Tissue Handling + Suture Patterns Flashcards
Who is William Stewart Halsted?
Human surgeon; came up with the basic principles of aseptic surgery
What are the seven Halsted’s principles?
Strict asepsis Good hemostasis Decreased Dead Space Minimize tissue trauma Maintain blood supply Avoid too much tension Apposition of tissue
What are the three types of biomaterials?
Suture + Metals/alloys + Polymers
What happens with physical-induced response w/ polymers?
Fibrous tissue formation
What happens with chemical-induced response w/ polymers?
Acute but mild inflammatory response or chronic response
What is the ideal response to polymers?
Minimal, thin layer of fibrous tissue
What are the four big things that suture materials need to be?
Non-electrolytic
Non-capillary
Non-allergenic
Non-carcinogenic
What are the three ways to classify sutures?
Degradable + Composition + Filaments
What is the strength of the wound dependent on?
Ability of the tissue to hold the suture
How strong should the suture be?
As strong as the tissue you are placing it in
Why is elastic suture material good?
to give room for edema
If wound is under tension what is the best method to handle it?
Increase suture number not size
What is important to do with the knot in a simple interrupted?
Offset
What determines the distance from the incision that you will place your simple interrupted?
Thickness of skin
What is one problem you can get with simple interrupted?
Too much tension leads to wound inversion
What is the upside of simple continuous sutures?
Fast and saves suture
What is the best tissue to use simple continuous?
Elastic tissue under little pressure
What is the downside to simple continuous?
One part breaks, it all breaks
Which one has more strength continuous or interrupted?
Interrupted
Where is interrupted horizontal mattress used?
Skin + SQ + Fascia + Muscle + Tendons
What is the down side to using interrupted horizontal mattress?
Reduced blood flow to edges
What occurs to the tissue edges with interrupted horizontal mattress?
Everting
What are mayo scissors commonly used for?
Dissection of CT
What are metzenblum scissors commonly used for?
Sharp/blunt dissection of delicate tissue
What are the three types of forceps?
Rat tooth + Adson + Brown-Adson
What are rat tooth forceps used for?
Manipulate skin and tough CT
What are adson forceps used for?
Thin skin and facial planes
What are Brown-Adson forceps used for?
Routine wound closure
What are the three types of ligatures?
Simple + Trans-fixation + Simple w/ clamps
What are trans-fixation ligatures good for?
Larger vessels w/ excellent security
What are simple ligatures w/ clamps good for?
Arteries and organ/tumor removal
What are the three types of retractors?
Gelpi + Weitlaner + Army-Navy
