Term
The goal of postoperative wound care is: |
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Definition
Prevention of infection and other complications |
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Term
How do we prevent infection and other complications? |
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Definition
By using drains and different types of dressings to protect the wound |
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Term
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Definition
Devices that have been designed to remove unwanted fluids or gases from the body, perioperatively. |
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Term
Identify parts of wound drains |
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Definition
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Term
Purpose of dressings is to: |
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Definition
Provides an optimal physiological environment to promote wound healing. Sterile technique and standard precautions must be employed. |
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Term
Dressing are changed how often |
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Definition
Within 48 hours of initial application, or if the wound is open/infected |
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Term
How are superficial tissues treated? |
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Definition
Generally left open and packed loosely with a fine mesh gauze, such as iodoform |
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Term
For superficial tissue wounds, how soon is packing removed? |
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Definition
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Term
If a superficial wound is still present after packing, how is it allowed to heal? |
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Definition
By second intention, and the wound should be re-packed 2X daily with wet to dry dressings |
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Term
The surgeon selects the BEST suture for the: |
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Definition
» Particular task and patient |
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Term
The surgeon selects the best wound closure technique that: |
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Definition
Provides optimal patient recovery |
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Term
Absorbable suture material is |
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Definition
Capable of being absorbed by tissue within a given period of time |
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Term
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Definition
Resist enzymatic digestion or absorption by tissue |
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Term
Monofilament suture material |
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Definition
Made of a single threadlike structure |
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Term
Mutifilament suture material |
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Definition
Consists of multiple thread-like structures braided or twisted into a single strand |
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Term
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Definition
Relatively inert (high tensile strength), Doesn't readily harbor bacteria, glides through tissues more easily, does minimal tissue damage in part due to the little resistance that they face |
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Term
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Definition
The capability to harbor bacteria |
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Term
Multifilament description |
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Definition
more prone to capillarity, retains tissue fluids, not to be used in the presence of infection, holds knots securely, Greater tensile strength, pliability and flexibility, Coated for enhanced handling capabilities and easier passage through tissues |
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Term
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Definition
Have points that extend from the surface that anchor to tissues rendering the suture knotless |
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Term
The function of sutures is to: |
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Definition
Support healing tissues by holding tissue edges together until they heal |
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Term
The elasticity of sutures helps: |
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Definition
Accommodate tissue swelling and strains placed on the wound by coughing or body movements |
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Term
The body treats sutures as: |
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Definition
Foreign material with the exception of surgical steel |
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Term
Natural sutures are made of: |
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Definition
Cellulose, animal products or tissue. They are digested by body enzymes that attack the suture strand |
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Term
Synthetic sutures are made of: |
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Definition
Polymers from petroleum-based products. They are then hydrolyzed by the body (by water in the tissues) |
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Term
The first choice for tissues that do not need continued support are: |
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Definition
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Term
Where continued strength is necessary, the suture of choice is: |
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Definition
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Term
The continued strength of nonabsorbable is necessary for these areas: |
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Definition
Any abnormal opening in the heart, Closing dura matter over the brain/spinal cord, and for the fascia and skin closure. Has slow healing |
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Term
Silk sutures are commonly used for: |
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Definition
Ligating Vessels (tying off) |
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Term
***The normal strength and healing characteristics of a tissue are modified by the condition of: |
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Definition
The proteins and carbohydrates in the body
Vascularization, Radiation therapy and metabolic factors, Age, Weight, Incision relative to fiber direction, thickness of tissue, amount of devitalized-weak tissue within a wound, and whether suffering from edema (hardening and thickening of tissue) |
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Term
