. Diabetes Mellitus
  7. References
    1. Howell (1997) Emerg Med Clin North Am 15(2):417
    2. Moy (1991) Am Fam Physician 44(6):2123
    3. Phenninger (1994) Procedures, p. P3-6
    4. Townsend (2001) Sabiston Textbook Surgery, p. 1552-3

Surgical sutures (C0038969)

Definition (MSH)Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed)
Definition (NCI)A natural (e.g. catgut, silk, or linen) or synthetic, or other (e.g. thin metal wire) monofilament or multifilament material used surgically to close a surgical or accidental wound and to secure apposition of the edges and join tissues. Three properties of a suture material affect its handling: memory, elasticity, and knot strength. Tensile strength, tissue reaction, and capability to be absorbed are other important characteristics of the suture material. The selection of the type of suture to be used depends on tissue type and anatomical location.
ConceptsMedical Device (T074)
EnglishSurgical suture, Surgical sutures, Suture, Suture material, Sutures
Spanishmaterial de sutura, sutura, sutura quirúrgica, sutura quirurgica, suturas quirúrgicas, suturas quirurgicas
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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