{"id":757,"date":"2010-12-02T16:45:55","date_gmt":"2010-12-02T16:45:55","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/suture-material\/"},"modified":"2024-06-18T10:46:00","modified_gmt":"2024-06-18T09:46:00","slug":"suture-material","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/minor-surgery\/set-up-and-equipment\/suture-material\/","title":{"rendered":"Suture Material"},"content":{"rendered":"<hr \/>\n<p><span style=\"color: #003366;\"><span style=\"color: #33cccc;\"><strong>Superficial skin lesions<\/strong><\/span> confined to the cutis can be closed with the aid of <span style=\"color: #33cccc;\"><strong>Steri-Strips<\/strong><\/span>, <span style=\"color: #33cccc;\"><strong>wound adhesive strips<\/strong><\/span>, or <span style=\"color: #33cccc;\"><strong>tissue adhesive<\/strong><\/span>. Wounds that extend deeper than the cutis are closed with <span style=\"color: #33cccc;\"><strong>atraumatic disposable suture material<\/strong><\/span>.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Suture Thread<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">Suture thread can be made of <span style=\"color: #33cccc;\"><strong>reabsorbable<\/strong><\/span> or <span style=\"color: #33cccc;\"><strong>non-reabsorbable material<\/strong><\/span>. Both categories contain <span style=\"text-decoration: underline;\">monofilament<\/span> and <span style=\"text-decoration: underline;\">multifilament<\/span> (<em>braided<\/em>) threads. They are available in various thicknesses. The diameter is reported with zeroes, whereby thinner thread corresponds with a higher number of zeroes: <strong>6 &#8211; 5 &#8211; 4 &#8211; 3 &#8211; 2 &#8211; 1 &#8211; 0 &#8211; 00 &#8211; 000 &#8211; 0000 &#8211; 00000 &#8211; 000000<\/strong>.<\/span><\/p>\n<p><span style=\"color: #003366;\">In practice, 3\/0 or 4\/0 monofilament suture thread is used for simple suturing (<em>5\/0 is sometimes used for the face<\/em>). A 3\/0 reabsorbable thread is used subcutaneously.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\">When selecting a suture thread, the following aspects should be considered:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\"><strong><em>Tensile strength<\/em>.<\/strong> This refers to the <span style=\"color: #33cccc;\"><strong>degree of stress<\/strong><\/span> a thread can be subjected to before it breaks.<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong><em>Knot security. <\/em><\/strong>This is greatest when the thread is <span style=\"color: #33cccc;\"><strong>elastic<\/strong><\/span>, <span style=\"color: #33cccc;\"><strong>non-smooth<\/strong><\/span>, and contains <span style=\"color: #33cccc;\"><strong>multiple filaments<\/strong><\/span> (<em>fibres<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong><em>Tissue reaction.<\/em><\/strong> The risk of tissue reactions is greater with <span style=\"color: #33cccc;\"><strong>reabsorbable thread<\/strong><\/span> than synthetic, non-reabsorbable thread.<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong><em>Capillary action<\/em>.<\/strong> Compared with monofilament thread, multifilament thread has a <span style=\"color: #33cccc;\"><strong>greater capacity<\/strong><\/span> for taking up fluid. Tissue fluid can penetrate between the filaments, forming a nutrient medium for bacteria. This capillary action can be reduced by encasing the multifilament thread (<em>nylon<\/em>) with impermeable material (<em>silicone or wax<\/em>). Multifilament thread should not be used for <span style=\"color: #33cccc;\"><strong>heavily contaminated wounds<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\"><strong><em>Allergic reactions<\/em>.<\/strong> These can arise when <span style=\"color: #33cccc;\"><strong>reabsorbable material<\/strong><\/span> is used.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Wound Adhesive Strips<\/strong>\u00a0<\/span><\/p>\n<p><span style=\"color: #003366;\">Correct application of Steri-Strips to incised wounds that run <span style=\"color: #33cccc;\"><strong>parallel<\/strong><\/span> to skin lines (<em>without tension and not running over joints<\/em>), yields excellent cosmetic results that are entirely comparable to those achieved with tissue adhesive <em><strong>[Figure 2]<\/strong><\/em>.<\/span><\/p>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-756\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-2.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-2.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/MinorSurgery_ms-fig-2-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 2<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Tissue Adhesive<\/strong><\/span><\/p>\n<p><span style=\"color: #003366;\">Tissue adhesive is an <span style=\"color: #33cccc;\"><strong>autopolymerising adhesive<\/strong><\/span> that polymerises within a few seconds. Tissue adhesive is applied only to <span style=\"color: #33cccc;\"><strong>superficial wounds<\/strong><\/span> confined to the cutis without tension. <\/span><span style=\"color: #003366;\">The edges of the wound must be <span style=\"color: #33cccc;\"><strong>dry<\/strong><\/span>.<\/span><\/p>\n<hr \/>\n<p><span style=\"color: #003366;\">Tissue adhesive has the following advantages over suturing with needle and thread: <\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">The result is <span style=\"text-decoration: underline;\">more attractive<\/span> (<em>there is no scarring from suture thread<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Adhesive <span style=\"text-decoration: underline;\">saves time<\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Infiltration anaesthesia is unnecessary.<\/span><\/li>\n<li><span style=\"color: #003366;\">Suture removal is avoided.<\/span><\/li>\n<li><span style=\"color: #003366;\">It is <span style=\"text-decoration: underline;\">less traumatic<\/span> for paediatric patients.<\/span><\/li>\n<li><span style=\"color: #003366;\">Since applying adhesive is a painless procedure, patients will <span style=\"text-decoration: underline;\">maintain their trust<\/span> in the general practitioner.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\">The disadvantages are:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\"><span style=\"color: #33cccc;\"><strong>Tissue toxicity<\/strong><\/span> &#8211; the adhesive can <span style=\"text-decoration: underline;\">damage<\/span> the eyes and blood vessels.<\/span><\/li>\n<li><span style=\"color: #003366;\"><span style=\"color: #33cccc;\"><strong>Improper use<\/strong><\/span> with deep wounds can create <span style=\"text-decoration: underline;\">dead spaces<\/span> (<em>no adaptation of deep-lying tissues<\/em>), whereby <span style=\"text-decoration: underline;\">infection<\/span> can occur.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><span style=\"color: #33cccc;\"><strong>Tissue adhesive<\/strong><\/span> should only be used for the following (see also &#8220;<em>Skills<\/em>&#8220;):<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Small wounds confined to the cutis.<\/span><\/li>\n<li><span style=\"color: #003366;\">Small wounds that run parallel to skin lines.<\/span><\/li>\n<li><span style=\"color: #003366;\">Non-contusional small wounds.<\/span><\/li>\n<li><span style=\"color: #003366;\">Small wounds without tension.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Superficial skin lesions confined to the cutis can be closed with the aid of Steri-Strips, wound adhesive strips, or tissue adhesive. Wounds that extend deeper than the cutis are closed with atraumatic disposable suture material. Suture Thread Suture thread can be made of reabsorbable or non-reabsorbable material. Both categories contain monofilament and multifilament (braided) threads. [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[73],"tags":[146],"class_list":["post-757","post","type-post","status-publish","format-standard","hentry","category-set-up-and-equipment","tag-minor-surgery"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Suture Material - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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