Week One - Questions

Question 1

What is in an NUNM suture pack?

Answer 1

• Needle holders
• Scissors
• Forceps
• Scalpels
• Syringes
• Hypodermic needles
• Hemostats
• Suture
• Anesthetics
• Gloves
• Drapes
• Antiseptics
• Dressings
• Steri-strips
• Minor surgery tincture
• Homeopathic remedies
• Always have at least two complete, sterile MS kits ready for use
• Have a third laceration tray in reserve

Question 2

What are the two types of forceps typically in an NUNM suture pack?

Answer 2

Adson Dressing Forceps
- No teeth
> May need extra pressure to securely grasp the wound edges, which can lead to crush necrosis

Brown-Adson Tissue Forceps
- Teeth

Babcock Forceps
- Preferred for removing cysts

Question 3

What are the differences between the structure and use of needle holders vs. hemostats?

Answer 3

Needle Holders

• Used to hold needles
• Jaws are usually straight and short
• Have knurled (textured) jaws to keep the needle from rolling
• Examples: Webster and Halsey

Hemostats
- Typically used for:
> Retrieving foreign bodies in a wound
> Clamping bleeding vessels
> Clamping a tourniquet
> Substitute needle holder when needed
- Can be straight or curved
- Jaws have a crosshatched (toothed) surface
- Example: Halsted Mosquito hemostat

Question 4

What are the typical scalpel sizes (and the configuration of the blade) and when are each used?

Answer 4

Non-Disposable Scalpel Handles

• # 3 or #4 handles used with #10, #11, and #15 surgical blades
• Now rarely used
• Use a hemostat to place blade on handle

Disposable Scalpels with Non-Retractable Blades

• # 15 for small lesions (most commonly used for minor surgery)
• # 10 for large lesions
• # 11 for draining abscesses
• All can be used for performing shave biopsies

Question 5

What are the different types of suture materials and some typical brands?

Answer 5

Non-Absorbable

• Used to be cotton or silk (caused reactions), but now mostly nylon
• Nylon is inert, but slippery and difficult to tie and keep tied
• Nylon is most frequently used to close skin
• Ethilon brand nylon used in clinic

Absorbable
- Used to be sheep gut, now synthetic polymers
- Vicryl is the most widely used synthetic polymer
- Designed for internal use
> Left in and gets phagocytized
- May cause an immune reaction that can be confused with an infection

• NUNM mostly uses FS1 needles with Ethilon nylon sutures

Question 6

What are the different basic types of needles and the uses of each?

Answer 6

Straight Suture Needle

• Used to close larger surgical wounds
• Tip has a flat (spear-like) cutting surface

Curved Suture Needle

• Typically needles are 3/8 circle
• Main manufacturers are Ethicon (FS), and Davis and Geck (CE)
• Cutting needles usually used for the skin
• Conventional cutting needle has the cutting edge facing the inside of the needle curve
• Reverse cutting needle has the cutting edge facing the outside of the needle curve
• Precision cosmetic needles are used when using 6-0 on the face

Question 7

What are the correct suture sizes to use on different body areas?

Answer 7

• On face/head, use 5-0, 6-0, or 7-0

- On general body, use 3-0, 4-0, 5-0, or 6-0

Question 8

What are the common needle sizes used for anesthetic injection in minor surgery and their applicable locations on the body?

Answer 8

• 25 gauge, 5/8”
• 25 gauge, 1 1/2”
• 27 gauge, 1” or 1 1/2”
• 30 gauge, 1/2” or 1” causes minimal pain, used for small lesion removal and facial or plastic surgery