Dressings and Supplies Flashcards
Blunt Dissection
Use of a sponge or blunt instrument to separate tissue on a normal anatomical plane
Dissection
Separation of tissues through anatomical planes; may be sharp or blunt dissection
Sharp Dissection
Use of a knife, scissors, or cutting instrument to separate tissue
Function of a surgical sponge
Absorb blood and tissue
Protect tissue
Apply Pressure
Retract tissue
Radiopaque
Impenetrable to X-rays or other forms of radiation
Will show if a radiopaque sponge was left in the patient upon closing and x-ray
Laparotomy
SUrgical opening of the abdomen
Peritoneum
The serous membrane lining of the abdomen
Thoracotomy
Surgical incision of the chest wall
Lap Sponge
Used in thoracotomy and abdominal surgeries
Most absorbable of surgical packages
Come in packs of 5
Lap sponges come in packs of
5
Rays/Raytecs come in packs of
10
Raytec (4x4)
Radiopaque sponges, also available in 4x8 size
Come in packs of 10
Dissecting sponges/Kitners/Peanuts
Used primarily in blunt dissections and are packaged in 5s
Load one at a time
Use with a Pean/Crile/Kelly Clamp
How are Kitners/Peanuts packaged
5s
Tonsil Sponges
Cotton-filled gauze balls with a cotton strong attached.
Radiopaque Strip
Long string
Use with a tonsil clamp
Opthalmic sponge
Weck-cel sponge
Neurosurgical sponges/Cottonoids/Patties
Can come in different shapes and sizes
Very small
Radiopaque, attached to a string
Groups of 10
Epithelial
Pertaining to the layer of cells forming the epidermis of the skin
Microbe
a unicellylar organism such as a bacteria or protozoan
Function of the Surgical Dressing
Keep the wound free of microbe (Prevent infection) Protect from outside injury Absorb drainage Provide Support Provide Pressure Provide aesthetic appeal Maintain a moist environment Apply medication NO RADIOPAQUE STRIPS
What type of dressings do not have a radiopaque strip
Surgical Dressings
What sponge should never be used as a dressing
Raytecs
Will distort an X-Ray
Just use normal 4x4 gauze
Astringent
An agent that has a constricting or binding effect
Denuded
Removal of the protecting layer of tissue through surgery, pathological change, or trauma
Exudate
A fluid released from the body with a high concentration of protein, cells, or solid debris
Granulation
Fleshy projections formed on the surface of a gaping wound that is healing by second or third intention
Hydrocolloid
Glue-Like substance in which water is the liquid
Permeability
Capable of allowing the passage of fluids
Biological Dressing
Used in treament of large denuded area of skin or burns to prevent infection and fluid loss; it may consist of live skin tissue or synthetic material
Types of skin grafts
Allograft
Xenograt
Autograft
Artificial
Autograft-
Skin transplanted from one part of the patient’s body t another part
Allograft
Skin graft transplanted from a genetically incompatible donor
Xenograft
Skin Graft transplanted between animals of different species
Artificial
Temporary skin graft that consists of synthetic epidermis and collagen-based dermis
One-Layer Dressings
COmprised of transparent adherent material and primarily used when only a slight amount of drainage is expected
Aerosol adhesive spray
Provides a secure and reliable seal and is unaffected by moisture
Bioexclusive
A thin, transparent polyurethane film that allows for observation of the wound
Dermabond
Used fro topical repair of cuts and closure of skin incisions (Super glue for skin)
Foams
Antimicrobial foam dressings used to support and manage both moisture and bacterial balance of the surgical wound
Gels
Chemical dressing used to form a thin barrier over the wound when no or slight drainage is expected from the surgical wound; washes or wears off after several days
Hydrocolloids
Wafers or ganules containing particles that interact with wound exudate to absorb the exudate by forming a gel
Steri Strips
Thin adhesive strips which can be used to close small wounds
Opsite
A Transparent, adhesive film used to provide a moist wound environment for usperficial wounds
*Sometimes has an island dressing with it
Benzoin
An alcohol solution of compound benzoin that is used to increase adhesiveness of steri-strips during closure of the skin
Mastisol
A Clear liquid adhesive used to secure difficult dressings for an extended period of time
Three-Layer Dressing
Inner, Intermediate, and outer layer dressings
Inner layer (of 3 Layer dressing)
Must stay in contact with the skin for 48 hours
Lies against the would to provide a barrier against pathogens and acts as a passageway for the wound’s secretions
Moves secretions away from the wound
Why is dry gauze not used on denuded areas of the body?
Because it adheres to the wound and acts as a foreign body. Granulation tissue will grow into it and bleeding can be reactivated when its remved
used when frequent dressing change is needed on the abdominal area
Montgomery Straps
chemical dressing used to form a thin barrier over the wound
collodian
used to secure dressing of the neck area when surgical tape cannot be used
thyroid collar
used to eliminate dead space and prevent edema and hematoma
pressure dressing
(Surgical Dressing)
made of transparent adherent polyurethane material.
