Midterm Flashcards
What’s inside a NCNM suture pack?
Forceps, hemostats, scissors, guaze
What are the two types of forceps typically in a NCNM suture pack?
Adson dressing forceps
Brown-Adson tissue forceps - teeth!
What is the difference between the structure and use of needle holders vs. hemostats?
Needle holders have serrated or smooth jaws. Hemostats have a crosshatched surface that will cause the needle to “roll”
What are the typical scalpel sizes, and when are each used?
#15 - small lesions #11 - draining abscesses #10 - large lesions
What are the different types of suture materials?
Nylon (Ethilon), Silk - non-absorbable
Vicryl - absorbable
The more 0000, the thinner the suture (3-0 > 6-0)
3-0 Ethilon is most common at NCNM
What are the basic types of needles used?
Strait suture needles - not used typically, only for very large wounds
Curved needles - #19 is the MC used at NCNM; conventional or reverse cutting
What suture sizes are used in various body areas?
Face/head - 5-0, 6-0, 7-0
General body - 3-0, 4-0, 5-0, 6-0
What are the common needle sizes used for anesthetic injection in minor surgery and applicable locations on the body?
27 gauge - 1” - typical
30 gauge - 1” - for minimal pain/facial lesions
What is considered the most important aspect of sterile technique?
Dawning on sterile gloves
What are the basic antiseptics commonly used?
60-90% alcohols 3% iodine 7.5-10% iodophors (betadine) 2-4% Chlorhexidine gluconate (Hibiclens, Hibiscrub, Hibitane) 0.2-2% Triclosan Hydrogen peroxide
Which is considered the best pre-surgical antiseptic?
Betadine
What are the pros/cons of nonionic surfactants?
Pro - surface active agents with the cleaning properties of soap but virtually no tissue toxicity, including the eye and cornea
Con - No antibacterial activity
Post-operative infection is determined by what risk factors?
Number of microorganisms entering the wound
Type and virulence of the bacteria
Patient vitality
External factors - surgery duration, length of hospital stay, etc.
What are the pros and cons of shaving skin before prepping for surgery?
Pros - visibility and sterility
Cons - shaving causes multiple areas of nicking of the skin which provides a portal of entry for secondary infections
Best to use scissors or clippers
What are the pros and cons of using alcohol for skin prep injections?
Pros - good sterile ability
Cons - no residual antiseptic effect
What are the standard numbers for effective autoclaving?
250 degrees F, at 15lbs/sq. in. for 30min
Informed consent implies that the patient completely understand what issues?
- The nature of the treatment
- All material risks for the treatment
- The possibility of risk
- Alternative treatments available and associated risks
- Consequences of going untreated
What is the meaning of PARQ?
P - procedure
A - alternatives
R - risk
Q - questions
What is the concept of “free margin”?
Free margins indicates that the edges of the biopsy are normal, indicating complete removal of the abnormal tissue
What is the “dead space”?
Deep wounds that, if closed superficially, leaves a space below
Why do you undermine?
It allows the skin to slide over the subcutaneous tissue more easily and stretch enough to close the opening with less tension, resulting in less scarring.
What are the four reasons for/advantages of using the subcutaneous suture? What type of suture would you typically use?
- Provide wound stability
- Close dead space
- Help evert the edges
- Relieve tension on the wound edge
A buried stitch