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CH11 HW WB
Hw/Wkbk
| Question | Answer |
|---|---|
| Breast biopsy frozen secion indicates cancer | Wound Classification I |
| Laparoscopic cholecystectomy, gallbladder removed with endobag | Wound Classification II |
| Cystoscopy with retrograde pyelogram (RPG); no stones found | Wound Classification II |
| Scheduled bowel resection; scrub observes bloody hole in glove; regloved | Wound Classification III |
| Emergency bowel resection; Feces noted during anastomosis | Wound Classification IV |
| Laparoscopic assisted vaginal hysterectomy; purulent left ovary | Wound Classification IV |
| Hernia repair; mesh utilized | Wound Classification I |
| Open reduction internal fixation (ORIF) open fracture | Wound Classification III |
| Incision & drainage of groin. STAT gram stains indicates gram-negative rods. | Wound Classification IV |
| Gunshot wound to abdomen; bowel resection & liver laceration repaired | Wound Classification III |
| Released from the damage cells to cause the inflammatory response | Histamine |
| Normal wound healing occurs | side to side |
| Five signs of the inflammatory response | pain heat redness swelling loss of function |
| 3 phases of normal (primary intention) wound healing | phase 1: Lag; inflammatory; last 3-5days phase 2: proliferation; up to day 20 phase 3: maturation/remodeling; up to 12 mos. |
| Granulation tissue occurs from inside-out and bottom-upward | 2nd intention |
| Incision opened under ideal conditions; minimal scar | 1st intention |
| Delayed closure | 3rd intention |
| Produces a weak union with a wide irregular scar | 2nd intention |
| Wound debrided then closed 4-6 days later to heal | 3rd intention |
| Used for dirty wounds, produces intermediate scar/TS | 3rd intention |
| Incision made with rapid wound healing to 70%-80% original streangth | 1st intention |
| Routine negative breast biopsy closure (mammogram) | 1st intention |
| Which type of healing is most likely used for debucutis ulcer | 3rd intention |
| Which type of healing is most likely to be used initially for a ruptured appendix | 1st intention |
| Describe the appropriate tissue handling techniques that should be utilized during any case | -length & direction of incision -dissection technique -duration of surgery -elimination of dead space -amount of tissue handling -achievement of hemostasis -precise tissue approximation -suture wound closure |
| Five causes of wound dehiscence | 1.friable tissue 2.abdominal distention 3.too much tention on the wound 4.inappropriate type/strength of suture material 5.improper suturing technique |
| difference between dihiscence and eviseceration | dehiscence is partial or total separation of wound evisceration is total separation & protrusion of viscral organs |
| most likely to be a factor in the cause of dehiscence | vertical incisions |
| Measures the STSR can take to prevent wound infections | -use scrupulous sterile technique -close dead space -handle tissue carefully -remove gross material -respond proactively to propable intective agents |
| Measures the STSR can take to prevent wound dehiscence | -avoid long paramedian incision -provide careful, adequate closure -retention suture on intra-abdominal pressure |
| when cutting suture for the surgeon on a monofilament suture for skin closure with a "tag", you would typically cut the suture approx. _________from the knot | 1/4 ends |
| when cutting suture for the surgeon on a multifilament suture inside the wound with a "tag", you would typically cut the suture approx. _________from the knot | 1/8 ends |
| large vessels are typiclly occluded with suture ligatures or ____________ to prevent hemorrhage | stick-tie |
| the most common sizes of suture ligatures are ______ and ______ and are made of _______ suture material | 2-0 3-0 silk |
| when passing ligature reels, check the size by the number of holes on the side of the reel & always pull the strand approx. ____ inch away from the reel | 1 |
| the needle should be clamped approx. ___ of the distance from the swaged end of the needle. if tough tissue is anticipated, the needle should be clamped at the ___ mark of the needle | 1/3 1/2 |
| Always wet ______ sutures prior to passing to the surgeons | cotton |
| If a muscle has been transversly incised and must be approximated, you would be prepared to supply the surgeon with an _______ suture | absorbable |
| the skin is usually closed with an interrupted or continuous _________,_________ suture on a ______cutting needle | monofilament nonabsorbable cutting |
| the preferred method of skin closure is _______ suture line to prevent bacteria and tissue from traveling the length of the wound | interrupted |
| skin closure tapes | reinforces subcuticular stitch-skin must be dry |
| stapler | approximation with noncrushing B-shaped steal |
| traction suture | nonabsorbable suture placed into a structure to retract |
| bridge or bolsters | device prevents pressure from secondary suture line loop |
| pursestring suture | circular stitch placed to close an opening or invert tissue |
| vessel loop | used for isolation, retention, temporary occlusion of vessels |
| umbilical tape | premoistened and loaded onto hemostat |
| button | device used for tendon repair |
| preknotted | endoscopic suturing |
| describe tensile strength & identify what factors affect the tensile strength of the suture | the maximum strength a material can with stand factors: type of suture, pressence of infection, tissue sites, absorbtion |
| identify one suture with very strong tensile strength | stainless steel |
| describe pliability | how easily they pass through tissue how easily they tie and how secure the knots are |
| describe how to remove memory | sutures should be drawn between gloved fingers |
| identify one suture with memory | polyglycolic acid (dexon) |
| The type of stapler that delivers two double staple lines and contains a knife to transect tissue is called a | linear cutter |
| A device used to anastomose tubular structures such as the colon is called a(n) | intraluminal (circular) staples |
| synthetic material used for fascia defects as a reinforcement or bridge between structures is called | polypropelene mesh |
| when using ______eyed needles, pull the suture into a v-shaped area; however, there is more tissue damage than with use of a swaged needle | french |
| a suture with a needle on each end of the suture strand is called a | double arm attachment |
| a suture designed to be removed with a quick pull is called | eyeless needle |
| when using a needle on the skin, you would typically use a _______ needle | cutting |
| when using a needle on delicate gastrointestinal tissue, you would typically use a ________needle | tapered |
| when using a needle on friable tissue such as the liver or kidney, you could use a ________ needle | blunt |
| the most common used body shape is the _______ circle | 1/2 |
| the most commonly used body shape for skin closure is the ____ circle | 3/8 |
Created by:
E.Ochoa
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