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SUTURES/SURGICAL WOUNDS > SUTURES/SURGICAL WOUND > Flashcards

SUTURES/SURGICAL WOUND Flashcards

1
Q

Types of Wounds

A 
Intentional
Chronic
Traumatic
SSI
Non healing
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2
Q

Intentional Wound

A
  • Created under sterile conditions
  • Incision
  • Excision–> removing something from skin surface
  • Puncture–> camera in body (scopes)
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3
Q

Chronic Wound

A
  • decubitus ulcer

- pressure sores /bed sores

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4
Q

Traumatic Wound

A

laceration-cut that goes beneath subcutaneous tissue

abrasion- a scrape

puncture- gun shot, stepping onto a nail

burn

Contusion/bruise

Hematoma

avulsion- tissue that as been torn off (a dog bite, finger cut off etc)

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5
Q

Types of Wound Healing

A 
1st intention 
   -primary union
2nd intention
   -granulation
3rd intention
   -delayed primary closure
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6
Q

1st Intention

A
  • Wound edges are approximated
  • CLEAN WOUND
  • GOOD HEALING
  • NO INFECTION
  • MINIMAL SCARRING (cicatrix)
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7
Q

2nd Intention

A
  • Mostly trauma wounds
  • healing via granulation
  • BACTERIAL CONTAMINATION
  • EXCESSIVE TISSUE LOSS
  • LONGER HEALING
  • PROUD FLESH
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8
Q

3rd Intention

A

-delayed primary closure
-INFECTED TRAUMATIC WOUNDS
-wound is cleaned and left open
DEBRIDEMENT
GRANULATION
-Patient is then brought back for primary closure

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9
Q

Phases of wound healing

A

LAG/INFLAMMATION PHASE
PROLIFERATION PHASE
MATURATION PHASE

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10
Q

Lag phase

A

-healing starts within mins of incision
-1-5 days post op
-body’s natural reaction to heal itself
HEMOSTASIS–> CLOT, SCAB
PHAGOCYTOSIS–>PUS (wound still not healed)
1st intention wound healing

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11
Q

Proliferation phase

A
  • lasts up to 2 weeks
  • when everything is in place so healing can fully begin
  • fibroblasts form from collagen
  • capillary network
  • granulation tissue
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12
Q

Maturation phase

A
  • after 2 weeks up to a few months
  • remodeling, differentiation
  • SCAR FORMATION(cicatrix)
  • wound regains it strength
  • contraction
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13
Q

wound complications/disruptions

A

Hemorrhage –> bleeding caused my inadequate hemostasis

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14
Q

dehiscence

A

wound reopening after closure

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15
Q

eviseration

A

internal organ structure coming out of wound

EMERGENCY**

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16
Q

herniation

A

organ protruding inside your body

-usually due to weakness of muscle wall

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17
Q

sinus tract formations

A

1 opening
fistula formation: 2 openings
-collection of fluid finds and outlet or passage

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18
Q

fissure

A

tear or rip in tissue (anal fissure)

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19
Q

hematoma

A

localized collection of blood outside the blood vessels

  • can cause wound to separate and get infected
  • can create swelling, pain, drainage
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20
Q

adhesions

A

abnormal scar tissue

-happens in abdominal region

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21
Q

granulomas

A

mass of granulation tissue

  • small area of inflammation
  • produced in response to infection etc.
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22
Q

excessive scar formation:

  • cicatrix
  • keloid
  • proud flesh
A

CICATRIX- scar of healed wound (not so noticeable)

KELOID- healing complication, excessive collagen growth on wound

PROUD FLESH- over growth of granulation ( new connective tissue /blood vessels)

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23
Q

Wound Classificaiton

A

CLASS I, CLASS II, CLASS III, CLASS IV

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24
Q

Class I -clean

A

-elective procedure
surgical incision
-ideal conditions
- NO BREAK IN ASEPTIC TECHNIQUE

25
Q

Class II -clean contaminated

A
  • when entering mucus membrane like GI , GU tract, or respiratory tract
  • MINOR OR NO BREAK IN ASEPTIC TECH.
  • NO INFECTION PRESENT
  • may treat w/ antibiotics after procedure (surgeon will classify after surgery)
26
Q

Class III- contaminated

A
  • gross spillage from GI tract
  • MAJOR BREAK IN ASEPTIC TECH.
  • INFLAMMATION PRESENT
  • Open traumatic wound less than 4 HRS old
  • def will treat patient w/ antibiotics post surgery
27
Q

