Chapter 06: Sutures, Needles, and Instruments

Chapter 06: Sutures, Needles, and Instruments

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The primary use for suture is essentially to:

a.	strengthen, re-form, and close tissue.
b.	ligate, suture, and close tissue.
c.	ligate, strengthen, and stop bleeding.
d.	clamp, divide, and attach tissue.

 

 

ANS:  B

Suture is a generic term for all materials used to sew severed body tissues together and to hold these tissues in their normal position until healing takes place; to suture is to stitch together cut or torn edges of tissue. A ligature is a strand of suture material used to tie off (seal) blood vessels for the prevention of minor bleeding, or to isolate a mass of tissue for excision (cut out). A variety of suture materials are available for ligating, suturing, and closing the wound.

 

REF:   Page 174

 

2. The ideal suture material is one that has handling characteristics such as:

a.	memory.
b.	slickness.
c.	ease of tying.
d.	removable knots.

 

 

ANS:  C

Key features used to evaluate the general properties of suture material are (1) physical characteristics, (2) handling characteristics, and (3) tissue reaction characteristics. Handling characteristics of suture material are related to pliability (how easily the material bends) and the coefficient of friction (how easily the suture slips through tissue and can be tied).

 

REF:   Page 174

 

3. Tissue reaction characteristics are important in a suture material because:

a.	the suture should absorb and nourish the healing tissue.
b.	the suture should not cause tissue inflammation or an allergic response.
c.	the suture should not support infection.
d.	the suture should not cause tissue inflammation or an allergic response and the suture should not support infection

 

 

ANS:  D

The ideal suture material is one that causes minimal inflammation and tissue reaction while providing maximal strength during the lag phase of wound healing. Tissue reaction characteristics include inflammatory and fibrous cell reaction, absorption, potentiation of infection, and allergic reaction.

 

REF:   Pages 174-176

 

4. The surgeon needs a suture material that will not degrade over time, but becomes encapsulated and supports a tissue structure that will continue to be exposed to pressure and stretching forces throughout the patient’s life. These physical properties are best described by a suture that:

a.	is nonabsorbable, has good tensile and knot strength, and is the appropriate diameter for the tissue.
b.	has a large diameter, is nonabsorbable, is highly reactive, and is a monofilament.
c.	is a monofilament, is synthetically manufactured, is absorbable, and has a large diameter.
d.	has good tensile strength, memory, and ease of tying and is absorbable.

 

 

ANS:  A

Physical characteristics of sutures can be measured or visually determined and include the following properties: Diameter (size) is measured in millimeters, and expressed in USP sizes with zeroes. The finer diameter (smaller size) provides better handling qualities and small knots. Improved suturing techniques are possible with sutures of finer diameter. Tensile strength is defined as the amount of weight (breaking load) necessary to break a suture (breaking strength); it varies according to the type of suture material. Knot strength is the force necessary to cause a given type of knot to slip, either partially or completely. The most common nonabsorbable suture materials are silk, nylon, polyester fiber, polypropylene, and stainless-steel wire.

 

REF:   Pages 176-179

 

5. Dr. Garrison was teaching the new residents as he closed the muscle and fascia layer following an open cholecystectomy. He stated that he liked the tensile strength of this monofilamented synthetic suture and also liked the pretty blue color, but it was hard to manage with its memory and slipperiness and normally needed six surgeon’s knots to hold. He was using:

a.	Ethilon.
b.	Prolene.
c.	Sofsilk.
d.	Monocryl.

 

 

ANS:  B

Prolene (polypropylene) is a clear or pigmented polymer. This monofilament suture material (Prolene, Surgilene, Surgipro, Dermalene) is used for cardiovascular, general, and plastic surgery. Because polypropylene is a monofilament and is extremely inert in tissue, it may be used in the presence of infection. It has high tensile strength and causes minimal tissue reaction. Sizes range from 10-0 to #2.