Suture- 5?s Flashcards
what are the first responders to site of injury
pro-inflammatory cytokines
What are the 3 basic principles for wound repair
minimize trauma to tissue
minimize tension on wound edges
accurately approximate wound edges and landmarks
What are the 3 phases of wound healing
inflammatory phase
prolifereative phase
remodeling phase
how long is the inflammatory phase
5 days
describe proliferative phase
starts in 24 hours, seals wound from water
continues for 6 months
describe the remodeling phase of wound healing
continues up to 2 years
what are cases when you want to close the wound
fresh wounds- hours out large clean wounds over cartilage or bone reduce scarring and bleeding surgically debrided and irrigated wounds
what are cases when you do not want to close wound
old days, contaminates, abscess that are drained
wounds that have opened after previous repair
foreign bodies in wound
in which direction do wounds heal
bottom up
why do local anesthetics not work in abscesses
generally high H+ environment
What does lidocaine do locally
block Na Channels of depolarization
what lines do you close sutures along
langers lines to provides least tension
What is a good suture to use on fragile tissue
horizontal mattress
where are vertical mattress sutures done
at place of greatest tension
Where are pulley stitches used
in huge wounds like thigh and abdomen in fatty areas too
What stitch gives the smallest scar formation
running subcuticular closure
what type of suture do you do for a wedge shaped wound
tip stitch
horizontal suture to allow blood vessels to penetrate
how do you repair a circular lesion
take out lens shape around then suture
what type of forceps do you use for sutures
teethed
what are types of non-absorbable sutures
nylon, ethilon dermalon, prolene, merseline
what are the sutures that absorbe in days
chromic gut
what are the sutures that absorb in weeks
vyvryl, monocryl, polyglycolic acid sutures
what are the absorbable sutures that last for years
silk and cotton
how many knots do you need for monofilatment suture
4-6
how many knots do you need fror braided suture
square knot and lock
at what angle are steristrips applied to sutures
right angle. tincture and benzoin help protect skin and make strips adhere better
how far apart are skin staples
4-5 mm apart
how long do facial stitches stay in
3-5 days
how long to scalp stitches stay in
7 days
how long do chest and extremities stitches stay in
8-10 days
how long do high tension stitches stay in (over hand or joints)
10-14 days
how long do back stitches stay in
10-14 days