Class IV- dirty or infected

A
  • perforated viscera (organ) –ex. rupture in appendix
  • dirty traumatic wound over 4-6 hrs OR foreign body present in wound
  • BACTERIA PRESENT IN WOUND BEFORE SURGERY
  • INFECTION W/ DRAINAGE
28
Q

debridement

A

removing dead tissue, scraping it away

29
Q

fistula

A

a tract between 2 epithelium- lined surfaces that is opened at both ends

30
Q

SUTURES:

monofliment

A

single continuous fiber

  • good healing properties
  • relatively inert
  • minimal tissue damage
  • NOT as easy to work with
31
Q

multifilament suture

A

multiple thread like structures(twisted or braided) into single strand

  • absorbs moisture and hold body fluid b/c of capillary action(WICKING)
  • HARBOR BACTERIA
  • NOT USED IN PRESENCE OF INFECTION
  • EASY to work with
32
Q
  1. absorbable suture

2. non- absorbable suture

A

absorbable- able to be absorbed by tissue via hydrolysis (fluid breaks down suture)
-designed to hold tissue edges together until they heal

non-absorbable- resists absorption by tissue
-get encapsulated by tissue

33
Q

natural absorbable sutures

A
  • SURGICAL GUT
    • from submucosa of sheep intestine
  • MONOFILAMENT
  • PACKED IN ALC

*PLAIN GUT

  • CHROMIC GUT–> processed with salts to extend lifespan–> used primarily for urinary tracts
    • absorbs fastest

CAT GUT–> collagen from animal intestine (multi)

34
Q

Synthetic absorbable sutures

A

DEXON
PDS
MONOCRYL
VICRYL

  • can be mono or multifilament
  • wound support for 3 weeks to 6 months
  • inert
  • absorbed by HYDROLYSIS
35
Q

natural non-absorbable sutures

A

SILK –> multi , high wicking action

STAINLESS STEEL–> strongest suture, most inert, special handling

36
Q

Synthetic NON- absorbable sutures

A

NYLON- mono

          - skin suture
          - minimal tissue reaction

NUROLON- multifilament nylon
- used to close dura (on brain) or meninges

POLYPROPYLENE-PROLENE- mono
-inert

37
Q

SUTURIING TECHNIQUES:

  • primary suture line
A
  • continuous. suture/ running suture
  • interrupted suture

Mattress suture

38
Q

subcuticular suture

A

used for cosmetic closure

-cant see on the dermal layer

39
Q

purse string suture

A

pulled through like a drawstring

-used for intestines or appendix removal, appendectomy

40
Q

Secondary suture line:

retention suture/stay suture

A

large gauged, non absorbable

  • bolsters, bridges or bumpers (plastic or rubber tubing)
    • -threaded over retention suture ends prior to tying*
41
Q

anastamosis

A

reconnection of 2 structures

42
Q

traction sutures

A

structures put in place to keep wound open instead of using retractor
–used for HEART & BRAIN

43
Q

synthetic adhesives– DERMABOND

A

a glue in the wound that seals skin closed

44
Q

pressure dressing

A

a bunch of DRESSING sponges on top of wound to prevent bleeding & dead space( fluid accumulation)

45
Q

ligatures

A

used to tie off bleeding vessels

suture ligature stick tie

continuous ligature reel

free tie –> pre cut, single strands in package

tie on pass –>loaded onto a curved clamp to tie to help placement of tie around vessel in deep surgical wound

46
Q

types of needles

A

keith – straight needle
curved – most commonly used
eyed – french eye, mayo

47
Q

parts of needle

A

POINT, BODY, EYE

48
Q

needle points

A

Cutting- used for SKIN, Cartilage, Tendons (cuts through tissue also)

Taper- just the point is sharp, doesn’t cut tissue around area, used for delicate, fine tissue like INTESTINE

Blunt- not very sharp, rounded blunt point,, used for organ structures that bleed a lot, like KINDEY, SPLEEN, LIVER

49
Q

Swaged needles

A

single armed or double armed

- 1 needle on end or 1 needle on each end (2 total)

50
Q

swaged contd. control release

A

when you can pull needle off of suture

51
Q

swaged contd. permanently swagged

A

you need scissors to cut needle off of suture

52
Q

tapered needle

A

round body, tapers to sharp point

-primary use is for soft tissue

53
Q

spatula needle

A

side cutting needles, slat on top &bottom

-used for ophthalmic surgery, eyes, extremely thin layers of tissue like cornea etc

54
Q

what type of wound that is expected to heal by 1st intention?

A

a clean wound

55
Q

which class of surgical wound is considered dirty or infected?

A

class IV

56
Q

when the wound is left open and allowed to heal from inner layer to outside surface is considered what type pf healing?

A

granulation… 2nd intention

57
Q

which phase of wound healing begins within minutes of injury ?

A

lag phase

58
Q

what is the suture diameter referred to as ?

A

gauge

59
Q

what suture is most likely used for orthapedic wounds and abdominal fascia?

A

1

SUTURES/SURGICAL WOUNDS (1 decks)

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