Surgery Instruments Flashcards
What does absorbable sutures mean?
Broken down and dissolve over time, resulting in loss of tensile strength as the suture is absorbed
What is the difference between monofilament versus polyfilament?
Monofilament has a smooth surface, causes less tissue trauma, does not harbor bacteria, and does not draw water up via capillary action. It is more prone to stretching.
Polyfilament (braided) suture is stronger, more pliable, has good handling, and results in stronger knots. However, it can harbor bacteria, causes tissue trauma, and draws water up via capillary action.
What are the 3 disadvantages of braided/polyfilament sutures?
Can harbor bacteria
Cause tissue trauma
Draws water up via capillary action
What sizes do needles range?
10-0 to 7
General use of 10-0 to 8-0
Common in ophthalmic surgery, microsurgery, small nerve and vascular injury (usually in the hand)
General use of 7-0 to 6-0
Diameter: 0.05–0.07 mm
(b) Repairing small vessels and nerves, vascular grafts
General use of 7-0 to 6-0
Larger vessels (abdominal aorta), skin closure
General use of 3-0 to 2-0
Skin closure, bowel repair/anastomosis, vessel ligation
General use of 0 to 1
Closing fascia, joint capsules, deep layers of back
General use of 2 to 5
Tendon repair, orthopedic surgery
General use of 6 to 7
Available only in surgical steel; closure of sternotomy
What is the tensile strength of vicryl sutures at 14 days and 28 days?
14 days - 75%
28 days - 25%
IS PDS an absorbable or non-absorbable suture?
Absorbable suture
What are nonabsorbable sutures used for?
Skin closures
Tendon
Nerve Repair
Vascular ligation and repair
What is the advantage of nonabsorbable sutures?
Minimizes water absorption and tissue friction, which allows them to retain their tensile strength longer than absorbable sutures.
When are non absorbable sutures typically used?
When high tensile strenth is needed (tendons, ligaments, skin)
What is the purpose of tapered round body sutures?
(a) Spreads tissue without cutting
(b) Used on less dense/fibrous tissue
(c) Commonly used for anastomoses
What are cutting needles?
(1) Three cutting edges
(2) Allows easy passage through dense, tough tissue
(3) Repetitive use will dull the needle point.
(4) Avoid grasping the tip of a cutting needle to prevent unintended blunting.
What is the purpose of tapered cutting needles?
(a) Combines round body tapered needle with advantages of cutting
(b) Cutting tip allows easy penetration of denser tissue.
(c) Tapered body prevents further cutting as needle is pulled through tissue.
(d) Commonly used for sclerotic vessels or tendon repair
What is the purpose of blunt needles?
(1) Tapered body with rounded tip
(2) Prevents damage to friable tissue
(3) Commonly used on liver and kidney
What is the common purpose of RB1 needles?
Small, tapered point, ½ circle, commonly used for vascular anastomoses
What is the common purpose of SH needles?
SH—tapered point, ½ circle, larger than RB1, most commonly used for bowel anastomoses
Scalpel - what is the #10 blade used for?
Broad base, used for large incisions
Scalpel -what is the #11 blade used for?
V-shaped, used for stab incisions (incision and drainage, trocar placement)
Scalpel -what is the #15 blade used for?
essentially a smaller version of a #10, used for smaller incisions, precise débridement and dissection, plastic/cosmetic procedures)
What is the difference between cutting vs coagulation?
Cutting: heat is produced continuously very fast and tissue is vaporized at the tip of the probe
Coagulation: pulsed heat, heat is produced more slowly, tissue damage is more widespread, causing blood coagulation
What is the difference between monopolar and bipolar?
Monopolar: Current is passed from the probe (active electrode) where cauterization occurs and the patient’s body serves as a ground. A grounding pad (returning electrode) is placed on the person’s body, usually the thigh, and it carries the current back to the machine. Careful application of the return electrode is necessary as extensive burns can occur undetected if the electrode is not correctly positioned.
Bipolar: The active and receiving electrodes are both placed at the site of cauterization. The probe is usually in the shape of a forceps with each tine forming one electrode, cauterizing only the tissue between the electrodes
