Test N Flashcards
important with stainless steel
always use wire scissors to cut
what is a suture?
material used to bring severed body tissue together and hold in normal position until healing takes place
ties
tying off bleeders or isolating tissue
disadvantages of surgical gut
causes more tissue reaction than cottton or silk
more expensive
not as safe
fine suture needle
used with fine suture on delicate tissue
what will you use most in the OR?
taper
controlled release swaged needles
multiple in a pack
what is a ligature?
strand of suture material used to tie off blood vessels
what should you do if a needle breaks?
get all the pieces, never leave in the wound
eyed needles
needle must be threaded with suture strand
what is bone wax made from?
beeswax
what are secondary suture lines used for?
skin, subq, fascia, muscle
ethilon/dermalon compared to silk
it is stronger
liga clips (hemoclips)
used to clamp small blood vessels (stay in body)
tissue for surgical gut
can be used when silk is not usually recommended like kidney, bladder, gallbladder
what is the suture trio
needle holder
tissue forceps
then mayo suture scissors
type of tissue for absorption time
absorbed more rapidly in serous or mucous membrane than in muscle
continuous stitches
sutures tied only at each end of the suture line
multi braided suture
more tensile strength
GIA
gastrointestinal anastomosis stapler
closing skin layers
peritoneum
fascia
subq
skin
disadvantages of stainless steel
harder to handle
bulk knots
diseased condition for absorption time
rapid absorption occurs in cancerous tissue
what is silk not used for?
bladder, kidney, ureter because it may become the nucleus for a stone
what is the trocar point used on?
tough tissue
LIGAMENTS, TENDONS, CERVIX
qualifications of suture material
must be sterile must be of definite and measured absorbability fine in gauge uniform in strength, size, absorbability remain tied not act as foreign body if nonabsorbable
cutting point
incises tissue as it passes
what is the blunt point used on?
very vascular
LIVER KIDNEY
who is Pare?
helped injured soliders
invented use of ligatures
dermabond
skin glue
SFM
skin and fascia model
double armed swaged needles
anastomosis of vessels or tubular organs
anatomy of surgical needles
point
body (shaft)
eye
stapling devices
used for ligation and division, resection, anastomosis, skin and fascia closure
what does the swaged elimate?
threading
what are the types of swaged needles?
single armed
double armed
permanent swaged
controlled release
dexon absorption
30 days
presence or absence of infection for absorption time
absorption takes place much more rapidly in the presence of infection
what is tensile strength?
amount of weight or pull necessary to break the suture of ligature material
what is the cutting point used on?
tough connective tissue
SKIN, EYES
polypropylene
inert in tissue
high tensile strength
holds knots well
used in infection
where is polypropylene used?
cardiovascular, general and plastic
most common wire
stainless steel
disadvantage of ethilon/dermalon
knots tend to come untied
hard to handle
surgical nylon
advantages of silk
high tensile strength
cheap and easy to sterilize
blunt point
dull tip
what is a stick tie?
threaded on a needle and used through a bite of tissue as well as on the end of the vessel
nonabsorbable suture
this is always removed
what is chromic surgical gut treated with?
chromic oxide
silk compared to surgical gut
silk has less tissue reaction than surgical gut
bone wax
stop oozing and bleeding from surfaces of bone
types of absorbable sutures
plain surgical gut chromic surgical gut vicryl monocryl PDS dexon
disadvantages of silk
not used for infection
how should you have needles when they aren’t being used?
on needle holder or in needle counter
heavy suture needle
used on heavy suture on tough tissue
interrupted stitches
each stitch is taken and tied separately and the suture cut
advantages of stainless steel
no tissue reaction
greatest strength
used for infection
taper point
minimum tissue damage
what are mersilene, tevdek, polydek, ethiflex, ethibond?
polyester
vicryl absorption
70 days
what does the blunt point do?
pushes tissue aside
spring or french eye needles
suture forced through the springs
what is the most common suture needle?
swaged
TA30, TA55, TA90
anastomosis organs and tissues
is there a needle on a tie?
no, it is just a single strand of suture
Quality of subcuticular stitch
Absorbable in the body
How long is a suture for interrupted?
18 inches
what is silk made from?
silkworm cocoons
steri strips
lacerations
what is the key with eyed needles?
it has to be threaded
going in for closing skin layers
skin subq fascia muscle peritoneum
allergy to surgical gut for absorption time
rapidly absorbed with resultant wound disruption
What should you not do to surgical gut?
Stretch it out, soak in saline
what does the ST do when the surgeon is suturing?
threading needle
what does a double suture strand cause?
tissue disruption
absorbable suture
digested by body cells and fluids, not removed
monocryl absorption
120 days
nutrition of patient for absorption time
absorbed faster in undernourished
eyeless, atraumatic, swaged
new sharp needle with every suture strand
halstad technique
many fine interrupted sutures gives firm support to the wound
how are curved needle handed to surgeon?
always on needle holder
what are suture needles used for?
inserting suture material into tissue
how should you hand swaged on needle in needle holder?
never clamp over the end of the needle, it is hollow there and may break from the pressure
how are eyed needles dispensed?
two at a time
how should you give the surgeon the Keith?
always hand, never put on needle holder
what is used in infection?
polypropylene
stainless steel
surgical gut
purse string
commonly used around the appendix
factors that influence absorption time
infection type of tissue nutrition of patient diseased condition allergy to surgical gut age of patient
what is the taper point used on?
soft, easily penetrated tissue
PERITONEUM, INTESTINE or HEART
advantage of surgical gut
easy to handle
used in presence of infection
absorbed by tissue
What is the purpose of retention sutures?
Reinforce primary suture line
what is GC or CT used for?
peritoneum
fascia and muscle
subq
what is GI or SH used for?
stomach intestines gallbladder esophagus common bile duct lungs
monofilament suture
more resistant to harbors MO’s
primary suture line
approximates the edges of the incision
chromic surgical gut absorption
90 days
what is the rule with tissue and shaft of needle?
the deeper the tissue in the wound, the greater the curvature of the shaft
where do you load the needle on the needle holder?
1/3 way down
plain surgical gut absorption
70 days
PDS absorption
180 days
