Chapter 4: Table of Contents
- 4.1 Suture Materials
- 4.2 Knots
- 4.3 Miller’s Knot
- 4.4 Modified Miller’s Knot
- 4.5 Hand Ties
- 4.6 Ligatures and Suture Patterns
- 4.7 Circumferential Ligature
- 4.8 Cruciate Pattern
- 4.9 Cushing Pattern
- 4.10 Ford Interlocking Pattern
- 4.11 Intradermal Pattern
- 4.12 Lembert Pattern
- 4.13 Mattress Suture Patterns
- 4.14 Modified Transfixing Ligature
- 4.15 Purse-String and finger trap
- 4.16 Simple Continuous Pattern
- 4.17 Simple Interrupted Pattern
- 4.18 Skin Staples
- 4.19 Subcutaneous closure & How to bury a knot
- 4.20 Suture Material and Patterns Quiz
Polymethyl Methacrylate (PMMA): A polymer commonly used as bone cement. PMMA is purchased as a liquid and powder, which are mixed together at time of use to form a slurry or a paste which is then placed on or in bone. Heat produced during polymerization (90-121°C) may damage or kill surrounding soft tissues. Bone cement appears as a radiopaque substance on radiographs because it also contains small amounts of barium sulfate (BaSO4). Bone cement may become infected if contaminated with bacteria at the time of surgery or later secondary to hematogenous contamination.
Dacron (polyethylene terephthalate): A commonly used vascular prosthesis made as woven, knitted or velour fabric implants to reproduce large diameter (>6mm internal diameter) vessels. Complications related to their use include dilatation, suture line failure, holes and perforations, bleeding and infection.
Teflon (polytetrafluoroethylene): A vascular prosthesis often used for arteries. Teflon comes in tubular and patch forms with 20um pores to control penetration and adhesion of cellular material inside the prosthesis.
Cyanoacrylates also referred to as tissue glue can be used to appose the skin and are especially popular for declaw procedures. Cyanoacrylates are liquids that become solid within seconds of contacting water in the tissues. They can delay healing, cause tissue reaction, granuloma formation and may promote surgical wound infection.