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PeriOp 101 > Wound Closure > Flashcards

Wound Closure Flashcards

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1
Q

Suture Characteristics:

Memory

A

Memory is the capacity to take back former shape after being tied

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2
Q

Suture Characteristics:

Coefficient of Friction

A

Coefficient of Friction is the ability to glide through tissue and retain a knot

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3
Q

Suture Characteristics:

Capillarity

A

Capillarity is the ability to soak up fluid along a strand

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4
Q

Suture Characteristics:

Pliability

A

Pliability is the ability to bend easily

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5
Q

Suture Characteristics:

Knot tensile strength

A

Knot tensile strength is the force, measured in pounds, that the suture strand can withstand before it breaks when knotted

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6
Q

Suture Characteristics:

Elasticity

A

Elasticity is the ability to regain original form and length after being stretched.

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7
Q

If a natural absorbable suture starts to dry during a procedure…

A

If a natural absorbable suture starts to dry during a procedure, the material may be restored by quickly immersing in sterile water or NS solution that is not above 98.6 F. it should NOT be soaked.

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8
Q

Natural Absorbable Suture:

Plain catgut (type A) is used for…

A

Plain catgut (type A) is used for

  • Ligation of small vessels
  • To suture subQ fat
  • To suture tissue under tension while healing.
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9
Q

Natural Absorbable Suture:

Chromic gut (type C) is used for…

A

Chromic gut (type C) is used for

  • Infected tissues and slow-healing tissue
  • Ligation of larger vessels, biliary, urinary tracts
  • Muscle and fascia closure
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10
Q

Synthetic Absorbable Suture (made of POLYmers):

Polydioxanone sutures (eg PDS) are used for…

A

Polydioxanone sutures (eg PDS) are used for

  • Abdominal and thoracic closure
  • SubQ tissue
  • Colorectal surgery
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11
Q

Synthetic Absorbable Suture (made of POLYmers):

Polyglyconate sutures (eg Maxon) are used for…

A 
Polyglyconate sutures (eg Maxon) are used for
* Soft tissue except cardiovascular neural and ophthalmic tissues
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12
Q

Synthetic Absorbable Suture (made of POLYmers):

Polyglactin 910 sutures (eg Vicryl) are used for…

A

Polyglactin 910 sutures (eg Vicryl) are used for

  • Ophthalmic procedures
  • When absorption is desired
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13
Q

Synthetic Absorbable Suture (made of POLYmers):

Polyglycolic acid sutures (eg Dexon) are used for…

A

Polyglycolic acid sutures (eg Dexon) are used for

* Peritoneal, fascial, and subQ closure

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14
Q

Natural Absorbable Suture:

Collagen suture is used for…

A

Collagen suture is used for

* Opthalmalogic surgery

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15
Q

General characteristics of natural absorbable sutures include:

A

General characteristics of natural absorbable sutures include:

  • Pkg’d in fluid which may be irritating
  • Open over a small basin to prevent splashing
  • Don’t open until needed (lose pliability when dry)
  • For eye procedures, rinse but don’t soak
  • If starting to dry, quickly immerse in sterile water or NS but don’t soak.
  • Unwind carefully & gently. Excessive handling weakens and damages the material
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16
Q

General characteristics of synthetic absorbable sutures include:

A

General characteristics of synthetic absorbable sutures include:

  • Use dry
  • Don’t soak or dip in H2O/NS - causes hydrolysis
  • They retain pliability & are soft / smooth.
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17
Q

General characteristics of natural nonabsorbable sutures include:

A

General characteristics of natural nonabsorbable sutures include:

  • Made of silk, surgical cotton, linen or stainless steel
  • 3 types of silk - dermal, virgin and surgical. Used dry.
  • Surgical cotton is used for ligating and suturing. Gains strength when wet.
  • Linen is used for GI surgery and has inferior tensile strength compared to other nonabsorbables.
  • Stainless steel is used for closure of abd wall or sternum, retention sutures, secondary repairs, respiratory tract, orthopedics and neuro.
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18
Q

Natural nonabsorbable suture:

Stainless Steel

A

Stainless steel is used for

  • closure of abd wall or sternum,
  • retention sutures,
  • secondary repairs,
  • respiratory tract, orthopedics and neuro.
  • Knot tying is painstaking
  • Be careful - may cut tissue or gloves
  • CAN be used with infection
  • CANNOT be used with another alloy like titanium
  • only cut with wire scissors
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19
Q

Natural NONAbsorbable Suture:

Surgical silk

A

Surgical silk suture gives good support during early ambulation and promotes rapid healing;

Used to close fascia when no infection is present

20
Q

Natural NONAbsorbable Suture:

Virgin silk

A

Virgin silk is composed of natural fibers and used for ophthalmic surgery.

