Surgical dressings ,sutures and ligatures

this contains information about sutures and ligatures

1. Fibres , Surgical dressings & Sutures. Surgical dressings & sutures PH103.82 1

2. PH103.82 2 DEPARTMENT OF TECHNICAL EDUCATION ANDHRA PRADESH Name : K.M. Vara Prasad Designation : Senior Lecturer Branch : Pharmacy Institute : Government Polytechnic for women, Kadapa Year : First year Subject : Pharmacognosy Subject code : Ph-103 (2/2) Topic : Fibres , Surgical dressings & Sutures. Duration : 50 minutes Sub-topic : Surgical dressings & sutures. Teaching aids : PPT, animations & photographs.

3. PH103.82 3 Recap In the last class we learnt about The different types of fibres both natural and other types used in the preparation of Surgical dressings and Sutures

4. PH103.82 4 Objectives On completion of this lesson you would be able to know about: Surgical Dressings & Sutures and Ligatures

5. PH103.82 5 Surgical Dressings Natural Fibres used for the preparation of Surgical Dressings obtained from Plants Animals Minerals Synthetic & other Fibres

6. PH103.82 6 Surgical dressings Bandage Surgical sutures Ligatures Fig.82.1 Fig.82.2

7. PH103.82 7 Surgical dressings : Material used alone or in combination to cover wound Protects the wound and favours its proper healing Material which holds the dressing in desired position……… BANDAGE Made up of fibres. Fig.82.3

8. PH103.82 8 Functions Reduce or prevent infection Mechanical support to the tissues Protection to healing wound Fig.82.4

9. PH103.82 9 Pharmacopoeial requirements Sterilised before use Stored in dry, well-ventilated place below 25 C Permitted antiseptics in prescribed concentrations be used Dyed unless mentioned in monograph Adhesive products not allowed to freeze No loose threads, fibre ends o

10. PH103.82 10 Types of recognised surgical dressings 1 Fibres & related materials : Viscose, wool, cellulose wadding 2 Carded products : Absorbent cotton, viscose wadding. 3 Non-extensible, non-adhesive woven products : Absorbent muslin, Domette bandage 4 Non-extensible adhesive woven products : Belladonna adhesive plaster, zinc oxide adhesive plaster.

11. PH103.82 11 5 Extensible non-adhesive products : Cotton bandage, Elastic web bandage. 6 Extensible adhesive woven products : Elastic adhesive bandage, Extension plaster 7 Non-woven products : Impermeable plastic surgical adhesive tape, Permeable plastic surgical adhesive tape.

12. PH103.82 12 Properties Absorbing wound exudates from the site Prevent or combat infection Physical protection to wound Mechanical support to the surrounding tissues Should not adhere to the granulating surface Easy to handle at all stages Durable Free from loose threads, ends or fibres Easily sterilised

13. PH103.82 13 Surgical dressing consists of 1 Wound facing layer : Inner layer Closest to the wound containing antiseptics and healing agents 2 Absorbent layer : Middle layer absorbs blood or pus or any exudate from wound 3 Outer layer : outer layer supports the inner layers

14. PH103.82 14 Special dressings : Pyroxillin, Acrylic polymer Absorbable Haemostats : Human fibrin foam Absorbable gelatin sponge Oxidised cellulose Calcium alginate

15. PH103.82 15 Sutures & Ligatures Sterile threads or strings specially prepared for use in surgery Sutures used for sewing or stitching together tissues like skin, muscle or tendon by using Needle Ligatures used to tie & constrict blood vessel vein or artery and no needle is used

16. PH103.82 16 Properties Sterility Adequate mechanical strength Non-irritant Fine gauze Time of absorption if absorbable

17. PH103.82 17 Classification Absorbable sutures : Absorbed & digested in the tissues of the body e.g. surgical catgut, kangaroo tendon synthetic absorbable polymers Non-absorbable sutures : Not absorbed, remain in the body, to be removed after wound healing. e.g. Silk cotton nylon synthetic polyesters stainless steel Fig.82.5

18. PH103.82 18 Absorbable sutures : Surgical catgut : Sterile strand prepared from collagen healthy animals like sheep and cattle Kangaroo tendon : Prepared from tails of kangaroo Synthetic polyesters : Condensed cyclic derivatives of glycolic acid with cyclic derivatives of lactic acid high tensile strength degraded by hydrolysis and absorbed by the tissues

19. PH103.82 19 Non-absorbable sutures… …….. must be removed after wound healing Silk sutures : Spinned or twisted fibres into a single strand smooth and strong Cotton sutures: Uniform in size used in critical parts where strength of suture required for long time Nylon sutures: Microfilaments braided into strands strong water resistant used in skin plastic surgery

20. PH103.82 20 ………Non-absorbable sutures Linen suture : Cheap, very strong no uniformity in diameter Metallic sutures : Silver & stainless steel used as surgical aid monofilaments, twists and braids

21. PH103.82 21 Sterilisation of sutures Chemical method : Sterilisation by Iodine solution long time and tedious Sterilisation by heat : Boilable method : Heating in high B.P. liquid like Tolune or Xylene in glass tube which was sterilised in Autoclave requires high temperature for drying,suture becomes stiff need soaking in sterilised water before use

22. PH103.82 22 Non- boilable method Suture in foil pack or plastic packet in alcohol with little water heated temperature should not be very high as it affects its quality. Irradiation method : Exposing the suture in finally sealed container to electron particles / gamma rays from cobalt 60 sterilisation dose 2.5 mega rads.

23. PH103.82 23 SUMMARY In this class we learnt about Surgical dressings : Properties Types Functions Surgical sutures & ligatures Types Properties Uses Sterilisation methods

24. PH103.82 24 Quiz Any material that covers, protects and aids in healing of wound a) surgical fibre b) surgical dressing c) bandage d) suture Material that holds and keeps dressing in position a) surgical dressing b) bandage c) suture d) ligature

25. PH103.82 25 …..QUIZ Sterile threads used for sewing skin and tissues with a needle a) dressing b) bandage c) suture d) ligature Most effective method of sterilisation of surgical catgut a) heating with iodine solution b) autoclaving c) irradiation d) hot air oven

26. PH103.82 26 Questions Define surgical dressings and classify them with examples. Classify surgical sutures and ligatures with examples. Define surgical suture and what are the properties of an ideal suture ? Differentiate the absorbable sutures and non-absorbable sutures.