Types of Suture Essay Example

Types of Suture Essay Example Types of Suture Essay Types of Suture Essay Types of Sutures 1) Surgical Sutures 2) Suture Types 1. Absorbable Sutures * Polyglycolic Acid Sutures * Polyglactin 910 Sutures * Catgut Sutures * Poliglecaprone Sutures * Polydioxanone Sutures 2. Non-absorbable Sutures * Polypropylene Sutures * Polyamide / Nylon Sutures * Polyester Sutures * Silk Sutures * Polyvinylidene fluoride / PVDF Sutures * Stainless Steel Sutures Absorbable and non absorbable sutures Sutures can be divided into two types – those which are absorbable and will break down harmlessly in the body over time without intervention, and those which are non-absorbable and must be manually removed if they are not left indefinitely. The type of suture used varies on the operation, with the major criteria being the demands of the location and environment and depends on the discretion and professional experience of the Surgeons. * Sutures to be placed internally would require re-opening if they were to be removed. Sutures which lie on the exterior of the body can be removed within minutes, and without re-opening the wound. As a result, absorbable sutures are often used internally; non-absorbable externally. * Sutures to be placed in a stressful environment, for example the heart (constant pressure and movement) or the bladder (adverse chemical presence) may require specialized or stronger materials to perform their role; usually such sutures are either specially treated, or made of special materials, and are often non-absorbable to reduce the risk of degradation. Absorbable sutures include :- Polyglycolic Acid sutures, Polyglactin 910 , Catgut, Poliglecaprone 25 and Polydioxanone sutures. Non-Absorbable sutures include :- Polypropylene utures, Nylon (poylamide), Polyester, PVDF, silk and stainless steel sutures. Monofilament and Multifilament Sutures Sutures can also be divided into two types on the basis of material structure i. e. monofilament sutures and multifilament or braided sutures. Braided sutures provide better knot security whereas monofilament sutures provide better passage through tissues. In general, Monofilament sutures elicit lower tissue reaction compared to braided sutures. Monofilament sutures include :- Polypropylene sutures, Catgut, Nylon, PVDF, Stainless steel, Poliglecaprone and Polydioxanone sutures. Multifilament or braided sutures include :- PGA sutures, Polyglactin 910, silk and polyester sutures. Synthetic and Natural Sutures Surgical sutures can also be divided into two types on the basis of raw material origin i. e. natural and synthetic sutures. Natural sutures include silk and catgut sutures whereas all other sutures are synthetic in nature. Suture Techniques Running, or Continuous Stitch| The Running stitch is made with one continuous length of suture material. Used to close tissue layers which require close approximation, such as the peritoneum. May also be used in skin or blood vessels. The advantages of the running stitch are speed of execution, and accommodation of edema during the wound healing process. However, there is a greater potential for malapproximation of wound edges than with the interrupted stitch. | | Interrupted Stitch| Each stitch is tied separately. May be used in skin or underlying tissue layers. More exact approximation of wound edges can be achieved with this technique than with the running stitch. | | Mattress Suture| A double stitch that is made parallel (horizontal mattress) or perpendicular (vertical mattress) to the wound edge. Chief advantage of this technique is strength of closure; each stitch penetrates each side of the wound twice, and is inserted deep into the tissue. | | Purse String| A continuous stitch paralleling the edges of a circular wound. The wound edges are inverted when tied. Commonly used to close circular wounds, such as a hernia or an appendiceal stump. | | Smead-Jones/Far-and-Near| A double loop technique alternating near and far stitches. Commonly used for approximating fascial edges. | | Continuous Locking, or Blanket Stitch| A self-locking running stitch used primarily for approximating skin edges. |