How do diseases affect suture choice? |
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Definition
It disrupts metabolic processes, which, in turn modify the condition of the tissues |
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Term
What are some diseases that affect suture choice? |
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Definition
Diabetes, Systemic infection, Localized infection, immune system diseases, pituitary gland dysfunction |
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Term
****Suture lengths range from: |
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Definition
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Term
Physical Characteristics of a suture include: |
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Definition
Configuration, Capillarity, Ability to absorb fluids, and size |
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Term
Physical characteristics of a needle are |
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Definition
The point (sharp end), The body, the Swage (the blunt tip end), and the suture material |
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Term
Tensile strength should equal |
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Definition
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Term
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Definition
Is measured by the force in pounds that the suture strand can withstand before it breaks |
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Term
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Definition
Helps healing because it adapts to changing tissue such as swelling without cutting into the tissue |
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Term
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Definition
The tendency to return to its original shape after being deformed by tying |
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Term
****Size of the suture indicates |
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Definition
The diameter of the suture material. This is also referred to as the gauge. Smaller sizes minimize the tissue trauma and the amount of foreign material implanted in the body |
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Term
****Which suture sizes are typically used for aortic anastomosis? |
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Definition
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Term
****Which sutures are used frequently for closure of orthopedic wounds and abdominal fascia? |
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Definition
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Term
****Which sutures are used for smaller vessel anastomoses such as on the coronary and carotid arteries? |
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Definition
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Term
Which sutures are used for microvascular and eye procedures? |
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Definition
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Term
Which sutures are used for subcuticular skin closures? |
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Definition
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Term
Controlled release (CR) suture needles are designed to: |
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Definition
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Term
****Plain gut suture made from collagen of beef intestine or submucosa of sheep intestine |
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Definition
- Absorbable natural monofilament
- Digested by enzymes within 70 days
- Tensile strength maintains for the first 7-10 days
- Has moderate tissue reaction with no coating
- Used to ligate superficial blood vessels and the subcutaneous
- Suture color is yellow
- Absorbed faster in presence of infection. Not to be used on tissues under stress. Not for use in CV and neurology. Packaged in alcohol; avoid opening near surgical wound
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Term
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Definition
- Absorbable natural monofilament
- Is absorbed within 90 days
- Tensile strength maintained between 10 and 14 days
- Moderate tissue reaction but less than plain gut with no coating
- Used to ligate superficial blood vessels and subcutaneous
- Beige/tan suture color
- Not used for tissues under stress, CV or neurology
- Packaged in alcohol
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Term
Polydioxanone (PDSII) Polyester polymer suture |
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Definition
- Absorbable synthetic monofilament
- Mostly absorbed by day 90 but completely gone within 6 months
- Tensile strength is at 70% at 2 weeks, 50% at 4 weeks and 25% at 6 weeks
- It has minimal tissue reaction and comes without coating
- Used on all types of soft tissue approximation, including orthopedics, gynecology, eye, plastic, digestive and pediatric CV
- Suture color is Clear, blue or violet
- Exhibits low affinity for microbes, good pliability, little memory
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Term
Poliglecaprone 25 (Monocryl) Copolymer of glycolide and epsilon-caprolactone suture |
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Definition
- Absorbable synthetic monofilament
- absorbed by hydrolysis within 91-119 days
- Loses tensile strength by day 21 if undyed and 28 if dyed
- Minimal tissue reaction with no coating on it
- used for soft tissue approximation and ligation
- Suture color is undyed or violet
- Undyed should not be used on fascia. should not be used on neural, CV, eye tissues, or microsurgery. good know security and pliability
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Term
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Definition
- Absorbable synthetic multifilament
- Absorbed completely in about 50-60 days and partially by day 40
- For sutures bigger that 6-0 tensile strength is 75% by 2 weeks and 50% by 3 weeks. For sutures smaller than 7-0 tensile strength is 40% by 3 weeks
- Minimal tissue reaction
- Coating of non-flaking lubricant
- used for tissues that need long term tensile strength and for soft tissue approximation
- suture color violet
- Good knot security and no memory
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Term
Nylon (Ethilon by Ethicon; Dermalon and Monosof by Syneture) Synthetic fiber polyamide polymer of coal, air, water |
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Definition
- Nonabsorbable synthetic Monofilament
- Degrades at a rate of 15-20% a year
- Minimal tissue reaction and no coating
- Used for general soft tissue approximation and ligation
- Suture color is undyed, black, blue, or green
- Memory of suture strand requires more throws in the knot. More pliable and easier to handle when damp. Gradual encapsulation by fibrous connective tissue
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