Wound Healing, Sutures, Needles, and Staples

Question 1

Incision made under ideal surgical conditions, no entry to GI tract

Answer 1

Class I: Clean (1-5% infection rate)

Question 2

Primary closer with wound drain, controlled entry into GI tract

Answer 2

Class II: Clean-Contaminated (8-11% infection rate)

Question 3

Open, traumatic wound that’s less than 4 hours old, Entry into GI tract with spillage

Answer 3

Class III: Contaminated (15-20% infection rate)

Question 4

Open traumatic wound that’s more than 4 hours old, Perforated viscera

Answer 4

Class IV: Dirty/infected (27-40% infection rate)

Question 5

Abrasion

Answer 5

Scrape

Question 6

Contusion

Answer 6

Bruise

Question 7

Laceration

Answer 7

Cut or Tear

Question 8

Punture

Answer 8

Penetration

Question 9

Thermal

Answer 9

Heat or Cold (can be chemical)

Question 10

Signs of inflammation

Answer 10

Pain, Heat, Redness, Swelling, and Loss of function

Question 11

Healing occurs from side to side where dead space has been eliminated and wound edges have been accurately approximated

Answer 11

1st Intention (Primary Union)

Question 12

Ist phase of primary union

Answer 12

Lag Phase (inflammation) immediately after injury and lasts 3-5days

Question 13

2nd phase of primary union

Answer 13

Proliferation Phase Collagen produces fibers occurs between days 3-20days

Question 14

3rd phase of primary union

Answer 14

maturation or Differentiation Phase, tissue slowly increases in tensile strength and formation of new blood vessels. Occurs on the 14th day

Question 15

Healing that occurs in large wounds that can’t be directly approximated. Causes a weak union and irregular scar (may result in herniation

Answer 15

Second Union (Granulation)

Question 16

Healing that occurs when the wound is left open to heal on either side by granulation. once the wound is infection free it’s left to heal by primary union

Answer 16

Third Intention (Delayed Primary Union)

Question 17

Physical conditions of a PT that effects wound healing

Answer 17

Age, Nutrition, Disease, Smoking, Radiation, Immunocompromised

Question 18

Dehiscence

Answer 18

Partial or total separation of layers of tissue after wound closure

Question 19

Friable

Answer 19

Easily torn

Question 20

Evisceration

Answer 20

Protrusion of vicera through a totally separate wound

Question 21

Adhesions

Answer 21

Abnormal attachment of two surfaces that are normally separate

Question 22

Fistula

Answer 22

A tract between two epithelial lined surfaces that’s open at both ends

Question 23

Sinus Tract

Answer 23

A tract between two epithelial lined surfaces that’s closed at one end

Question 24

Keloid Scar

Answer 24

hypertrophic scar formation

Question 25

Suture with greater tensile strength but harbors bacteria

Answer 25

Multifilament

Question 26

Suture that causes less tissue trauma and is less susceptible to harbor bacteria. But has weaker tensile strength

Answer 26

Monofilament

Question 27

Traction sutures

Answer 27

Used to retract a structure

Question 28

Suture for Peritoneum, Fascia, Muscle, Subcutaneous, Subcuticular

Answer 28

Absorbable sutures

Question 29

Skin Suture

Answer 29

Nylon or Prolene, non-absorbable monofilament

Question 30

Bridges and Bolsters

Answer 30

Keeps retention sutures from cutting into the skin, Bolsters are rubber threaded over the retention suture end

Question 31

Buttons and lead shots

Answer 31

Suture pulled through a buttonhole to prevent tissue damage

Question 32

Vessel loops and umbilical tape

Answer 32

Retraction

Question 33

Tincture, Benzoin

Answer 33

Used to prep the skin for adhesive skin closure (used typically for tendons)

Question 34


Answer 34

Linear Stapler (GIA linear), Doesn't Cut

Question 35


Answer 35

TA Linear Stapler (Staples and Cuts)

Question 36


Answer 36

Endo GIA (Linear cutter for endoscopic procedures)

Question 37

Intraluminal Staplers

Answer 37

Used to anastamose and cut circular structures (GIA tract)

Question 38


Answer 38

EEA Intraluminal Stapler

Question 39


Answer 39

Skin Stapler

Question 40


Answer 40

Pursestring Stapler

Question 41

When can Polypropylene Mesh be used

Answer 41

It can be used in the presence of infection (high tensile stregnth

Question 42

What type of mesh is Polyglactin 910 Mesh

Answer 42

Absorbable, temporary mesh

Question 43

What are the characteristics of PTFE (Polytetrafluoroethylene) Mesh

Answer 43

Not absorabable and should not be used in the presence of infection

Question 44

What are the charateristics for sainless steel mesh

Answer 44

Can be used in the presence of infection, but is uncomfortable for the patient. Best for in the presence of infection

Question 45

What are the characteristics of Polyester Fiber Mesh

Answer 45

Never use in the presence of infection because it is mutifilament