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Principles of Surgery > Suture and Suturing > Flashcards

Suture and Suturing Flashcards

1
Q

what is a caveat of surgical tape on instrument packs

A

only tells you it reached a certain temperature on the outside, not internally (and it doesn’t guarantee is was that hot for long enough to sterilize)

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2
Q

if right handed, where do you want your scalpel blade/ other commonly used instruments

A

to the right

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3
Q

the small metal bowl is for ___________ and the large metal bowl is for _______________

A

saline; garbage

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4
Q

after scrubbing in, what two “extras” do you need to get for your bowls

A

1) saline for small bowl
2) chlorhexidine for beaker

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5
Q

when do you use the following grip for a scalpel

1) finger/dinner knife
2) pencil

A

1) initial/longer incisions
2) stab/short incisions

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6
Q

if I needed to make a stab incision I would use _____ grip but if i needed to make my long, initial incision I would use _______ grip

A

pencil; finger/dinner knife

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7
Q

what technique do you want to use for making your incision through the linea

A

stab (pencil grip) while tenting tissues; reverse press cut (cutting edge is facing upwards)

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8
Q

what forcep do we use for general tissue handling

A

Adson tissue

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9
Q

what are examples of tissues we can use Adson tissue forceps on

A

SQ fat, linea alba during closure

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10
Q

how does Adson brown differ from Adson tissue

A

Adson brown allows a stronger grasp of tissues

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11
Q

to tent the linea during initial abdominal approach you would use _______ forceps and for closure of the linea you would use _______ forceps

A

Adson brown; Adson tissue

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12
Q

what would you use debakey forceps for

A

handling gentle tissues like vessels, GI, bladder

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13
Q

what grip do we use for all forceps

A

pencil grip

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14
Q

what grip do we use for needle drivers

A

tripod (thumb and ring finger)

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15
Q

what type of scissors are used on suture

A

sharp-blunt

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16
Q

you would use _______ scissors for the linea alba and _______ scissors for fat and soft tissue

A

mayo; metzembaum

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17
Q

when would you use tip clamping vs jaw clamping

A

tip clamping: single vessel
jaw clamping: vascular pedicle

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18
Q

what is a benefit of carmalt hemostats and why

A

prevents tissue slippage due to longitudinal striations down entire length and cross-striations at bottom

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19
Q

what is a perfect use for carmalt hemostats

A

ovariohysterectomy -> used to clamp large vascular pedicles

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20
Q

you can use ________ hemostats for large vascular pedicles, _________ for small vascular pedicles, and ________ for single vessels and very small vascular pedicles

A

carmalt; kelly/crile; mosquito

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21
Q

swaged needles are more _______ but less _________ compared to eyed needles

A

expensive; traumatic

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22
Q

what is the difference between absorbable and non-absorbable suture

A

absorbable: loses significant tensile strength within 60 days of implantation

non-absorbable: maintains 100% of tensile strength for at least 60 days

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23
Q

how are natural vs synthetic absorbable sutures absorbed

A

natural: enzymatic processes of cellular proteases and collagenases

synthetic: hydrolysis

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24
Q

rate of absorption should be proportional to….

A

rate of returning strength of healing tissue

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25
Q

what is the following healing time (approximate):

  • stomach/bladder
  • GI
  • fascia
  • tendons
A

stomach/bladder: 2 weeks
GI: 3 weeks
fascia: 6-7 weeks
tendons:&raquo_space;

26
Q

multifilament can be (2)

A

braided or twisted

27
Q

when do we use knotless/barbed suture

A

laproscopy

28
Q

coated sutures are created to improve __________, improve _________, reduce ________ and reduce __________

A

pliability; knot formation; drag; infection

29
Q

what is elasticity

A

the degree to which suture will deform under stress or load and return to its original form when the load is removed

30
Q

what is capillarity

A

the degree to which a suture will absorb fluid following immersion

31
Q

T/F suture metric and standard sizes are inconsistent and can vary between materials and manufacturers

A

T

32
Q

what is catgut made from

A

sheep intestinal submucosa or cattle intestinal serosa

33
Q

what can we use catgut on

A

vessel ligations

34
Q

why is catgut not commonly used

A

rapid and inconsistent absorption and lots of tissue reaction

35
Q

Vicryl maintains _____ of its tensile strength within _____ weeks

A

50%; 2-3 weeks

36
Q

what type of suture is Vicryl (Polyglactin 910)

A

synthetic braided, multifilament, absorbable suture

37
Q

what is Vicryl (Polyglactin 910) a good option for

A

intradermal; used often in large animals

38
Q

what type of suture is Monocryl (Polyglecaprone 25)

A

synthetic monofilament, absorbable suture

39
Q

what are the absorption characteristics of Monocryl

A

loses 50% of its tensile strength within 1 week and 70-80% within 2 weeks; gone by 90-120 days with little tissue reaction

40
Q

when might we use Monocryl

A

subq, intradermal, urinary tract (if no infection)

41
Q

what type of suture is PDS II

A

monofilament, synthetic, absorbable

42
Q

how is PDS II absorbed

A

approx 50% of tensile strength remains at 5-6 weeks

43
Q

what tissues is PDS II great for

A

the linea alba (heals in 6-7 weeks)

44
Q

put the following suture in order from fastest to slowest absorption:

  • Vicryl
  • Monocryl
  • PDS II
A

Monocryl, Vicryl, PDS II

45
Q

what type of suture is Prolene

A

non-absorbable, synthetic, monofilament, polyolefin

46
Q

why is Prolene very resistant to degradation

A

lacks hydrolyzable bonds

47
Q

what is Prolene good to use for

A

skin closure (must remove later)

48
Q

T/F Prolene can be used intradermally

A

F; need to be able to go back and remove it

49
Q

what type of suture is Nylon

A

non-absorbable, synthetic, monofilament, polyamide

50
Q

T/F nylon is a great option for permanent implantation

A

F; susceptible to degradation

51
Q

what type of knots do we want to see while suturing

A

square

52
Q

how many throws to form a secure simple interrupted knot

A

5

53
Q

when would you want to use a surgeons throw

A

1) fatty ovarian pedicle ligature
2) linea

would NOT want to use on a small vessel (larger loop so not as tight)

54
Q

T/F surgeons throws are safer than simple throws

A

F

55
Q

what are the rules for performing a continuous suture line? when do we forget the rules?

A

first knot should have 1 extra throw (6) and the last knot should have 2 extra throws (7); does not apply to a buried SQ or intradermal (not enough space)

56
Q

how big should suture tags be

A

2-4mm

57
Q

T/F you should stabilize the needle with the teeth of your forceps

A

F; behind the teeth

58
Q

when suturing, you always want to keep your hands

A

parallel to the table

59
Q

what is the most common way to lose a square not

A

not maintaining even tension and not keeping hands parallel

60
Q

how big should your suture tags be for skin sutures

A

6-10 mm

61
Q

what type of suture pattern is more likely to prevent slippage off of the pedicle cut end

A

Miller knot

Principles of Surgery (8 decks)

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