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SURG TESTS > Chapter 11 pt 2 > Flashcards

Chapter 11 pt 2 Flashcards

wound closure

1
Q

what is the ideal kind of suture to use

A

highest tensile strength and smallest diameter

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2
Q

what is inertness of suture tissue

A

doesn’t react with tissue
(not treated as foreign body)

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3
Q

what is the most inert suture you can put in body
relatively inert?

A

stainless steel

monofilament

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4
Q

what is an absorbable suture like

A

capable of being absorbed by tissue within giving period of time

should be completely absorbed by the time tissue no longer needs them

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5
Q

what is a nonabsorbable suture like

A

resists enzymatic digestion of absorption by tissue

permanent until removed

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6
Q

classifications of suture: elasticity and pliability

A

stretch and bindability, able to withstand movement

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7
Q

classifications of suture: barbed

A

anchors tissue, can’t back up
v-loc and stratafix

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8
Q

characteristics of monofilament suture

A

single thread (no bacteria)
doesn’t hold knots well
memory
doesn’t harbor bacteria
relatively inert

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9
Q

characteristics of multifilament suture

A

braided
capillarity
handle greater tensile strength
coated to pass through tissue easier

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10
Q

two classifications of suture material

A

natural
synthetic

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11
Q

natural suture material

A

made out of natural things
guts and silk

digested by body enzymes that attack suture strand and destroy it

tissue reaction: moderate

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12
Q

synthetic suture material

A

consists of polymer from petroleum based products
hydrolyzed the body

tissue reaction: minimum

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13
Q

factors affecting selection of suture

A

biological characteristics
healing characteristic of tissue
type of procedure
surgeon specific

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14
Q

MEMORIZE TABLE OF SUTURES IN BOOK

A

MEMORIZE TABLE OF SUTURES IN BOOK

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15
Q

what is suture size referred as

A

gauge

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16
Q

who bases what suture guage should be

A

USP (United States pharmacopeia)

