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Suturing

SUTURING

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Suturing

  1. 1. SUTURING PRESENTED BY: PROF.VIJAYREDDY VANDALI PHD SCHOLAR, M.SC(N).PGCDE,MIPHA,. DEPT OF MEDICAL-SURGICAL NURSING INDIA, Email: vijayvandali@yahoo.com
  2. 2. INTRODUCTION • Suture means to sew or seam. • Sutures are used to close wounds of skin or other tissues. While sutures a wound, use a needle attached to a length of “thread” to stitch the wound shut. • There are a variety of available materials that can be used for suturing. doctor will choose a material that’s appropriate for the wound or procedure.
  3. 3. DEFINITIONS 1.Suture is a any strand of material utilized to ligate blood vessels or approximate tissues. Silverstein L H 2.Suture is a stitch or series of stitches made to secure opposition of the edges of a surgical /traumatic wound. WILKINS
  4. 4. PURPOSES OF SUTURING • Maintain hemostatsis • Provide adequate tension • Promote healing • Provide support to tissues • Reduce pain • Permit proper flap position • Prevent bone exposure • Prevent infection
  5. 5. EQUIPMENT/ARTICLES • Equipment required for suture closure of a wound includes the following: • Tray • Suture material • Needle • Needle holder
  6. 6. SUTURE QUALITIES • It is sterile • It is suitable for all purposes (ie, is composed of material that can be used in any surgical procedure) • It causes minimal tissue injury or tissue reaction (ie, is non-electrolytic, non-capillary, non-allergenic, and non-carcinogenic) • It is easy to handle • It holds securely when knotted (ie, no fraying or cutting) • It has high tensile strength • It possesses a favorable absorption profile • It is resistant to infection
  7. 7. SUTURE CLASSIFICATION Sutures may be classified in terms of their origin, their structure, and their absorbability. Natural vs synthetic: Natural sutures can be made of collagen from mammal intestines or from synthetic collagen (polymers). Tissue reaction and suture antigenicity lead to inflammatory reactions, especially with natural materials. [26, 27] Synthetic sutures are made of artificial polymers. Monofilament vs multifilament: Monofilament suture material is made of a single strand; this structure is relatively more resistant to harboring microorganisms. It also exhibits less resistance to passage through tissue than multifilament suture does. However, great care must be taken in handling and tying a monofilament suture, because crushing or crimping of the suture can nick or weaken it and lead to undesirable and premature suture failure. Absorbable vs non-absorbable: Absorbable sutures provide temporary wound support until the wound heals well enough to withstand normal stress. Absorption occurs by enzymatic degradation in natural materials and by hydrolysis in synthetic materials. Hydrolysis causes less tissue reaction than enzymatic degradation
  8. 8. TYPES OF SUTURES The different types of sutures can be classified in many ways. • First, suture material can be classified as either absorbable or non-absorbable. • Absorbable sutures don’t require to remove them. This is because enzymes found in the tissues of your body naturally digest them. • Non-absorbable sutures will need to be removed but later date or in some cases left in permanently.
  9. 9. TYPES OF ABSORBABLE SUTURES • Gut. This natural monofilament suture is used for repairing internal soft tissue wounds or lacerations. Gut shouldn’t be used for cardiovascular or neurological procedures. The body has the strongest reaction to this suture and will often scar over. It’s not commonly used outside of gynecological surgery. • Polydioxanone (PDS). This synthetic monofilament suture can be used for many types of soft tissue wound repair (such as abdominal closures) as well as for pediatric cardiac procedures. • Poliglecaprone (MONOCRYL). This synthetic monofilament suture is used for general use in soft tissue repair. This material shouldn’t be used for cardiovascular or neurological procedures. This suture is most commonly used to close skin in an invisible manner. • Polyglactin (Vicryl). This synthetic braided suture is good for repairing hand or facial lacerations. It shouldn’t be used for cardiovascular or neurological procedures.
  10. 10. TYPES OF NON-ABSORBABLE SUTURES • Some examples of non-absorbable sutures can be found below. These types of sutures can all be used generally for soft tissue repair, including for both cardiovascular and neurological procedures. • Nylon. A natural monofilament suture. • Polypropylene (Prolene). A synthetic monofilament suture. • Silk. A braided natural suture. • Polyester (Ethibond). A braided synthetic suture.
  11. 11. THERE ARE MANY DIFFERENT SUTURE TECHNIQUES. SOME OF THEM ARE: Continuous sutures This technique involves a series of stitches that use a single strand of suture material. This type of suture can be placed rapidly and is also strong, since tension is distributed evenly throughout the continuous suture strand. Interrupted sutures • This suture technique uses several strands of suture material to close the wound. After a stitch is made, the material is cut and tied off. This technique leads to a securely closed wound. If one of the stitches breaks, the remainder of the stitches will still hold the wound together. Deep sutures This type of suture is placed under the layers of tissue below (deep) to the skin. They may either be continuous or interrupted. This stitch is often used to close facial layers.
  12. 12. Contd… Buried sutures • This type of suture is applied so that the suture knot is found inside (that is, under or within the area that is to be closed off). This type of suture is typically not removed and is useful when large sutures are used deeper in the body. Purse-string sutures • This is a type of continuous suture that is placed around an area and tightened much like the drawstring on a bag. For example, this type of suture would be used in your intestines in order to secure an intestinal stapling device. Subcutaneous sutures • These sutures are placed in your dermis, the layer of tissue that lies below the upper layer of your skin. Short stitches are placed in a line that is parallel to your wound. The stitches are then anchored at either end of the wound.
  13. 13. SUTURE REMOVAL • Sutures are removed will depend on where they are on the body. According to American Family Physician, some general guidelines are as follows: • Scalp: 7 to 10 days • Face: 3 to 5 days • Chest or trunk: 10 to 14 days • Arms: 7 to 10 days • Legs: 10 to 14 days • Hands or feet: 10 to 14 days • Palms of hands or soles of feet: 14 to 21 days
  14. 14. REFERECES 1.www.healthline.com 2.www.slideshare.net
  15. 15. THANK YOU

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