21
Q

Natural NONAbsorbable Suture:

Dermal silk

A

Dermal silk strands are encased in gelatin or protein substances and used for skin sutures.

22
Q

Natural NONAbsorbable Suture:

Surgical cotton

A

Surgical cotton is the weakest of the nonabsorbable sutures but gains strength when wet.

23
Q

Natural NONAbsorbable Suture:

Linen

A

Linen suture is used for GI surgery and has inferior tensile strength compared to other nonabsorbables.

24
Q

Synthetic NONabsorbable Suture characteristics:

A

Synthetic NONabsorbable Suture characteristics:
* made of synthetic polymers
* Advantages - higher tensile strength, less tissue reaction and the material retains its strength in tissue.
Disadvantages – knot tying is hard b/c the material is slick.
* Handle as little as possible - easily damaged, pulled, stretched.
* A special knot is needed for security.

25
Q

Synthetic NONabsorbable Suture:

Monofilament nylon

A

Synthetic NONabsorbable Suture:

Monofilament nylon = Ethilon and Dermalon

26
Q

Synthetic NONabsorbable Suture:

Coated multifiliment nylon

A

Synthetic NONabsorbable Suture:

Coated multifiliment nylon = Surgilon

27
Q

Synthetic NONabsorbable Suture:

Uncoated polyester fiber

A

Synthetic NONabsorbable Suture:

Uncoated polyester fiber = Mersilene & Dacron

28
Q

Synthetic NONabsorbable Suture:

Coated polyester fiber

A

Synthetic NONabsorbable Suture:

Coated polyester fiber = Ticron, Ethibond, Teflon, Polydek, Tevdek

29
Q

Synthetic NONabsorbable Suture:

Polybutester

A

Synthetic NONabsorbable Suture:

Polybutester = Novafil

30
Q

Synthetic NONabsorbable Suture:

Polyethylene

A

Synthetic NONabsorbable Suture:

Polyethylene = Dermalene

31
Q

Synthetic NONabsorbable Suture:

Polypropylene

A

Synthetic NONabsorbable Suture:

Polypropylene = Prolene and Surgilene

32
Q

Desirable characteristics of suture needles include

A

Desirable characteristics of suture needles include:

  • strong, not easily broken
  • rigid yet flexible enough to bend w/o breaking
  • sharp, to penetrate with minimal resistence
  • Same diameter as suture material
  • Free from corrosion or burrs
33
Q

The 3 parts of the needle are…

A

The 3 parts of the needle are the eye, the body and the point.

34
Q

The 3 types of needle points are…

A

The 3 types of needle points are:

  • Cutting (conventional, reverse, side, trocar)
  • Taper (point or cut)
  • Blunt (for dissection of friable tissue)
35
Q

More on CUTTING needle points…

A

Cutting needle points:

  • Conventional - cutting edge on inside curve, creates small path that heals quickly.
  • Reverse – curved with cutting edge on outside curve
  • Side – do not penetrate underlying tissues, split tissue layers. Used for eye surgery.
  • Trocar – Used to punch through tough tissue
36
Q

More on TAPER needle points….

A

Taper needle points:

  • Taper Point - pushes tissue aside when passing through
  • Taper Cut – Has a cutting edge at the point only
37
Q

More on BLUNT needle points…

A

Blunt needle points:

  • Used on organs (less apt to puncture vessels)
  • Dissection of friable tissue
38
Q

_________ needles are in continuity with the suture material?

A

Eyeless or swagged needles are made continuous with the suture (“swagged on” during manufacturing process)

39
Q

What type of needle is known as a pop-off needle

A

A controlled release needle is AKA a pop-off needle. Won’t release inadvertently but will release when intentionally pulled.

40
Q

Skin staplers are used to…

A

Skin staplers are used to…

approximate edges skin edges.

41
Q

Linear staplers are used to…

A

Linear staplers are used…

throughout the alimentary tract and in thoracic procedures.

42
Q

Intraluminal circular staplers are used to…

A

Intraluminal circular staplers are used for…

intraluminal anastomosis of a tubular hollow organ, usually the GI tract.

43
Q

Ligating and dividing staplers are used to…

A

Ligating and dividing staplers are used to…

ligate and divide omental vessels or soft tubular structures

44
Q

Skin clips are used to…

A

Skin clips are used to…

secure stockinet or towels to the skin

45
Q

Skin closure strips

A

Skin closure strips (aka steri-strips) are used to…

approximate edges of superficial lacerations or as a primary closure.

46
Q

The features and benefits of a French eye (split eye) needle include:

A

The French eye (split eye) needle…

  • must be used with pliable braided material such as silk, or cotton, in a medium to fine size.
  • should NOT be used with surgical gut (may fray)
  • Easy to thread
  • DON’T double wrap (causes tissue trauma)
  • diameter of needle should match type of suture

PeriOp 101 (6 decks)

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