Learning Mandarin Chinese

Learning Mandarin Chinese Mandarin Chinese is a difficult language to learn, especially given its unintuitive pronunciations and use of characters rather than an alphabet system. Learning Chinese can be a daunting idea, and often many beginner students dont know where to start. If you are feeling overwhelmed, this guide can give you the basic building blocks of Chinese grammar, introductory vocabulary, and pronunciation tips to help you build a foundation in Chinese. Be sure to click on hyperlinked text to access each lesson. The 4 Mandarin Tones Mandarin Chinese is a tonal language. Meaning, the way a syllable is pronounced in terms of sound and tone changes its meaning. For example, the syllable ma can mean horse, mother, scold, or hemp depending on which tone is used. Mastery of the four  Mandarin tones  is the essential first step to  learning this language. The  four Mandarin tones  are high and level, rising, falling then rising, and falling. You must be able to pronounce  and  understand the Mandarin Tones.   Once you have learned the tones, you can start learning new vocabulary and phrases while learning pinyin Romanization. Reading and writing Chinese characters is the last step. Mandarin Pronunciation Guide There are 37 unique sounds in Mandarin Chinese, which consist of 21 consonants and 16 vowels. Through a myriad of combinations, around 420 different syllables can be produced and are used in the Chinese language.   Lets take the Chinese word for often as an example. The character  Ã¥ ¸ ¸ is pronounced as chng, which is a combination of the sounds ch and ang.   The sound  chart in this guide has audio files of all 37 sounds along with their Pinyin spellings. Pinyin Romanization Pinyin  is a way to write Chinese using the Roman (Western) alphabet. It is the most common of many forms of  Romanization, and is used in most teaching materials particularly for Western students learning Chinese. Pinyin allows beginner  Mandarin  students to read and write Chinese without using Chinese characters. This allows students to concentrate on spoken Mandarin before tackling the formidable task of  learning Chinese characters.   Because pinyin has many pronunciations  which are unintuitive to English speakers, it is necessary to study the pinyin system to avoid pronunciation errors.   Introduction to PinyinPinyin Pronunciation Essential Vocabulary Of course, there is a seemingly endless of vocabulary words to learn. Ease yourself in by starting with some of the most commonly used, everyday Chinese words. In order to refer to people in a conversation, you will need to know Mandarin pronouns. This is the equivalent to terms like I, you, he, she, they, we.  Mandarin words for colors  is also elementary vocabulary that can be easily learned. As you see different colors in your everyday life, try and remember the Chinese word for it.   Understanding Mandarin numbers  is also a good place to start. After you have mastered reading, writing, and pronouncing numbers, learning  calendar terms  (such as days  in  the week and months) and how to  tell time  will be easier.   Conversation Topics As you progress in your mastery of Mandarin, you will be able to have conversations. These lessons will prepare you for conversing about particular topics. All conversations start with a greeting. Learn Mandarin greetings  to be able to say hello or good afternoon! In introducing yourself, common questions might be where are you from? or where do you live? This handy list of  Mandarin names for North American cities  can help you respond. Many social events and get-togethers happen at restaurants. Learning  food vocabulary  and  restaurant vocabulary  can be helpful so that you know what to order or how to ask for help if you need another pair of chopsticks. If you are traveling in a Chinese-speaking country, you may be staying in a hotel or have to deal with banking in terms of withdrawing money, exchanging money, and so on. These  hotel vocabulary  and  banking vocabulary  lessons can be a good addition. Mandarin Grammar Mandarin Chinese grammar is very different from English and other Western languages. The first step is learning basic  Mandarin sentence Structures. For a beginner-level Mandarin student, it is also important to know how to  ask questions in Chinese  because asking questions is the best way to learn about a language and a culture. Particularly helpful questions to know include how do you say X in Chinese? or what does this idiom mean?  Ã‚   An interesting difference between English and Chinese is the use of  Mandarin measure words. For instance, in English one would say a piece of paper or a loaf of bread. In these examples, piece and loaf are measure words for the nouns paper and bread. In Chinese, there are many more measure words. Reading and Writing Chinese Characters Chinese characters  are the hardest part of learning Mandarin. There are over 50,000 Chinese characters, and a dictionary will typically list 20,000 characters. An educated Chinese person will know around 8,000 characters. And to read a newspaper you must learn about 2,000 to read a newspaper. The point is, there are a lot of characters! While the only way to really learn characters is to memorize them, knowing character  radicals  can give you some hints too. Engaging with beginner-level  Chinese text and books  can be a great way to practice. If you want to practice by writing Chinese online, here is how you can  write Chinese characters using Windows XP.