Final Practicum Oral Board

Question 1

Monocryl Plus (Braided or Monafilament)

Answer 1

Synthetic Absorbable

Monofilament

Question 2

Monocryl Absorption Rate

Answer 2

91-119 days

Question 3

Monocryl Breaking Strength Retention:

Answer 3

Undyed= 50-60% at week 1, 20-30% at week 2

Dyed= 60-70% at week 1, 30-40% at week 2

Question 4

Monocryl Indications for use

Answer 4

(LUVPBS)

Ligation
Uterus
Vaginal Cuff
Peritoneum
Bowel
Skin Repairs

Question 5

Vicryl Plus (Braided or Monofilament)

Answer 5

Synthetic Absorbable- Braided

Question 6

Vicryl Plus Absorption rate:

Answer 6

56-70 days

Question 7

Vicryl Breaking strength retention

Answer 7

75% at 2 weeks, 50% at 3 weeks, 25% at 4 weeks

Question 8

Vicryl Indications for use:

Answer 8

LGOB

Ligation
General Closure
Orthopedic Surgery
Bowel

Question 9

PDS Plus (Braided or Monofilament)

Answer 9

Synthetic absorbable Monofilament

Question 10

PDS Absorption rate:

Answer 10

182-238 Days

Question 11

PDS breaking strength retention

Answer 11

4-0 & smaller- 60% at 2 weeks, 40% at 4 weeks, 35% at 6 weeks

3-0 & Larger- 80% at 2 weeks, 70% at 4 weeks, 60% at 6 weeks

Question 12

PDS indications for use

Answer 12

FBPOP

Fascial Closure
Blood vessel anastomosis
Pediatric cardiovascular and Ophthalmic procedures except for in contact with the cornea or sclera
Orthopedic
Patients with compromised wound healing conditions

Question 13

Bacteria for Monocryl, Vicryl, PDS

Answer 13

Monocryl and PDS: Staph A, Staph E, MRSA, MRSE, E. Coli, K. Pneumoniae, E. Cloacae

Vicryl: Staph A, Staph E, MRSA, MRSE

Question 14

Describe Qualities of Prolene Suture, and types of procedures?

Answer 14

Qualities: Synthetic, Monofilament, Non-Absorbable

Procedures- Cardiovascular (CABG), Ophthalmic, Neurological

Question 15

Describe Key features of everpoint:

Answer 15

Made of unique tungsten-rhenium coating that allows that for more penetration, durability, strength, and stiffness

Compared to traditional steel needles:
70% Sharper
38% Stronger
121% more bend resistant

Non magnetic

Question 16

What are the Key Features and benefits of Dermabond PRINEO?

Answer 16

Microbial barrier: proven to be 99% effective through 72 hours in vitro against most commonly associated with SSI, including: pseudomonas aeurginosa, esherichia coli, enterococcus faecium, staph A, staph E

Dermabond PRINEO is 40% stronger than a 4-0 Monocryl suture, and 33% stronger than skin staples

At the time of removal, PRINEO is associated with less pain than other wound closure devices

Question 17

Define the value proposition for STRATAFIX

Answer 17

Security: provides strength and security of an interrupted closure without the knots

Efficiency: no knots, no need for an assistant following the suture, no need to hold/maintain tension after each pass, and potentially less time under anesthesia

Consistency- allows for easier management of tension and gives the ability to control approximation providing for a more consistent closure

Question 18

Describe the key differences between STRATAFIX symmetric and VLOC 180?

