Chapter 31 - postoperative Management book notes Flashcards
The wound and surrounding skin should be ____ immediately after closure.
immediately - because this region might be too painful for cleaning when patient is fully awake
What is a sterile wound cover?
a cover that protects a wound from coming into direct contact with the environment postoperative
The surgical assistant can assist in the postoperative care of a surgical patient by?
cleaning the wound, placing a bandage, submitting a biopsy sample or writing the surgical report
What is suturing?
the act of joining two surfaces together with a stitch or a series of stitches.
What is the goal of a suture?
is to hold the wound edges in apposition to one another until the tissue has sufficient time to heal.
Tissues that heal quickly, such as those of the stomach, intestine, and bladder are often closed with?
absorbable sutures
______ sutures may be prudent in tissues that heal more slowly, such as fasciae and tendons.
nonabsorbable
Sutures can be ______ (composed of a single strand or ______ (several filaments twisted or braided together)
monofilament
multifilament
What are some characteristics of monofilament sutures?
- considered easier to pass through tissue because they cause less resistance, but attention is needed during knot tying because they are slippery and can untie
What are some characteristics of multifilament sutures?
- have greater capillary action, making them more susceptible to bacterial colonization
Sutures are constructed in?
monofilament or multifilament forms
______ sutures are less resistant to contamination in infected wounds.
Multifilament
Most sutures are referred to in terms of?
their USP size (mm diameter size)
What is a surgical report?
an account of all procedures performed during surgery and includes any implants or sutures that were used.
When choosing suture material, what must be considered?
- If infection is a possibility, choosing a suture that can withstand infection.
- the type of organ being sutured
- if the area needing to be sutured is a hollow organ - pick sutures that can withstand degradation by intraluminal substances
- tissues that heal quickly (i.e., stomach) use absorbable sutures
- tissues that heal slowly (i.e., tendons) use nonabsorbable suture
Sutures are available in what sizes?
from 11-0 (thinnest) to the largest of 7 (thickest)
When using sutures, the greater the number of zeros the ______ is the suture.
thinner
Which suture is larger, a size 2 or a size 3?
a size 3
Which suture is larger, a size 2-0 or a 3-0?
a size 2-0
The strength of a suture is measured by the ____ required to break a knotted suture strand.
force
The suture that is selected to close a wound should be at least as strong as the ____ that it is holding together.
tissue
Suture handling is related to memory, what does this mean?
the capacity of a suture returning to a previously determined shape after undergoing deformation
Why is having a “lower memory” (or no memory) is considered a beneficial trait, why?
because these sutures are much easier to handle, and the quality of the knots is improved
What can you do to decrease memory and improve handling?
sutures can be gently pulled to remove some of the curl
When are knots formed in sutures?
when “throws” or wrappings of strands of suture are framed around each other and pulled together
The ___ is the weakest point in the suture?
knot
The security of the knot is affected by what?
- the quality of the knot
- knot tying technique
- the coefficient of friction
- the size of the suture material
- when placed in tissue fluids
Sutures are classified by different methods, what are they?
- type of material (natural or synthetic)
- biological behavior (absorbable or nonabsorbable
- method of construction (monofilament or multifilament)
Absorbable sutures are those that lose most of their breaking strength within ____ days of placement.
60 days
T or F
Only synthetic sutures are absorbable.
F
Both synthetic and natural versions of sutures are absorbable.
T or F
Both monofilament and multifilament forms are absorbable.
T
Absorbable sutures are absorbed by \_\_\_\_\_ \_\_\_\_\_ (natural) or by \_\_\_\_\_\_ (synthetic).
enzymatic degradation
hydrolysis
Natural absorbable sutures consist of?
catgut and collagen
_____ is a multifilament suture constructed from the intestines of sheep, goats, or cattle and consists mostly of collagen.
Catgut
Catgut sutures are maintain for only a short time. plain gut ____ to ___ days; chromic gut ____ to ____ days. Essential gone after ____ weeks.
7 to 10
10 to 14
2
_____ collagen is an alternative natural absorbable suture to catgut.
reconstituted - made from bovine flexor tendon
The most commonly used synthetic absorbable sutures in veterinary medicine include?
polyglactin 910, polyglycolic acid, poliglecaprone 25, polydioxanone, and polyglyconate
The nonabsorbable natural sutures used are?
silk and metallic
The nonabsorbable Synthetic sutures used are?
Polyamide (nylon)
Polypropylene (Prolene)
Polybutester (Novafil)
Polyester (Mersilene)
Suture needles can be _____ with suture or can require _____ onto an eyed needle.
preloaded (i.e.waged)
loading
Most needle are _____.
swaged
Why are needles swaged?
helps in making entry less traumatic than eyed needles because the tissue damage produced is minimal
Eye needles can be ____, _____, or ____.
- closed
- French (contain a slit to ease threading)
- double-armed suture (contains a needle on both ends of suture)
____ needles caue greater tissue trauma than _____ needles.
Eyed
swaged
Suture needles are classified according to their ____, ____ and type of __ ___.
shape, size,
needle point
____ and _____ of the needle should be considered when needle size is discussed.
Length and diameter
The ____ needle that can effectively reach both sides of the incision should be used to decrease ____-____ tissue trauma.
smallest
needle-induced
____ ___and ___ of the incision also need to be considered when needle size is determined.
Tissue thickness and depth
Several needle shapes are available, what are they?
straight
half-curved
parts of a circle (1/4, 3/8, 1/2, 5/8)
_____ needles are generally used only in locations where the fingers can be used to pass the sutures.
Straight
____ needles are manipulated with needle holders.
Curved
___ and ____ needles are most commonly used.
3/8 and 1/2
Needle points are categorized as?
cutting, tapering, or blunt
Cutting needles are recommended for?
tough tissue (skin)
Taper needles contain a sharp tip that is capable of piercing and spreading tissue use commonly used where?
intestines, subcutaneous tissue and fascia
Blunt-point needles have a tapered body with rounded, blunt point that is recommended when suturing the ____ and ____.
liver and kidney
Basic suture patterns include?
interrupted and continuous
At least how many people does it take to perform draping of a horse?
at least 2
_____ surgery is one of the most common surgical procedures on a horse.
Abdominal