Question

List the different layers closed for abdominal wounds. Please list in order and what suture and needle type would be used as well as stitch. Sutures are a key component in the OR, please be as thorough as possible

Answer 1

Answer :

There are nine layers to the abdominal wall:

• Skin
• Subcutaneous tissue .
• External oblique muscle.
• Internal oblique muscle.
• Transverse abdominis muscle .
• Transversalis fascia.
• Preperitoneal adipose and areolar tissue.
• Peritoneum

What is suture :

Suture is a stich or series of stiches made to secure apposition of the edges of a surgical or traumatic wound .

Types of sutures :

• Absorbable sutures
• Non absorbable sutures

Absorbable are : catgut ,chromic ,collagen ,fascia lata and beef tendon .

Non absorbable are : silk, silk warm gut ,linen ,cotton and ramie.

Suture materials :

Absorbable : monofilament : surgical gut plain chromic ,collagen plain chromic ,monocryl ,PDS 2 ,ployglactin 910

Multi filament are : polyglycolic acid ,poly glactin 910 and poly glactin 910 rapid .

Types of needles :

- round body needles .

- cutting needle : conventional ,reverse cutting .

Closure of abdominal wounds :

For skin : suture type is non absorbable , needle is curved cutting needle and suture material is nylon synthetic monofilament material .poly propylene is often preferred for nylon . Suture is interrupted type . Some times mattress sutures .

For subcutaneous tissue: absorbable poly dioxanone is used subcutaneous tissue ,suture type is interrupted or continuous ,needle is round body .

For muscle layers : absorbable plain catgut or polygalatin 910 used for muscle layers ,needle is round body.

For peritoneal layer : surgical catgut absorbable suture material can be used to reapproximate mucosal surface or peritoneal edges ,but they lack the tensile strength for use in facia closure .

- poliglecaprone 25 ( monocryl ) is an absorbable suture that retains 50% of its tensile strength .

Needle is round body ,sutues are continues sutures or mattress sutures can be used .