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Surgery > Sutures & Needles > Flashcards

Sutures & Needles Flashcards

1
Q

Which types of tissue tend to heal slowly?

A

Dense fascia

Tendons

Ligaments

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2
Q

40%

2 months time

A

Fascia regains approximately ___ percent of its orginal strength in ___ months.

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3
Q

True or false:

Visceral wounds heal rather slowly.

A

False

Visceral wounds heal rapidly, attaining maximal strength within 14-21 days

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4
Q

True or false:

No tissue ever regains 100% of its original strength.

A

False

The urinary bladder will regain 100% of its original strength within 14 days

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5
Q

How long will the stomach take to regain maximum strength?

A

14-21 days

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6
Q

True or false:

Skin heals relatively quickly.

A

False

Skin heals relatively slowly

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7
Q

When sutures are removed from the skin at the 10-14 day mark, a wound has regained only what percentage of its original strenth back?

A

10%

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8
Q

Collagen synthesis occurs ___ days postoperatively.

A

5-42 days postoperatively

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9
Q

List in order the following tissues from the slowest to heal to the fastest to heal:

Colon

Stomach

Bladder

Fascia

Skin

A

Fascia

Skin

Colon

Stomach

Bladder

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10
Q

Which type of sutures are broken down by the non-inflammatory process of hydrolysis?

A

Synthetic absorbables:

Monofilament

Multifilament

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11
Q

Which type of sutures undergo digestion by acid proteases produced by inflammatory cells?

A

Natural absorbables:

Catgut

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12
Q

What are the advantages of using a SYNTHETIC absorbable?

A

Predictable rate of breakdown

Non-reactive

Do NOT stimulate inflammatory cells

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13
Q

What are 2 examples of a SYNTHETIC absorbable suture?

A

Monocril

Vicryl

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14
Q

Which type of suture is “encapsulated and walled off by the body’s fibroblasts”?

A

Nonabsorbable

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15
Q

What are the NATURAL nonabsorbable sutures?

A

Silk

Cotton

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16
Q

What are the METAL nonabsorbalbe sutures?

A

Stainless steel

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17
Q

What are the SYNTHETIC nonabsorbable sutures?

A

Nylon

Polyester

Polypropylene

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18
Q

Which type of nonabsorbable suture is often preferred for skin suturing?

A

Synthetic NYLON

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19
Q

True or false:

Synthetic absorbable sutures disappear more quickly than they lose tensile strength.

A

False

Synthetic absorbable sutures lose strength more quickly than they disappear.

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20
Q

Which type of suture is the following referring to? :

More throws for knots

More tension for tissue apposition

Less drag

No capillarity

A

Monofilament

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21
Q

Which type of suture is the following referring to? :

Better knot security

Less tension required for tissue apposition

Coated to reduce drag

A

Multifilament

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22
Q

True or false:

The construction of multifilament sutures allows bacteria, tissue fluids, and inflammatory cells to penetrate the interstices of the stand.

A

False

Multifiament sutures DO NOT allow inflammatory cells to penetrate them.

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23
Q

What is the downside to suture capillarity?

A

Bacteria are sequestered away from PMNs and macrophages

(Bacteria and tissue fluids are able to penetrate the interstices of the multifimant suture stand, BUT inflammatory cells CANNOT!)

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24
Q

Place the following in order of increasing stiffness:

Braided polyesters

Silk

Stainless steel

Nylon and gut

A

Silk - least stiff

Brainded polyesters - less stiff

Nylon and gut - stiff

Stainless steel - very stiff

25
Q

True or false:

Multifilament nonabsorbable sutures should NEVER be used in a contaminated wound with the potential for infection.

26
Q

True or false:

Synthetic absorbables elicit minimal inflammatory responses, similar to nylon.

27
Q

True or False:

All absorbable sutures induce a cellular reaction.

A

FALSE

All NON-absorbable sutures induce a cellular reaction.

28
Q

Put the following in order of increasing potential of causing a cellular reaction:

Polyester

Nylon

Silk and cotton

Polypropylene and steel

A

Polypropylene and steel

Nylon

Polyester

Silk and cotton

29
Q

Tissues that heal slowly such as skin, fascia, and tendons/ligaments should usually be closed with what type of sutures?

A

Nonabsorbable sutures

30
Q

Tissues that heal rapidly such as viscera, bladder, and GI tract may be closed with which type of sutures?

A

Absorbable sutures

31
Q

Which type of sutures should be used in URINARY and BILIARY tracts?

A

Rapidly absorbable sutures

32
Q

Place the following in order of increasing infection-potentiating effect:

Synthetic monofilament

Synthetic multifilament

Natureal materials (gut, silk, etc.)

A

Synthetic monofilament

Synthetic multifilament

Natureal materials (gut, silk, etc.)

33
Q

Which type of suture should you use where infection is more likely, monofilament or multifilament?

A

Monofilament

34
Q

Dead space = potential infection

Sutures = potential infection

WHAT DO YOU DO??

A

Close dead space in the least amount of suture material possible.

35
Q

True or false:

Extra throws can add additional strength.

A

False

Extra throws do NOT add strength, just bulk!

36
Q
A

Square knot

37
Q
A

Granny knot

38
Q
A

Half-hitch (or tumbled) knot

39
Q
A

Surgeon’s knot

40
Q

Where are sutures the WEAKEST?

A

At the knot

41
Q

For interrupted sutures, how many throws and knots are adequate?

A

4 throws

2 knots

42
Q

For continuous patterns, how many throws and square knots are adequate?

A

6-8 throws

3-4 knots

43
Q

How long should cut ends be in length?

A

3-5 milimeters

44
Q

Which suture pattern is stronger, interrupted or continuous?

A

Continuous

45
Q

What are the components of a needle?

A

Swage - green

Body - yellow

Point - purple

46
Q

Which type of needle should be used for soft tissues that do NOT resist needle penetration, such as (1) abdominal viscera, (2) cardiovascular, and (3) neurological procedures?

A

Tap & taper cut

47
Q
A

Taper & taper cut

48
Q

What type of needle should be used for (1) skin, (2) fascia, and (3) dense tissue?

A

Reverse cutting

49
Q
A

Reverse cutting

50
Q
51
Q

What are spatula needles used for?

A

Cornea, sclera, eyelid muscle repairs

52
Q

What type of needle should be used in hernia repairs?

A

Blunt taper

53
Q

What else can the blunt taper needle be used for?

A

Used to suture friable tissues such as LIVER and KIDNEY

54
Q
A

Blunt taper needle

55
Q

Compaired to sutures, what are the advantages of staples?

A

Greater resistance to infection

Decreased inflammatory response

Decreased closure time

Promotion of skin edge eversion

Good cosmetic results

56
Q

What type of wounds can skin glue be used on?

A

Small skin wounds with NO TENSION

57
Q

When will the skin glue slough from the skin?

A

Typically sloughs with the keratinized epithelium in 5-10 days after application

58
Q

True or false:

Skin glue is intended for use as a bridge over the top of a wound, between cut edges, and to glue skin together.

A

FALSE

Do NOT put glue between cut edges

Do NOT super glue skin together

ONLY use as a bridge over the top

Surgery (15 decks)

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