Skin & Fascial Wound Closure Flashcards
Layers incised to perform ventral midline celiotomy
skin, SQ tissues, linea alba (+/- rectus abdominus muscle), retroperitoneal fat & peritoneum
Linea alba
aponeurosis of rectus sheath (surrounds the rectus abdominis muscle); where incision is made.
Layers incised to perform flank laparotomy:
skin, SQ tissue, external abdominal oblique, internal abdominal oblique, transversus abdominal muscle, retroperitoneal fat & peritoneum
What are the holding layers involved in fascial closure?
linea alba & external rectus abdominus fascia which prevents herniation d/t high collagen content (attributing to high tissue strength)
Should you suture the peritoneum?
No, this increases risk of adhesions!
Why should you avoid large bites of muscle?
it loosens closure and increases inflammation/risk
What is undermining skin?
cutting off blood supply ( applying too much pressure to tissues) & creates dead space
Is subcutaneous skin closure a holding layer?
No, it has minimal strength
What 2 layers are used in skin closure?
SQ + epidermis
What suture type is used for SQ closure?
non-reactive absorbable (short period of tensile strength) & small diameter (smaller than what is used in linea) - PDS, Monocryl
What suture type is used for cutaneous closure?
monofilament, non-absorbable (SA) or absorbable (LA) w/ reverse cutting needle (require because tough skin)
When should you not use skin staples?
Thin skin or wound under tension