the more Os the smaller the suture

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17
Q

suture size ranges

A

12-0 to #5

5” to 59” long

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18
Q

most common suture gauge range

A

4-0 to 1

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19
Q

what size is ortho fascia suture

A

0-1 g

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20
Q

what size is skin suture

A

3-0 to 4-0 g

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21
Q

what size are small vessel suture

A

6-0 to 7-0 g

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22
Q

what size are micro vascular sutures

A

11-0 to 9-0 g

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23
Q

what size are aorta dura suture

A

5-0 to 4-0 g

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24
Q

what size of suture is for microvascular and eyes

A

8-0 to 11-0

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25
what is on the box if it comes with more than two needles
the number of needles Is written in red
26
*anatomy of suture needle*
*eye (where swaged on), point, body*
27
***what causes the least amount of tissue damage***
***swagged (eyeless) needles*
28
*what are needle eye *
portion of needle where suture is attached *suture inserted into hollow end and crimped by manufacture*
29
what is double armed needle eye
needle swaged into each end go suture strand
30
*permanent or controlled release (pop off)*
able to pull the needle off quickly
31
*French eye needle*
*pulled through V area quicker load but most damage*
32
*3 types of cutting type needle tips*
*conventional* - triangle, for sclera + skin *reverse* - upside down triangle for skin *side* - opthalmic, pentagon shaped
33
*what body parts are cutting needle points used for*
*sclera tendon and skin*
34
what is the benefit of reverse cutting needle tip
more surface area, stronger clamp of skin together
35
what is the benefit of conventional needle point
less scarring
36
*tapered needle point*
round shaft, no cutting edge *delicate tissues* (bowel)
37
*Taper cut needle point* ( ground point wire needle)
round body only tip is tapered vascular tissue or mesh grafts
38
*blunt needle tip*
round shaft ending in blunt tip (just dull tipped needle) *weak, pulp tissues- kidney liver*
39
what is length of needle body determined by
the "bit" deeper tissue (depth of bite) requires longer needle
40
what is shape of needle body determined by
determined by how it is used
41
*what Is a ligature*
a tie
42
what are ligatures used for
to occlude vessels for hemorrhage control or organ/ extremity removal
43
three forms of ligatures
precut full length - cut to size radiopaque reel
44
*clamp-clamp-cut-tie*
1st vascular clamp (Kelly) 2nd vascular clamp (Kelly) tissue scissor (Metz) suture tie - multifilament - monofilament
45
*how close do you cut multifilament suture tie internal and external*
internal: ⅛" external: on knot for skin
46
*how close do you cut monofilament suture tie internal and external*
internal: ¼' external: ⅛" on skin
47
*what is the order after you cut the suture*
remove clamp suture scissor suture tie remove clamp suture scissor
48
what is the realistic order of ligatures and suture cuts
clamp - Kelly, mixter clam- kelly, mixter cut (vessel) - Metz tie - 2.0 silk tie - 2.0 silk cut - mayo cut - mayo
49
what are the main sutures you use as ties range?
chromic, plain gut, vicryl, silk 2-0 to 4-0
50
what is the most common instrument for a tie on a pass
tonsil if shallow, right angle
51
*what is a stick tie*
*suture ligature with suture needle attached* to occlude large vessels prevents suture slippage
52
what do you do for suture preparation for procedures
look at DPC talk with surgeon bout variations open only as many as needed counted and arranged on field
53
*how are abdominal wounds closed*
inner layer to outer *peritoneum fascia muscle subcutaneous subcuticular skin*
54
three ways to eliminate dead space
meticulous closure of tissue pressure dressings wound drains
55
what type of suture do you use for parietal peritoneum
3-0 absorbable
56
*what provides the greatest support to abd cavity*
*fascia*
57
*what is the layer you ALWAYS HAVE to close*
*fascia*
58
which two layers do not tolerate suture well
subcutaneous! muscle
59
what suture is used for muscle
absorbable multifilament vicryl
60
what type of suture is used for vessel anastomosis
prolene non absorbable monofilament double armed taper SYNTHETIC
61
suturing technique: primary
approximate would edges for first intention wound healing (side to side)
62
suturing technique: secondary
support primary suture line
63
three suture techniques
primary secondary endoscopic
64
*what does the tech do during primary suturing*
*"follows" the suture necessary to maintain tension and keep suture our of surgeons way*
65
contradictions with primary suture technique
not used to close tissue under a lot of tension not used in presence of infection
66
what suture do you not use in an infection
multifilament
67
primary: continuous (running) simple technique
long straight incisions when wound edges easily evert stitches equal distances apart even tension
68
primary: continuous (running) locking (blanket) technique
suture is locked prior to placement of the next throw increases wound edge eversion and reduces skin tension
69
primary: continuous (running) subcuticular technique
sutures placed in the sub cuticular in short lateral throws under epidermis wound reinforced with sterile strips and derma bond patients prone to keloids
70
*primary: continuous (running) purse string technique*
drawstring suture placed in a circular fashion around structure in a way that pulling on the suture ends tightens and closes an opening *constant strong internal pressure: appendectomy*
71
*primary: interrupted suture technique*
used to close tissues under tension *used to close tissues that are infected*
72
how are stitches placed on primary simple interrupted sutures
each string individually placed
73
how are stitches placed on a primary interrupted figure 8 stick tie
suture placed through vessel to prevent slippage , then wrapped around vessel occlude large vessels
74
how are stitches placed on a primary interrupted figure 8 mattress
forms a figure 8 across wound, unidirectional pull suture tendons
75
how are stitches placed on a primary interrupted vertical mattress
2 bit suture technique when under a lot of tension approximates well used for deep wounds
76
how are stitches placed on a primary interrupted horizontal mattress
2 stitches placed parallel used when under a lot of pressure used for deep wounds approximates well
77
five kinds of primary interrupted sutures
simple figure of 8 (stick tie/ mattress) vertical horizontal buried
78
how are primary interrupted buried sutures placed
knot is located under the layer to be closed an is not projecting outward
79
what are traction sutures
(retraction sutures) retract a structure that may not be easily retracted with an instrument nonabsorbable suture, cut out at end of procedure - ends are clamped with a hemostat
80
secondary: retention suture
placed lateral to primary suture to reinforce (wider than primary) large gauged, bigger than primary
81
bolsters
plastic rubber tubing that keeps retention sutures from cutting into the skin (padding) - red rubber Cath keeps cost down
82
suture anchors
fixing tendons or ligaments to bone eyelet for suture to pass through
83
*adhesive skin closer strips*
(steri strips) *used in epidermal layer when sub cuticular wound closure has been done for good cosmesis*

SURG TESTS (24 decks)

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