SUTURE MATERIAL.pptx

suture material and its types- basics

1. SUTURE MATERIAL

2. contents Definitions Goals of suturing Suture characteristics Armamentarium of suturing Suture materials Principles of suturing

3. DEFINITION what is suture ? Suture is a stich or series of stiches made to secure apposition of the edges of a surgical or traumatic wound. What is suture material? Suture material is an artificial fibers used to keep wound together until they hold themselves by natural which is synthesized & oven into a stronger scar.

4. GOALS OF SUTURING Wound edge apposition. Provide adequate tension. Maintain hemostasis. Aid in wound healing. Avoid wound infection. Produce aesthetically pleasing scar by approximating skin edges.

5. SUTURE CHARACTERISTICS

6. PHYSICAL STRUCTURE MONOFILAMENT- This suture material is smooth & tends to slide through tissues easily. Difficult to knot. Can be damaged by gripping it with needle holder or forceps.That can lead to fracture of the suture materials.

7. PHYSICAL STRUCTURE MULTIFILAMENTS Easy to knot. Have a greater surface area than monofilaments. Have a capillary actions where bacteria may lodge & be responsible for persistent infections. This material can be coated with silicone in order to make it smooth.

8. TENSILE STRENGTH It can be expressed as the force required to break it when pulling the two ends apart.It depends upon – Constituent of suture materials. Thickness of suture materials. How it is handled in the tissues.

9. ABSORBABILITY Suture materials may be absorbable or non- absorbable.This property must be taken into consideration when choosing suture materials for specific wound closures. Oral mucosa & Deep sturcture need to be absorbable suture materials but vascular anastomoses need non-absorbable suture materials. Biological Behaviour : It depends upon the constituent of raw materials.

10. BIOLOGICAL BEHAVIOUR It depends upon the constituent of raw materials.

11. ARMAMENTARIUM OF SUTURING Needle holder A suture needle Suture material

12. HOW TO HOLD The needle holder is held with thumb & ring finger through the rings & with the index finger along the length of needle holder to provide stability & control.

13. A SUTURE NEEDLE Made up of either SS(stainless steel) or carbon steel. Parts : 1.tip/point 2. body/shaft 3.eye/swaged end

14. SHAPE OF NEEDLE

15. According to Shape : St r aight 2.Cu r ved According to eye: Eyed needle/Traumatic Eyeless needle/Atraumatic Classification of needle

16. According to cutting edge Round body 2.Cutting body- ▶ Conventional ▶ Reverse cutting According to its tip T rian g u l ar 2.Round 3.Blunt Classification of needle

17. SUTURE MATERIAL

18. Ideal properties : Easy to handle. Predictable behaviour in tissues. Predictable tensile strength. Sterile. Secure knotting ability. Minimal tissue reaction. Non- alergenic,non - carcinogenic,non -shrinkage.

19. According to source: 1. Natural 2. S ynthe t ic 3.Metallic According to structure: 1.Monofilament 2.Multifilament CLASSIFICATIONS OF SUTURE MATERIALS

20. According to fate: Absorbable 2. Non-absorbable According to coating: 1.Coated 2.Uncoated CLASSIFICATIONS OF SUTURE MATERIALS

21. NATURAL Absorbable catgut Ch r omic catgut Collagen Fascia lata Beef tendon ACCORDING TO SOURCE Non- a b s o rbable Silk Silk worm gut Linen Cotton Ramie

22. SYNTHETIC Absorbable ▶ Polyglycolic acid ▶ Polyglactic acid ▶ Polyglactin( vicryl ) ▶ Polydioxanone(PDS) ACCORDING TO SOURCE Non- a b s o rbable nylone (polyamide) ▶ P ol y p r opyl i n e ( P r olen e ) ▶ Polyesters ▶ polyethelene

23. SS(stain l ess steel) Tantalum Silver Gold Aluminium METALLIC

24. MONOFILAMENT Absorbable Catgut Ch r omic catgut Vicryl PDS ACCORDING TO STRUCTURE Non-absorbable PolyPropylene Polyester Nylone P olyveny l eidene fluoride/PVDF suture

25. MULTIFILAMENT Absorbable Vicryl P olygly c olic acid ACCORDING TO STRUCTURE Non-absorbable Silk Cotton linen

26. MONOFILAMENT VS MULTIFILAMENT MONOFILAMENT MULTIFILAMENT Has no capillary action Less infection risk Smooth tissue passage Higher tensile strength More throws required Has capillary action Increased infection risk Less smooth passage Less tensile strength Better knot security

27. Condition of the wound. Tissues to be repaired. Tensile strength. Knot holding characteristics. Reaction of surrounding tissues. Selection of suture materials

28. COMMONLY USED SUTURE MATERIALS

29. It is synthetic ,non-absorbable monofilament suture materials. Polymer of propylene. Uses: General surgery. 2.Plastic surgery. 3. Cardiovascular surgery. 4. Skin closure . POLYPROPYLENE( prolene )

30. Advantages: Won’t loose tensile strength over time. Good knot security. 3.Very little tissue reaction. 4.High plasticity. Disadvantage : Stretch when pulled. Loosens when edema subsides. Polypropyelene

31. It is natural, non-absorbable multifilament suture materials. Made from the filament spun by silkworm larva . Uses: Ophthalmic surgery. 2.General surgery . 3.plastic surgery . SILK

32. Advantage: 1.Ease of handling. Good knot security. Cost effective. Di s ad v anta g e : 1.Very reactive. can’t be used in presence of infection. SILK

33. It is synthetic & absorbable suture materials. Monofilament/multifilament & coated/uncoated. Available in purple color/undyed. Uses: 1. Intra oral suturing . 2. Gut anastomoses. 3.Vascular ligature. 4.Opthalmic surgery 5. Superficial soft tissue approximation of the skin and mucosa. VICRYL

34. USES OF DIFFERENT SIZES OF NEEDLE

35. The early response is a generalized acute aseptic inflammation involving primarily polymorphonuclear leucocytes. After few days mononuclear cells fibroblast & histiocytes become evident. Capillary formation occurs at the end of this initial phase . BIOLOGICAL RESPONSE TO SUTURE MATERIALS

36. Natural absorbable- Proteolytic degradation. Intense tissue response. Synthetic absorbable- Hydrolysis. Less intense response. Non-absorbable- Encapsulation. Acellular response. BIOLOGICAL RESPONSE TO SUTURE MATERIALS

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