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PERIOPERATIVE NURSING

PERIOPERATIVE NURSING. SUTURE. BY MURSIDI H.A. WHAT IS SUTURE. “a thread, wire, or other materials used in the operation of stitching parts of the body together” “to suture is to unite by stitching (sewing) until healing take place”

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PERIOPERATIVE NURSING

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  1. PERIOPERATIVE NURSING SUTURE BY MURSIDI H.A

  2. WHAT IS SUTURE • “a thread, wire, or other materials used in the operation of stitching parts of the body together” • “to suture is to unite by stitching (sewing) until healing take place” • Purposes – ligating bleeding vessels, suturing internal structures, wound closure and retraction purposes

  3. Characteristic of Suture Materials • Physical characteristic • Monofilament or Multifilament • Capillarity • Predetermined diameter (caliber) • Good tensile strength • Knot strength • Maintained elasticity • Memory capacity

  4. Characteristic of Suture Materials • Handling characteristic • Pliability (easily bends) • Co-efficient of frictions (slip easily) – to prevent tissue drag, knot slippage and to facilitate knot tying • Tissue-reaction characteristic • Non-allergenic • Non-carcinogenic • Minimal tissue reactions

  5. TYPES OF SUTURE MATERIALS • ABSORBABLE SUTURE • “a sterile, flexible strand prepared from collagen derived from healthy mammals or synthetic polymers” • Capable of being absorbed by living tissues through hydrolyzed or enzymatic process • May be impregnated with coating, softening or anti-microbial agents • Varies in treatments, colour, sizes, packaging and resistance to absorption according to purposes

  6. Types of Absorbable sutures • COLLAGEN DERIVED • Surgical Gut • SYNTHETIC DERIVED • Coated Vicryl • Monocryl • PDS • DERIVED FROM SILKWORM LARVA • Silk suture

  7. TYPES OF SUTURE MATERIALS • NON-ABSORBABLE SUTURE • “a strands of materials that effectively resist enzymatic digestion in living tissue” • May be uncoated or coated with substance to reduce capillarity and friction • Encapsulated by tissues around it during healing • Required removal of suture after wound healing

  8. Types of Non-Absorbable sutures • SYNTHETIC DERIVED • Ethilon (Nylon) • Prolene • Ethibond • Monosof • SURGICAL WIRE • Stainless steel wire

  9. INDIVIDUAL CHARACTERISTIC OF SUTURE(collagen derived absorbable sutures)

  10. INDIVIDUAL CHARACTERISTIC OF SUTURE(synthetic absorbable sutures)

  11. INDIVIDUAL CHARACTERISTIC OF SUTURE(synthetic non-absorbable sutures)

  12. INDIVIDUAL CHARACTERISTIC OF SUTURE(SILK AND SURGICAL WIRE)

  13. MONOFILAMENT SUTURES PLAIN GUT PROLENE POLYPROPYLENE STEEL WIRE CHROMIC GUT SILK

  14. BRAIDED/MULTIFILAMENTS SUTURES CHROMIC GUT SILK CHROMIC GUT SILK VICRYL NYLON

  15. TENSILE STRENGTH AND DIAMETER • Refer to knot pull strength of the suture rather than straight pull strength • Suture diameter refer to the size of the strand (heavy size 7 to fine size of 11-0) • SUTURE LENGTH • Standardized length - 50 or 60 inches • Precut length – 17,18 or 24 inches • SUTURE PACKAGING • Sealed in a primary inner packet with inside dry and outer, see-through peel-back packet – sterilized • Sterility maintained until opened or date of expiry arrived

  16. IDENTIFCATION OF SUTURE SUTURE SIZE BATCH NUMBER SUTURE NAME SUTURE LENGTH NEEDLE SIZE & SHAPE PRODUCT NAME

  17. SUTURES COLOUR CODING PACKAGES

  18. COLOUR CODING AND PACKAGES OF SUTURES

  19. ASEPTIC TRANSFER OF SUTURE • METHOD 1 – Retrieval by scrub person • Hold the packet flaps between extended thumbs • Rolls hands outward to peel outer packet apart • Exposed inner packet (suture) are then grasp by scrub person • METHOD 2 – “Flipping” suture packet • Standing a safe distance from sterile trolley, the circulator rolls the flaps of the outer package backwards • Project (flips) the inner packet onto sterile trolley

  20. ASEPTIC SUTURE TRANSFER TECHNIQUE SUTURE RETRIEVAL TECHNIQUE FLIPPING TECHNIQUE

  21. SURGICAL NEEDLES • Made of a steel alloy with high carbon • content (stainless steel) • Varies in shape, size, point design and wire • diameter

  22. ANATOMY OF NEEDLE

  23. BASIC PARTS OF SURGICAL NEEDLES • THE EYE ROLLED END ATRAUMATIC REGULAR EYE SPRING EYE SPRING DOUBLE

  24. BASIC PARTS OF SURGICAL NEEDLES • THE BODY SHAPE 1/2 Circle 3/8 circle 1/4 Circle J shape compound 5/8 Circle straight ½ curve

  25. GENERAL USES OF NEEDLE ACCORDING TO IT’S SHAPE

  26. BASIC PARTS OF SURGICAL NEEDLES • THE POINT Taper cut Spatulated end Cutting edge Blunt Point

  27. COMMON USAGE OF ATRUMATIC NEEDLES

  28. WORKING WITH SUTURES AND NEEDLES • MOUNTING THE NEEDLE • THREADING THE NEEDLE

  29. WORKING WITH SUTURES AND NEEDLES • PASSING THE NEEDLE HOLDER WITH SUTURE • NEEDLES’ COUNTS

  30. TYPES OF WOUND SUTURING

  31. OTHER METHODS OF WOUND CLOSURE • SURGICAL STAPLER • SKIN STRIPS & SKIN GLUE

  32. TISSUE REACTION AFTER SUTURING • Suture act as a foreign substance • Begins when the suture inflicts injury to the tissue during insertion • Increased factors include allergic, absorption period, cell reactions and types of suture

  33. Comparison of tissue resorption according to sutures

  34. REMOVAL OF WOUND CLOSURE(SUTURE AND STAPLE)

  35. THANK YOU

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