Suture Materials

1
Suture Materials

• ABSORBABLE
• lose their tensile strength within 60 days.

• NON-ABSORBABLE

2
Surgical Needles
3
Surgical Instruments
4
Needle Holders
5
Forceps

• Dressing forceps

• Tissue forceps

6
Suture Removal Scissors
7
Wound Evaluation

• Time of incident
• Size of wound
• Depth of wound
• Tendon / nerve involvement
• Bleeding at site

8
Wound Irrigation

• Check physician's order for dressing change.
• Prepare necessary equipment and supplies
• Sterile dressing set.
• Sterile irrigation solution.
• Clean disposable gloves.
• Sterile gloves
• Sterile gauze.
• Sterile syringe.
• Sterile basin.
• Sterile forceps.
• Rubber sheet.
• Disposable bag.
• Tape.
• Blanket.

9
Identify the client. Explain the procedure to the
client. Determine if the client has allergy to
any of the materials or solutions needed for the
procedure. Wash hands. Close the room door or
curtains windows. Place the bed at a
comfortable position. Assist the client to a
comfortable position. Expose the area and drape
the client with blanket if needed. Place rubber
sheet under the wound area. Using aseptic
technique, open sterile set on work area.
10
Principles And Techniques

• Place disposable bag within easy reach for use
  during the irrigation.
• Wear clean disposable gloves and remove the
  soiled dressings.
• Assess the wound for size, appearance , amount of
  drainage and the appearance of the surrounding
  tissues.
• Discard the dressings in disposable bag.
• Remove gloves and put them in disposable bag.
• Using sterile technique ,prepare a sterile field
  and add all the sterile supplies needed for the
  procedure to the field.

11

• Pour warmed sterile irrigating solution into the
  sterile container or basin.
• Wear sterile gloves.
• Position the sterile basin below the wound when
  collect the irrigating fluid.
• The irrigation solution will flow from the upper
  end of the wound toward the lower end.
• Make sure all areas of the wound are irrigated.
• Use a syringe with an irrigating tip to flush the
  wound.
• Insert irrigating tip into the wound until
  resistance is met.
• Watch for the solution to flow smoothly and
  evenly.
• When the solution from the wound flows out clear,
  discontinue irrigation.

12
Dry the surrounding skin with a sterile gauze
sponge. Apply a new sterile dressing to the
wound. Apply dry sterile gauze over wound. Remove
gloves and dispose of them properly. Secure
dressing with tape. Return the bed to the lowest
position and raising the side rails as
needed. Remove the equipment and dispose it
properly. Wash hands. Documentation.
13
Suturing

• Apply the needle to the needle driver
• Clasp needle 1/2 to 2/3 back from tip
• Rule of halves
• Matches wound edges better avoids dog ears
• Vary from rule when too much tension across wound

14
Suture Removal

• Time frame for removing sutures
• Average time frame is 7-10 days
• FACE 4-5 days
• BODY SCALP 7 days
• PALMS, BACK OR OVER JOINTS 10 days
• Any suture with pus or signs of infections
  should be removed immediately.

15
Suture Removal

• Clean with hydrogen peroxide to remove any
  crusting or dried blood
• Using the tweezers, grasp the tie and cut the
  suture below the tie, close to the skin
• Pull the suture line through the tissue- in the
  direction that keeps the wound closed - and place
  on a 4x4

16
Suture Removal

• Once all sutures have been removed, count the
  sutures
• The number of sutures needs to match the number
  indicated in the patient's health record