Surgical Equipment

Question 1

what is an example of a natural absorbable suture material?

what are its features?

Answer 1

Catgut
- inexpensive but not ideal

natural - made of ruminate intestine

digested by enzymes

moderate to high tissue reaction
- enzymes need to be brought to the area
- delayed healing time

two variants
- chromic - tensile strength lost 21-28 days
- plain - tensile strength lost 10-14 days

Question 2

what are examples of synthetic multifilament absorbable suture material?

what are its features?

Answer 2

Vicryl and Dexon

similarities
- synthetic, absorbable and multifilament (braided)
- absorbed by hydrolysis - reduced tissue reaction
- fully absorbed in 60-90 days
- good knot security
- high tensile strength
- high capillarity so unsuitable for infected wounds

differenced
- dexon - considerable drag and chatter due to no coating - causes tissue reaction
- vicryl - coating reduces tissue drag

Question 3

what is an example of synthetic monofilament absorbable suture material?

what are its features?

Answer 3

PDS and Monocryl - both ideal (pick one then explain)

Similarities
- synthetic, absorbable and monofilament
- absorbed by hydrolysis - reduced tissue reaction
- low tissue drag
- low memory (monocryl lowest)
- fair knot security
- low capillarity

Differences
- PDS - tensile strength reduced to 70% after 14 days
- Monocryl - tensile strength reduced to 30-40% after 14 days
- PDS - fully absorbed by 180 days
- Monocryl - fully absorbed by 90-120 days

Question 4

what are examples of synthetic non-absorbable suture material?

what are its features?

Answer 4

Supramid, Ethilon and Prolene
- often used for skin sutures to be removed

similarities
- synthetic
- high memory
- indefinite tensile strength
- fair knot security (multifilament versions better)

differences
- ethilon - mono
- supramid - mono or multi
- prolene - mono
- monofilament version have lower drag tissue and a low capillarity

Question 5

what is an example of natural non-absorbable suture material?

what are its features?

Answer 5

Mersilk

features
- natural - made from silk
- multifilament
- low memory
- excellent knot security
- tensile strength lost by one year - technically classed as non-absorbable

Question 6

when and why would we use suction?

how do you correctly maintain suction equipment?

Answer 6

to aspirate fluid or gas peri-operatively
- ex-lap
- splenectomy
- endoscopy
- dentals
- cystotomy

maintenance
- empty cylinder after each use
- change filter regularly
- service and PAT testing

Question 7

what are the features of a suction machine?

Answer 7

Suction regulator
- has a pressure dial
- controls pressure in canister = level of suction

Filter
- at exit of regulator
- prevents anything entering regulator and damaging system

Collection canister
- always need an air gap to allow for pressure change
- so never over fill
- often has measurement lines for recording volume

Valve
- at canister entrance
- body contents can only enter canister
- stops back flow into patient

Sterile tube and suction tip
- enters patient at site require suction
- linked to canister

Question 8

What is diathermy? when would you use it?

how do you correctly maintain diathermy equipment?

Answer 8

High frequency, alternating current used to produce heat within a tissue
The type of waveform used then determines its purpose
- interrupted = coagulation
- continuous = cutting
Usually activated by depression of foot peddle connected to the generator
Some require a base plate

Types of procedures used
- eye enucleation
- bitch spays
- lap spays
- orthopedics

Maintenance
- cleaning main unit after use
- cleaning and sterilising attachments after use
- regular servicing and PAT

Question 9

Different diathermy types?

Answer 9

Monopolar - require earthed/grounding
- current passes from probe electrode into patients tissues
- then from patients tissues to base plate under patient
- back to diathermy generator

an inadequately earthed monopolar unit can cause serious burn or electric shock

bipolar
- probe can be forceps of scissors
- two sides of probe - active and return electrodes
- current passes between electrodes then back to machine

Question 10

What are the different functions of diathermy?

Answer 10

Pure cut
- used for dissection only
- does not act as a haemostatic
- use when not worried about coagulation (eg ligament not likely to bleed)

Blend cut
- cuts and coagulates simultaneously
- blend can adjust based on level of haemostasis needed

Coagulation
- pinpoint - active electrode in direct contact with tissues - good for small or specific area of haemorrhage
- fulguration (spray) - active electrode held away from tissue (only monopolar) and sparks jump air space and contact tissue - useful for large areas of haemorrhage