Surgery Basics

Question 1

List at least 3 types of absorbable sutures

Answer 1

Plain Catgut
Chromic Catgut
PDS (polydioxanone)
PGA (polyglycolide)
Monocryl (glycolide/epsilon-caprolactone)
Vicryl (polyglactin)

Question 2

List at least 3 types of non-absorbable sutures

Answer 2

Silk
Nylon
Polypropylene
Stainless Steel wires

Question 3

What sutures do you use to repair a stomach?

Answer 3

one layer non-absorbable suture

OR

two layer with inner absorbable suture and outer non-absorbable suture

Question 4

What is the preferred suture of choice for repairing a lip laceration?

Answer 4

absorbable suture (especially in children)

Question 5

What type of suture do you use to repair a diaphragmatic injury?

Answer 5

running non-absorbable suture

Question 6

What is the most effective method of midline abdominal fascial closure? What type of suture? Suture length to wound length ratio?

Answer 6

Mass closure (not layered closure) with a simple running technique [decreases dehisence rate from 11% –> 1%]

• Use #1 or #2 absorbable monofilament suture material
• Suture length to wound length ratio of 4 to 1

Question 7

What type of repair (type of sutures and # of layers) should you use for repair of a bladder?

Answer 7

two-layer water tight closure with ABSORBABLE sutures (with urethral catheter placement)

Question 8

What type of suture do you use for repair of ureteral injuries?

Answer 8

absorbable sutures

Question 9

What type of suture do you use to repair an AAST Grade I small bowel injury?

Answer 9

3-0 silk suture in Lembert fashion to repapproximate the seromuscular layers

Question 10

How do you repair an AAST Grade II or III small bowel injury?

Answer 10

closer in two layers in transverse manner to minimize potential luminal narrowing

Question 11

How do you repair an AAST Grade IV or V injury?

Answer 11

resection and reanastamosis

Question 12

How do you repair an AAST Grade I colon injury?

Answer 12

single layer of Lembert sutures

Question 13

How do you repair an AAST Grade II colon injury?

Answer 13

primarily in two layers

Question 14

How do you repair an AAST Grade II and above colonic injury?

Answer 14

resection with either anastomosis or colostomy

Question 15

With what suture/stitch do you repair an AAST I to III rectal injury?

Answer 15

two-layer closurer: 1) full-thickness running absorbable suture –> 2) interrupted silk seromuscular sutures