Sutures - scrub/scout

Question 1

Absorbable sutures

Answer 1

Don’t need to be removed
- Enzymes found in the body’s tissues naturally digest them.

Question 2

Non-absorbable sutures

Answer 2

Will need to be removed or in some cases left in permanently.
- Suture material can be classified according to the actual suture of the material.
- Generally used for soft tissue repair including CV or neuro procedures

Question 3

Monofilament sutures

Answer 3

Consists of a single thread.
- Allows the suture to more easily pass through tissues

Question 4

Braided sutures

Answer 4

Consists of several small threads braided together.
- Stronger suture material but also increase the risk of infection as bacteria can live in the braid
- Antimicrobial coated sutures to further reduce the risk

Question 5

Absorbable suture - Gut

Answer 5

Natural monofilament suture
- Used for repairing internal soft tissue wounds or lacerations.

Question 6

Absorbable suture - Polydioxanone (PDS)

Answer 6

Synthetic monofilament suture
- Used for many types of soft tissue wound repair (abdominal closures) as well as paediatric cardiac procedures

Question 7

Absorbable suture - Poliglecaprone (Monocryl)

Answer 7

Synthetic monofilament suture is used for general use in soft tissue repair.

Question 8

Absorbable suture - Polyglactin (Vicryl)

Answer 8

Synthetic braided suture
- Repairing hand or facial lacerations

Question 9

Non-absorbable sutures -Nylon

Answer 9

Natural monofilament suture

Question 10

Non-absorbable - Polypropylene (prolene)

Answer 10

Synthetic monofilament suture

Question 11

Non-absorbable - Silk

Answer 11

Braided natural suture

Question 12

Non-absorbable - Polyester (Ethibond)

Answer 12

A braided synthetic suture

Question 13

Suture selection

Answer 13

suture material is graded according to the diameter of the suture strand.
- Grading system uses the letter “O” preceded by a number to indicate material diameter.
- The higher the number the smaller the diameter of the suture strand.

Question 14

Key points of selection

Answer 14

• Size or gauge of the needle
  
  • Needle Sharpe
  • Needle length
• Type and suture material

Question 15

Continuous - suture

Answer 15

Involves a series of stitches that use a single strand of suture material.
- Can be placed rapidly and is strong
- Tension is distributed evenly throughout the continuous suture strand.

Question 16

Interrupted - suture

Answer 16

Uses several strands of suture material to close the wound.
- After a stitch is made, a material is cut and tied off

Question 17

Deep - suture

Answer 17

Type of suture is placed under the layers of tissues below (deep) to the skin.
- Either continuous or interrupted.
- Used to close fascial layers

Question 18

Buried - suture

Answer 18

Applied so that the suture knit is found inside
- Type or suture is typically not removed and is useful when large sutures are used deeper in the body

Question 19

Purse-string - suture

Answer 19

Type of continuous suture that is placed around an area and tightened much like the drawstring on a bag.
- Used in your intestines in order to secure an intestinal stapling device.

Question 20

Sub/cut - suture

Answer 20

Placed in your derms the layer of tissues that lies below the upper layer of your skin.
- Anchored at either end of the wound

Question 21

Scalp - suture removal

Answer 21

7-10 days

Question 22

Face - suture removal

Answer 22

3-5 days

Question 23

Chest or trunk - suture removal

Answer 23

10-14 days

Question 24

Arms - suture removal

Answer 24

7-10 days

Question 25

Legs - suture removal

Answer 25

10-14 days

Question 26

Hands or feet - suture removal

Answer 26

10-14 days

Question 27

Palms of hands or soles of feet - suture removal

Answer 27

14-21 days

Question 28

Suture definition

Answer 28

needle attached to a thread
- needle can be from 5.5mm-13mm in size, shaped a pointed’, spatulated, reverse cutting, taper cut, straight cutting, conventional cutting and others.

Question 29

Determining type of needle

Answer 29

The operative side and speciality will determine the body or type of needle and suture material attached that will be used.

Question 30

surgical skin preparation

Answer 30

Intact skin is one of the pt best defences against the entry of infection

Question 31

surgical skin antisepsis

Answer 31

• Achieved through surgical skin disinfection, which removes transient bacteria through a combination of mechanical removal, chemical killing and inhibition.
• Antimicrobial agent which has a broad-spectrum, rapid and persistent effect

Question 32

Antisepsis solution

Answer 32

aqueous povidone-iodine and chlorhexidine solutions

Question 33

3 principles of skin prep

Answer 33

1. removal of hair
2. chemical disinfection
3. Mechanical washing

Question 34

Skin prep technique

Answer 34

• Should commence from the cleanest area, usually the operative and/or incision site and proceed in a concentric fashion to the least clean area
• Never go back over a prepared site, use a new swab to go over an area in a circular manner
• the area with a lower bacterial count should be prepared first, followed by the area of a higher contamination
• avoid drying with swab or sponge as this reduces efficiency
• solution should dry completely naturally

Question 35

skin preparation solutions

Answer 35

• Chlorhexidine Gluconate
  
  • Aqueous chlorhexidine
  • Iodophors
  • Aqueous betadine
• Alcohol betadine