Benang revision

PELATIHAN BEDAH DASAR
KOLEGIUM ILMU BEDAH INDONESIAKOLEGIUM ILMU BEDAH INDONESIA
Surgical SuturesSurgical Sutures
and Needlesand Needles

SUTURESSUTURES

The Ideal SutureThe Ideal Suture
Moynihan 1912Moynihan 1912
 Monofilament
 Use for any procedure
 Easy to handle
 Minimal tissue reaction
 High breaking strength
 Hold knots securely
 Absorbable
 Predictable Absorption
 Sterile

Classification of SuturesClassification of Sutures
CHARACTERISTIC Absorbable Nonabsorbable
STRUCTURE Monofilament Multifilament
MATERIAL Synthetic Biological

AdvantageAdvantage
ABSORBABLE
Broken down by body
No foreign body left
NONABSORBABLE
Permanent Wound
Support

DisadvantageDisadvantage
ABSORBABLE
Time of wound
support
NONABSORBABLE
Foreign body left
Suture sinus
Suture extrusion

AdvantageAdvantage
MONOFILAMENT
Smooth surface
Low friction
– Less drag
– Less tissue trauma
No bacterial harbours
No capilarity
MULTIFILAMENT
Strength
Soft & pliable
Good handling

MONOFILAMENT
Handling & Knotting
Ends/knot burial
Strecth
MULTIFILAMENT
Bacterial harbours
Capillary action
Tissue trauma
– Drag
– Cutting

AdvantageAdvantage
BIOLOGICAL
Handling & Knotting
Economical
SYNTHETICS
Resemble natural
substances
Absorption by
hydrolysis
Predictable
absorption
Strong

BIOLOGICAL
Absorption by
enzymatic action
Tissue reaction
Unpredictable
absorption
SYNTHETICS
Monofilament
handling

AbsorbableAbsorbableAbsorbableAbsorbable
BiologicalBiologicalBiologicalBiological
SyntheticSyntheticSyntheticSynthetic
Plain/F.A. Gut
Chromic Gut
VICRYL*
PDS II*
MONOCRYL*
VICRYL*Rapide
PANACRYL*
* Trademark

Absorption TerminologyAbsorption Terminology
ABSORBABLE SUTURESABSORBABLE SUTURES
 Wound support
 No loss of suture
bulk
 Strength reduced
 Elimination of Suture
 Material removed
LOSS OF
TENSILE STRENGTH
ABSORPTION OF
MASS

Suture HandlingSuture Handling

Absorbable SuturesAbsorbable Sutures
WOUND SUPPORT ABSORPTION OF
MASS
Catgut 7 – 10 60 – 90
VICRYL* Rapide 6 – 14 by 42
Chromic Catgut 17 – 21 90 – 110
MONOCRYL* 14 – 21 90 – 120
Coated VICRYL* 28 – 35 56 – 70
PDS* II up to 56 by 182

Coated VICRYL*Coated VICRYL*
AbsorptionAbsorption
Coated VICRYL* 2/0 at 14 days
Minimal Tissue Reaction
around suture
Chromic Catgut at 14 days
Extensive tissue reaction with
acute inflammatory response
Synthetic Absorbable – Hydrolysis
Predictable absorption
Minimal tissue reactions

PROLENE* PolypropylenePROLENE* Polypropylene
MINIMAL TISSUE REACTIONMINIMAL TISSUE REACTION
Enlarged photomicrograph
PROLENE* suture
Implanted 6 months

NEEDLESNEEDLES

Needle SelectionNeedle Selection
Minimal trauma to
tissue
Sharpness
Bend resistance
Corrosion resistance
Sterility
Size, shape & design

Use of Needle HoldersUse of Needle Holders

Anatomy of a Surgical NeedleAnatomy of a Surgical Needle

Eyed NeedlesEyed Needles
Double suture strand
Threading time
Resterilisation
Point maintenance
Risk of corrosion
Risk of unthreading
EyedEyed French / splitFrench / split
eyeeye

Suture AttachmentSuture Attachment
Channel
Drilled

““Swage”Swage”
Single Armed: satu jarum dengan satu benang
Double Armed: dua jarum pada satu benang
Loop: satu jarum pada satu benang dengan konfigurasi loop

Needle ShapesNeedle Shapes
¼Circle¼Circle 33
//88 CircleCircle ½ Circle½ Circle 55
//88 CircleCircle
½ Curved½ Curved
StraightStraight
CompoundCompound
CurveCurve
J ShapeJ Shape

Needle Size RangeNeedle Size Range
MICROSUTURES 3.75mm – 8mm
OPHTHALMIC 5mm – 16mm
CARDIOVASCULAR 8mm – 40mm
SKIN RANGE 9mm – 60mm
G.I. RANGE 13mm – 40mm
CLOSURE 30mm – 110mm
HAND HELD 55mm – 110mm
110mm110mm 3mm3mm
45 needle sizes from 3mm to 110mm

Needle TypesNeedle Types
Round Bodied
Cutting

Cutting NeedlesCutting Needles
CONVENTIONALCONVENTIONAL
CUTTINGCUTTING
Apex of edges on
inside curvature

Conventional CuttingConventional Cutting
PRIME*PRIME*
Sisi cutting “di dalam”
Prime Geometry
meningkatkan penetrasi
Dipipihkan pada lokasi
genggaman needle holder
untuk stabilitas
Series: PC Prime, CCS,
CPS-3

Cutting NeedlesCutting Needles
REVERSEREVERSE
CUTTINGCUTTING
Apex of edges on
outside curvature

Reverse CuttingReverse Cutting
Sisi “cutting “di luar”
Kelebihan desain ini:
– Lebih kuat
– Mengurangi “tissue cut-out”
atau robekan
Series: P, PS, FS, M, C,
LS, LR, OS, CP
Microsurgery: Series G

Taper PointTaper Point
 Tidak ada sisi “cutting”, lebih bersifat
“menusuk” dan memperlebar tusukan
sejalan dengan membesarnya
diameter. Tidak memotong
 Digunakan pada Intestinal
Anastomosis, Fascia Closure,
Gynecology, Hernia dan pada
Cardiovascular surgeries
 Series: BV, C, C, BB, SH, MH, LH,
MO, CT, TP, UR
.
22° 12:1 TRU TAPER

TAPERCUT*TAPERCUT*
Kombinasi antara taper dan
cutting, dimana pada ujung
bersifat cutting naun “body”
bersifat round body
Digunakan pada cardiovascular
yang mengalami hardening
Old TAPERCUT*
New TAPERCUT*

PACKAGINGPACKAGING

Packaging – Foil PackPackaging – Foil Pack
USP Gauge Metric
Gauge
Code number
Denotes Easy
Access packaging
Sterilisation Method
Manufacture
& Expiry date
Product description
& colour
Length
Needle
description
IDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGSIDENTIFICATION OF MARKINGS

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