Answer 18

Superior tissue holding strength

Antibacterial properties

Appropriate for use in fascia

Superior needle performance

Extended tensile wound healing strength

Question 19

Surgicel Bleeding Situation

Answer 19

Continuous oozing is a situation that will not stop with compression or single packing, and it is more time consuming than it is difficult

Question 20

Surgicel Mechanism of action

Answer 20

Biologic: once moistened, the cellulose breaks down, releasing glucuronic acid which has a pH of 2.5, when it comes to contact with blood which has a pH of 7.4 decreases the blood’s to 4.4 which aids in vasoconstriction, the acidity of pH also gives bactericidal properties

Mechanic- as the blood continues to be absorbed, it swells into a gelatinous mass which serves as a matrix for platelet adhesion and aggregation

Question 21

Surgicel Indication

Answer 21

Indicated for use adjunctively to control or assist with capillary, venous, or small arterial hemorrhages when ligation or conventional methods are ineffective or impractical

Question 22

Describe why SURGICEL is bactericidal against the pathogens most commonly associated with SSI’s:

Answer 22

The normal condition of blood will start with a blood pH of 7.4, which is a pH level that allows bacteria to proliferate

Once the moisture reaches SURGICEL the cellulose begins to break down and that initiates the release of glucoronic acid

With the release of glucuronic acid and the interaction with the blood pH, it drops the pH to 4.4 which gives it bactericidal properties so that bacteria can’t proliferate

Question 23

What selling points does SURGICEL powder have over ARISTA AH?

Answer 23

89% faster to hemostasis

Induces vasoconstriction, which provides matrix sites to aid in platelet adhesion and aggregation

Surgicel powder penetrates the source of the bleed by having large particles sink to the source of the bleed, whereas ARISTA floats on the surface of the blood

Surgicel powder forms a more durable clot that maintains hemostasis even after being irrigated

Powder is the #1 most trusted adjunctive hemostat

Demonstrated bactericidal against MRSA, MRSE, PRSP, VRE, E. COLI

Question 24

SURGIFLO Mechanism of action

Answer 24

Mechanical: provides a matrix for platelet adherence, accelerating the formation of the platelet plug

Biological: when used with thrombin, thrombin converts fibrinogen into fibrin, aiding in fibrin clot formation

Question 25

SURGIFLO Indication

Answer 25

Used adjunctively in surgical procedures to assist in the control of capillary, venous, or small arterial hemorrhages when ligation or other conventional methods of control are ineffective or impractical (except for ophthalmic)

Question 26

SURGIFLO Bleeding situation

Answer 26

Difficult to access is when it occurs in tight and irregular spaces and you cannot see the exact source of the bleed, there is concern accessing a tight space will cause more harm

Question 27

VISTASEAL mechanism of action

Answer 27

Initiates fibrin clot formation through the reaction of thrombin and fibrinogen to form a fibrin clot

Question 28

VISTASEAL Indications

Answer 28

Used as an adjunct to hemostasis in mild to moderate bleeding in adults undergoing surgery when control of bleeding by standard surgical techniques is ineffective or impractical (effective in heparinized patients)

Question 29

VISTASEAL Bleeding situation

Answer 29

Potential re-bleeding risk is a situation that can be addressed intraoperativley, but could later develop into more serious complications, especially in high risk patients

Question 30

EVARREST mechanism of action

Answer 30

Achieves hemostasis when fibrin clot integrates with patch component and adheres to the wound surface, this then provides a physical barrier and achieves hemostasis

Question 31

EVARREST indications

Answer 31

Indicated for use with manual compression as an adjunct to hemostasis in adult patients undergoing surgery, when control of bleeding by conventional methods is impractical or ineffective

Question 32

EVARREST contraindications

Answer 32

(TOPICAL USE ONLY) do not use to treat bleeding from large defects in arteries or veins ( not to be used in place of suture, ligature, cautery)

Do not apply intravascularly

Do not apply to patients known to have anaphylactic reactions to human blood products

Question 33

EVARREST bleeding situation

Answer 33

Situation where bleeding is accessible, but is likely to be more than routine and likely to be resistant to conventional methods and could take numerous attempts to stop

Question 34

5 steps of hemostasic cascade

Answer 34

Vessel injury

Vasoconstriction

Platelet plug formation

Fibrin clot formation

Fibrinolysis

Question 35

Monocryl polymer

Answer 35

Poligelcaprone 25

Question 36

Vicryl polymer

Answer 36

Polyglactin 910

Question 37

PDS Polymer

Answer 37

Polydiaxonone