Single Layer
(Surgical Dressing)
lies against the wound to provide a barrier against pathogens.
inner layer
Surgical Dressing
provides easy visualization of the surgical wound.
single layer
Surgical Dressing
stays in contact with the wound surface for at least 48 hours.
Inner Layer
Surgical Dressing
made of a non-adherent material for easy removal from the wound
Cotton-Filled Gauze balls with a cotton string
Tonsil
largest and most absorbable of the surgical sponges; sometimes used to pack a body cavity
Laps
used to protect delicate tissue such as brain, spinal cord, and nerves
Cottonoids
gauze sponges that include an x-ray detectable string
Raytec
All of the following are uses of surgical sponges except: A. absorb blood B. protect tissue during procedure C. dress wounds D. apply pressure
Dress Wounds
of the following statements regarding surgical dressings are true except?
Select one:
A. dressings keep incisions free of microorganisms
B. dressings with pressure reduce or eliminate dead space
C. prevent post-op wound infections
D. causes wound edema and post-op bleeding
causes wound edema and post-op bleeding
All of the following are true except:
Select one:
A. counts protect the patient from retained items
B. counts protect the surgical team from liability
C. counts provide verification of a successful procedure
D. counts assist in infection control
Counts provide verification of a successful procedure
All of the following statements regarding surgical wound packing are true except:
Select one:
A. available in long thin strips of gauze-like material
B. used in body cavities such as the nose and the vagina
C. does not need to be changed until the wound heals
D. may be impregnated with antibiotic ointment
does not need to be changed until the wound heals
All sponges used during a surgical procedure should be:
Radiopaque
Always place small dissecting sponges such as peanuts and kitners on a(n)
Pean
Counts are performed perioperatively When?
prior to the incision, as additional items are added, change of personnel, before closure of a cavity
During an extreme emergency, what is to be done if a count is omitted?
document with an x-ray, document on the patient’s operative record, and complete and incident report
If the package of sponges contains an incorrect number of sponges, the STSR should
hand the entire package to the circulator and the package should be isolated or removed from the room and not used
Laparotomy sponges may also be called all of the following except: A. Raytec B. laps C. tapes D. saline sponges
Raytec
Laparotomy sponges should be moistened with ___ when packed inside a body cavity.
Sterile Saline
The circulator and the STSR should count all items in the following order:
on the surgical field, mayo stand, back table, off the sterile field
The major cause of lawsuits arising from surgery are a result of:
retained items left in the surgical wound
The responsibility to ensure that no item is retained in the surgical wound belongs to:
circulator and the STSR
The uses of surgical sponges include all of the following except:
Select one:
A. apply pressure to bleeding surfaces
B. pack or isolate structures from the operative site
C. absorb blood and tissue fluid during operative procedure
D. sharp tissue dissection
Sharp tissue dissection
(Should only be used for blunt tissue dissection)
Tonsil Sponges come packaged in groups of
5
Until the final count of the procedure is verified as being correct, \_\_\_ must remain in the operating room. Select one: A. instruments B. sponges and sharps C. linen and trash D. all of the above
All of the above
Which of the following items will be included in a count?
lap sponges, crile clamp, cottonoids
Which of the following materials are commonly used as the “inner layer” of a dressing?
telfa, Vaseline gauze, adaptic
Which of the following materials are commonly used as the “intermediate layer” of a dressing?
4 x 4 gauze, ABD, kerlix
What should be done if a sponge is not located following a sponge count?
inform the surgeon, and then recount, if sponge is still not located, take an x-ray to verify sponge is NOT in patient,
complete and incident report for lost sponge
Who has the responsibility to keep track of how many and what kind of instruments are inside of the wound.
surgeon and STSR
True or False:
A surgical count is performed by two people.
True
True or False:
Additional instruments distributed to the field during surgery must be added to the surgical count.
True
True or False:
Application of the surgical dressing is not considered part of the surgical procedure.
False
True or False:
Common sizes for Raytec sponges include 4” x 4” and 4” x 8”.
True
True or False:
Dissecting sponges are used for sharp dissection and for blotting blood or fluid in wide shallow areas of the wound.
False
True or False:
Radiopaque sponges should not be used as part of the surgical dressing.
True
True or False:
Surgeons establish policies directing sponge, sharps, and instrument counts that have been recommended by JCAHO, AORN,and AST.
False
True or False:
Surgical dressings retract tissue from the operative site.1000000000000
False
True or False:
The dressing should be kept sterile prior to placing it on the patient.
True
True or False:
The dressing should not be opened or introduced onto the sterile field until the final count has been performed.
True
true or False:
The law does not specify the qualifications of those who perform the count or the manner in which it is performed.
True (Though our professor said at least 1 person involved in the count must be an RN)
At least 1 person involved in the surgical count must be
An RN
True or False:
When assisting the surgeon with hemostasis, it is best to blot bleeding tissue instead of wiping it.
True
