Surgery I - Suture Word Scramble
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| Question | Answer |
| What is the first and most important principle of wound care? | Copious irrigation and adequate debridement The solution to pollution is dilution! |
| To minimize scars, wound closures should run parallel to which connective tissue bundles? | Langer's lines |
| When should wound closure be delayed? | If the wound is contaminated or if the time elapsed from injury exceeds 8 hours |
| Which wound types should never be closed? | Puncture wounds, human bites, or grossly infected wounds |
| What type of forceps should be used: 1. On the skin 2. On delicate internal tissue | 1. Adson or 3-4s (teeth) - Addison on ga has nice teeth 2. Debakey (smooth) - Debbie does dallas has a smooth ass |
| What is the general rule for skin closure regarding wound edges? ** | Approximate, do not strangulate |
| How long should sutures be left in: ***** 1. on the face and neck? 2. trunk? 3. UE's? 4. LE's? | 1. 3-5 days 2. 7-10 days 3. 10-12 days 4. 12-16 days |
| In which patient populations should sutures be kept in longer than usual? | IN those who are immunosuppressed, on steroids, or who have poor nutrition, including those with diabetes and peripheral vascular disease |
| How should hair be removed in preparation for surgery or wound repair | Using clippers Note: Never shave eyebrows |
| Where should epinephrine never be used and why? | On tissues with poor collateral circulation such as the nose, fingers, or ears as it may cause ischemia |
| Name two basic kinds of suture | Braided and monofilament |
| What is an advantage of a monofilament suture? | Causes less trauma and inflammation as it passes through tissue |
| What is an advantage of braided suture? | Has less tendency to kink or curl and requires fewer knots to be held into place |
| List four types of absorbable sutures | Plain gut, chromic gut, Dexon and Vicryl |
| What is the source of plain and chromic gut? | Bovine small intestine |
| Which has more tensile strength, plain or chromic? | Chromic (14-21 days) Plain (7-14 days) |
| How long is tensile strength retained in Dexon and Vicryl? | 14-21 days |
| Name the most common nonabsorbable sutures | silk, nylon, polypropylene, steel |
| Which suture type is the most widely used and why? | Silk - easy to manipulate and strong (braided) |
| What is an advantage to using braided synthetic over silk? | Synthetics are less reactive than silk |
| What is an advantage of using steel suture? | It retains its strength and can be twisted down to any desired degree of tension |
| Which body part is the only one in which steel suture is still used? | Chest - closing sternotomy wounds |
| What size suture would you use in the following areas? 1. Chest 2. Abdomen 3. Skin 4. Blood vessels 5. Eye surgery | Largest is No. 7 smallest is 11-0 1. No. 6 2. No. 1 3. 3-0 4. 5-0 thru 7-0 5. 8-0 thru 10-0 |
| What is the name for the site of suture attachment on a surgical needle? | Swage |
| List the four characteristics used to describe suture needles | Eye, shape, point and size |
| Which needle point is used in the following areas? 1. skin 2. soft tissue and fascia 3. prosthetic grafts 4. liver | 1. conventional cutting 2. taper 3. ground point wire 4. blunt |
| How far from the wound edge should an interrupted stitch be placed? | 4-5 mm |
| Which is the dominant knot used in surgery? | Square knot |
| What is the surgeon's knot? | A square knot with a double first throw |
| What must be done differently when using a nylon suture as compared to a silk suture? | Additional throws are necessary to secure the knot when using nylon sutures |
| What is the most useful and most commonly used suture closure? | Simple interrupted |
| Which type of skin closure has the best cosmetic result? | Subcuticular closure |
| Should wound edges be inverted or everted? | Wound-edge eversion is paramount to achieving a cosmetically acceptable scar |
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eedavila
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