Test 6 Basic incisions, closure, and sutures

Question 1

Incision approaches vary by…

Answer 1

Target anatomy
surgeon preference
patient factors

Question 2

Name the vertical incisions

Answer 2

Median/midline- down the middle
paramedian- lateral to the midline

Question 3

Name the transverse incisions

Answer 3

midabdominal
Pfannenstiel- “bikini line”

Question 4

Name the oblique incisions

Answer 4

subcostal- liver, gallbladder
McBurney’s- appendix
Inguinal- hernia, testicle

Question 5

Where is the thoracoabdominal incision

Answer 5

along the side
thoracic and descending aorta
kidneys
lower esophagus

Question 6

What are port sites?

Answer 6

small incisions for trocar placement

Question 7

What are the 9 abdominal regions

Answer 7

1 R hypochondriac
2 Epigastric
3 L Hypochondriac
4 R Lumbar
5 Umbilical
6 L Lumbar
7 R Iliac
8 Hypogastric
9 L Iliac

Question 8

Define suturing

Answer 8

the process of joining or approximating tissues with a needle and thread so tissues can bind together and heal

Question 9

Define sutures

Answer 9

the materials used to close a wound to maximize the opportunity for wound healing

Question 10

What are the functions of sutures

Answer 10

-hold tissues together
-provide strength to wound
-provide approximation
-method of hemostasis
-tie off tissues to be removed

Question 11

Factors for choosing suture

Answer 11

-surgeon preference
-tissue type
-presence of infection
-disease processes affecting wound healing

Question 12

What is suture gauge

Answer 12

diameter of suture
#7 thickest
0 middle diameter
11-0 thinnest

Question 13

Tensile strength

Answer 13

amount of tension a suture can withstand before it breaks

Question 14

Elasticity

Answer 14

ability to stretch or expand

Question 15

Memory

Answer 15

ability to return to former position

Question 16

capillarity/ capillary action

Answer 16

-pulls tissue fluids to move along the suture strand
-may cause microorganisms to migrate along the suture

Question 17

pliability/ malleability

Answer 17

able to bend freely and repeatedly without breaking

Question 18

tissue drag

Answer 18

“rope burn”
how easily a suture passes through a tissue

Question 19

knot strength

Answer 19

resistance to a knot failure
knot is the weakest part

Question 20

what are barbed sutures

Answer 20

they have spikes running along the length of the suture
Brands: v-loc and stratafix

Question 21

What is tissue reaction

Answer 21

how the body will react to it
looking for inert suture (low reaction)

Question 22

What are the 6 main classifications of sutures?

Answer 22

absorbable
nonabsorbable
synthetic (manmade)
nonsynthetic (natural)
monofilament
multifilament (braided)

Question 23

Describe monofilament sutures

Answer 23

-single thread
-passes through tissue easily
-for skin closure
-resist harboring bacteria

Question 24

Describe multifilament (braided) sutures

Answer 24

2 or more threads
twisted together
can harbor bacteria
can maintain fluid

Question 25

What are 2 types of absorbable- nonsynthetic sutures (surgical gut)

Answer 25

plain gut chromic gut made from sheep or beef intestine

Question 26

What are the 4 types of absorbable- synthetic sutures

Answer 26

Monocryl- Vicryl- Dexon PDS

Question 27

Describe Monocryl sutures

Answer 27

=polyglicaprone monofilament used in GYn, general, GU, and plastics

Question 28

Describe Vicryl sutures

Answer 28

=polyglactin 910 multifilament used in GU

Question 29

Describe Dexon sutures

Answer 29

=polyglycolic acid used in GU

Question 30

Describe PDS sutures

Answer 30

=polydioxanone monofilament abdominal fascia closures

Question 31

What are absorbable sutures

Answer 31

-digested by tissue enzymes - not used long term mono or multifilament

Question 32

Wha tare nonabsorbable sutures

Answer 32

not absorbed by body permanent or removable support for long term encapsulated by tissue over time mono or multifilament

Question 33

Name 2 nonabsorbable- nonsynthetic sutures

Answer 33

silk surgical stainless steel

Question 34

Describe silk sutures

Answer 34

from silkworm cocoons multifilament Gi tract and bowel *contraindicated in urinary tract- encourages stones

Question 35

Describe surgical stainless steel sutures

Answer 35

chromium and nickel alloys *most inert can be used with infection not near other metals mono or multifilament used in abdomin, sternum, hernia repair, tendon, and bone repair

Question 36

What are the three types of nonabsorbable- synthetic sutures

Answer 36

polyester prolene nylon

Question 37

What are the 2 types of polyester sutures

Answer 37

Ethibond, Dacron, Ticron- has lubricant coating Mersilene- uncoated -multifilament -strongest used in tendons

Question 38

Describe prolene suture

Answer 38

=polypropylene monofilament most inert used in cardiovascular and abdominal closure

Question 39

What are the 2 types of Nylon

Answer 39

Ethilon Nurolon/ Surgilon

Question 40

Describe Ethilon sutures

Answer 40

monofilament inert used in eye, plastic, and microsurgery

Question 41

Describe Nurolon/ Surgilon sutures

Answer 41

multifilament coated to reduce drag used in neurosurgery and hernia repair *4-0 most commonly used

Question 42

What are the parts of a surgical needle

Answer 42

-point (reverse/skin; blunt/liver; taper most common) -shaft -eye -