14. Sutures and Wound Repair 1

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Questions and Answers

Which of the following men discovered that the body absorbs sutures made from animal tissues?

Joseph Lister

Philip Syng Physick (correct)

Ambroise Paré

William Stewart Halsted

Which of the following suture materials is not absorbed but remains as a living tissue in the body?

Ribbon gut

Fascia lata (correct)

Nylon

Cargile membrane

The space caused by the separation of wound edges which have not been closely approximated by sutures is called:

Dehisced space

Dead space (correct)

Palmar space

Intervillous space

An interrupted suture, which is placed through the tissue from one side of the wound to the other and then back through the tissue again, is called:

Mattress Signup and view all the answers

In the presence of infection, the absorption rate of surgical gut is:

Increased Signup and view all the answers

Which of the following sutures may be used in the presence of infection?

Polypropylene Signup and view all the answers

A suture in which short lateral stitches are taken beneath:

Subcuticular Signup and view all the answers

The healing process in which a wound is purposely left open and allowed to heal from the bottom upward is called:

Secondary intention Signup and view all the answers

Surgical gut is made from the:

Submucosa layer of sheep's intestines Signup and view all the answers

Which of the following is most inert in tissue?

Wire Signup and view all the answers

A stay suture does not pass through:

Mesentery Signup and view all the answers

The spitting open or gaping of a wound is called:

Dehiscence Signup and view all the answers

Which of the following is used to stop bleeding and oozing on the surfaces of severed bones?

A mixture of waxes (chiefly beeswax) Signup and view all the answers

The protrusion of bowel through the separated edges of an abdominal wound closure is called:

Evisceration Signup and view all the answers

Silk is not recommended for use in the gallbladder, kidney, or bladder because:

It may become the nucleus for stone formation Signup and view all the answers

Most braided or twisted nonabsorbable sutures should not be used in the presence of active infection because:

The sutures become a breeding place for infection Signup and view all the answers

The Halsted Technique consists mainly of:

Interrupted silk sutures Signup and view all the answers

Another name for a stick tie or transfixion suture is:

Suture ligature Signup and view all the answers

Bumpers or guards are used on tension sutures to:

Prevent the heavy suture from cutting into the skin Signup and view all the answers

Tissue trauma will be kept to a minimum by using:

Sutured swaged to a needle Signup and view all the answers

The amount of weight or pull necessary to break the suture or ligature material is called:

Tensile strength Signup and view all the answers

Which of the following would have a weakening effect on suture?

All of the above Signup and view all the answers

Which of the following synthetic nonabsorbable suture material is least reactive in tissue?

Polypropylene Signup and view all the answers

What type of suture would be used when closing the anus for the perineal stage of an abdominal perineal resection?

A purse-string suture Signup and view all the answers

Study Notes

Sutures and Wound Repair

Philip Syng Physick discovered that the body absorbs sutures made from animal tissues, leading to the development of absorbable sutures that do not require removal after healing.
Fascia lata remains as living tissue in the body and is used as autograft suture material, integrating into surrounding tissues instead of being absorbed.
Dead space is created by inadequately approximated wound edges, which can fill with fluid or blood, increasing infection risk and delaying healing. Proper suturing techniques aim to minimize this space.
Mattress suture is an interrupted suture type that offers secure closure and evenly distributes tension, making it suitable for high tension areas or deep tissue closure.
Suture material like fascia lata can become encapsulated by fibrous tissue during healing, integrating with surrounding tissues for better wound support.
The absorption rate of surgical gut increases in the presence of infection due to heightened enzyme activity, potentially compromising wound closure.
Polypropylene is a suitable suture material for infected wounds because it is synthetic, non-absorbable, and less likely to harbor bacteria compared to multifilament sutures.
The subcuticular suture technique involves taking short lateral stitches beneath the skin's surface for cosmetic closure, minimizing visible scarring in sensitive areas.
Secondary intention healing involves intentionally leaving a wound open for healing from the bottom upward, often employed for infected or large wounds.
Surgical gut, or catgut, is derived from the submucosa of sheep intestines and is known for its strength and absorbable properties.
Wire sutures exhibit minimal tissue reactivity, making them the most inert option among various materials and suitable for long-term applications.
A stay suture typically does not pass through the mesentery due to its delicate nature; it is used for providing temporary support during procedures.
Dehiscence is the partial or complete separation of wound edges post-surgery—a serious complication requiring urgent medical attention.
Bone wax, primarily made of beeswax, controls bleeding from severed bone surfaces during surgery by sealing small blood vessels.
Evisceration occurs when bowel protrudes through the edges of an abdominal wound, necessitating immediate surgical care.
Silk sutures are avoided in organs like the gallbladder or kidney as they can become a base for stone formation due to their rough surface.
Multifilament nonabsorbable sutures should not be used in active infections as they can harbor bacteria, exacerbating the infection.
The Halsted Technique utilizes interrupted silk sutures, emphasizing careful tissue handling for optimal wound healing.
A suture ligature, also known as stick tie or transfixion suture, is useful for securing large vessels or tissue bundles.
Bumpers or guards on tension sutures prevent heavy sutures from cutting into skin, distributing pressure to reduce tissue damage.
Swaged sutures, where the needle is attached to the suture, cause less tissue trauma compared to eyed needles and minimize wound size.
Tensile strength is the maximum force that a suture can tolerate before breaking; it's crucial for selecting sutures used in varying tension scenarios.
All previous actions, such as soaking sutures in saline, testing their strength, or straightening them, can weaken the material.
Polypropylene suture is the least reactive nonabsorbable synthetic material and is preferred in contaminated wounds due to its low tissue reactivity.
A purse-string suture is ideal for closing the anus following abdominal perineal resection, offering a secure closure similar to a drawstring bag.

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Description

Test your knowledge on sutures and wound repair techniques in this quiz. Learn about historical figures like Philip Syng Physick and their contributions to surgical advancements. Discover the importance of absorbable sutures in modern medicine.