Scribd
Upload
237 views

Suture Workshop: Presented by Joanna Jarvis and Craig

The document outlines an upcoming suture workshop which will cover the history of sutures, suture classification and selection, needles, and basic suture techniques. Attendees will learn about suture materials through time, how to select the right suture and needle for different tissues, and participate in hands-on suturing exercises to practice knot tying. The workshop aims to provide foundational knowledge and skills around sutures to improve surgical techniques.

Uploaded by

Saad Abdulrahman
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
237 views

Suture Workshop: Presented by Joanna Jarvis and Craig

The document outlines an upcoming suture workshop which will cover the history of sutures, suture classification and selection, needles, and basic suture techniques. Attendees will learn about suture materials through time, how to select the right suture and needle for different tissues, and participate in hands-on suturing exercises to practice knot tying. The workshop aims to provide foundational knowledge and skills around sutures to improve surgical techniques.

Uploaded by

Saad Abdulrahman
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
You are on page 1/ 30

Suture Workshop

Presented by Joanna Jarvis and Craig


Atkinson
Presentation Contents

•History
•Suture classification and selection
•Needles
•Suture label
Workshop Contents

•Suture presentation
•Basic Suture Techniques Video
•Knot tying & suture exercises
•Evaluation. Delegate bags
HISTORY

1650 BC – 2000’s AD
The origins of surgery can be traced back many
centuries. Through the ages, practitioners have used a
wide range of materials and techniques for closing
tissue……..
Ants

In the tenth century BC, the ant was held over


the wound until it seized the wound edges in its
jaws. It was then decapitated and the ant's death
grip kept the wound closed.
Thorns

The thorn, used by African tribes to close tissue,


was passed through the skin on either side of the wound.
A strip of vegetable fibre was then wound
around the edge in a figure eight.
Sterilised Catgut

The tough membrane of sheep intestine was provided


to the surgeon pre-sterilised and required threading
through the eye of the needle before use.
Swaged On Needles

Post World War II brought the swaged-on needle. The thread fits
into the hollow end of the needle, allowing it to pass through tissue
without the double loop of thread that exists with a conventional
needle, reducing tissue trauma.
Suture Classification and Selection
Suture Classification

• Natural or Synthetic (man made)


• Monofilament or Multifilament (braided)
• Absorbable or Non-Absorbable
The Ideal Suture
• Minimal tissue reaction
• Smoothness - minimum tissue drag
• Low Capillarity
• Max tensile strength
• Ease of handling - Minimum memory
• Knot security
• Consistency of performance
• Predictable performance
• Cost effectiveness
Suture Classification
Monofilament Multifilament (braided)
Braided v Monofilament
Has capillary action No capillary action
Increased infection risk Less infection risk
Less smooth passage Smooth tissue passage
Less tensile strength Higher tensile strength
Better handling Has memory
Better knot security More throws required
Absorbable Sutures

• These are absorbed within the living tissue


• Two main characteristics are:
•Tensile strength retention
•Absorption rate

Maxon: Day 14: 75% Absorption: 180 days


Caprosyn: Day 10: 30% Absorption: 56 days
Absorbable Sutures
Caprosyn Biosyn Maxon Polysorb Dexon II
60% Glycolide
60% Glycolide 90%
10% caprolactone 100%
26% Trimethylene Poly- Polyglycolic acid
MATERIAL 10% Trimethylene Polyglycolic
carbonate glyconate 10% Polylactic
carbonate acid
14% Dioxanone Acid
10% Lactide

Mono-
STRUCTURE Monofilament Monofilament Braided Braided
filament

Caprolactone /
Glycolide, Polycaprolac
COATING NA NA NA
Calcium stearoyl tone
lactilate
SIGNIFICATE
TENSILE 10 Days 21 days 42 Days 21 Days 21 Days
STRENGTH
ABSORPTION 180-210
56 Days 90-110 Days 56-70 Days 60-90 Days
PROFILE Days
Characteristics of Non-
Absorbable Sutures
• Permanent
• Only used when long term support is required
• Removed when used for skin (e.g. in A+E)
• Tissue reaction generally low (except silk)
• However silk, linen and even nylon will lose tensile strength over
a period of time
• True non-absorbable sutures include polyester, polyethylene,
polybutester, polypropylene and steel
Suture Size
USP (United States Pharmacopoeia)

A+E

5..4..3..2..1..0..2/0..3/0..4/0..5/0..6/0..7/0..8/0..9/0..10/0..11/0

General

Thick Thin
Suture Selection

Bowel: 2/0 - 3/0


Fascia: 1 - 0
Ligatures: 0 - 3/0
Pedicles: 2 - 0
Skin: 2/0 - 5/0
Arteries: 2/0 - 8/0
Micro surgery 9/0 - 10/0
Corneal closure: 9/0 - 10/0
Suture Handling

1. Package Memory
Grasp strand close to needle and at end of strand
and gently stretch
2. Opening suture foil
Tear in direction indicated to gain best needle
exposure
3. Arming needle
Arm needles 2/3rds distance between tip and swage
Closure using Clips
Closure using Caprosyn
Needles
Needle point Geometry

•Suited to soft tissue


Taper-Point •Dilates rather than cuts

•Very sharp
Reverse •Ideal for skin
cutting •Cuts rather than dilates
•Very sharp
Convention •Cuts rather than dilates
al Cutting •Creates weakness allowing suture tearout
•Ideal in tough or calcified tissues
Taper- •Mainly used in Cardiac & Vascular
cutting procedures.
Needle Point Geometry

•Also known as “Protect Point”


Blunt •Mainly used to prevent needle stick
injuries i.e. for abdominal wall closure.
•Ophthalmic Surgery
Premium point
spatula
•Ophthalmic Surgery
Spatula
•NEW: ½ The Penetration force
DermaX* •½ The Penetration force
•Superior Cosmetic Effect
Needle Curvature
The Right Needle Choice

• The appropriate needle choice for


any situation is…………….
……………The needle that will cause
least possible trauma to the tissue
being sutured
Summary of Needles

1. Needles are made of steel alloy (Surgalloy) with a


Nucoat coating so they stay sharp for multiple passes
through tissue

2. Different needle points for different tissues

3. Choose the needle that will cause the least trauma


Suture Label
The Suture Packaging

PRODUCT
CODE
STRAND
SIZE NEEDLE
CODE
MATERIAL WITH LIFE
SIZE
PICTURE
OF
STRAND NEEDLE
LENGTH

NEEDLE POINT NEEDLE


COLOUR CIRCLE TYPE LENGTH
Knot Tying & Suturing

You might also like