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Chap11
Terms to know
51
Medical
Undergraduate 1
06/25/2024

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Term
The goal of postoperative wound care is:
Definition
Prevention of infection and other complications
Term
How do we prevent infection and other complications?
Definition
By using drains and different types of dressings to protect the wound
Term
Wound Drains
Definition
Devices that have been designed to remove unwanted fluids or gases from the body, perioperatively.
Term
Identify parts of wound drains
Definition
[image]
Term
Purpose of dressings is to:
Definition
Provides an optimal physiological environment to promote wound healing. Sterile technique and standard precautions must be employed.
Term
Dressing are changed how often
Definition
Within 48 hours of initial application, or if the wound is open/infected
Term
How are superficial tissues treated?
Definition
Generally left open and packed loosely with a fine mesh gauze, such as iodoform
Term
For superficial tissue wounds, how soon is packing removed?
Definition
After 4-5 days
Term
If a superficial wound is still present after packing, how is it allowed to heal?
Definition
By second intention, and the wound should be re-packed 2X daily with wet to dry dressings
Term
The surgeon selects the BEST suture for the:
Definition
» Particular task and patient
Term
The surgeon selects the best wound closure technique that:
Definition
Provides optimal patient recovery
Term
Absorbable suture material is
Definition
Capable of being absorbed by tissue within a given period of time
Term
Nonabsorbable sutures
Definition
Resist enzymatic digestion or absorption by tissue
Term
Monofilament suture material
Definition
Made of a single threadlike structure
Term
Mutifilament suture material
Definition
Consists of multiple thread-like structures braided or twisted into a single strand
Term
Monofilament description
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
Term
Capillarity
Definition
The capability to harbor bacteria
Term
Multifilament description
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
Term
Barbed sutures
Definition
Have points that extend from the surface that anchor to tissues rendering the suture knotless
Term
The function of sutures is to:
Definition
Support healing tissues by holding tissue edges together until they heal
Term
The elasticity of sutures helps:
Definition
Accommodate tissue swelling and strains placed on the wound by coughing or body movements
Term
The body treats sutures as:
Definition
Foreign material with the exception of surgical steel
Term
Natural sutures are made of:
Definition
Cellulose, animal products or tissue. They are digested by body enzymes that attack the suture strand
Term
Synthetic sutures are made of:
Definition
Polymers from petroleum-based products. They are then hydrolyzed by the body (by water in the tissues)
Term
The first choice for tissues that do not need continued support are:
Definition
Absorbable sutures
Term
Where continued strength is necessary, the suture of choice is:
Definition
Nonabsorbable sutures
Term
The continued strength of nonabsorbable is necessary for these areas:
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
Term
Silk sutures are commonly used for:
Definition
Ligating Vessels (tying off)
Term
***The normal strength and healing characteristics of a tissue are modified by the condition of:
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)

Term
How do diseases affect suture choice?
Definition
It disrupts metabolic processes, which, in turn modify the condition of the tissues
Term
What are some diseases that affect suture choice?
Definition
Diabetes, Systemic infection, Localized infection, immune system diseases, pituitary gland dysfunction
Term
****Suture lengths range from:
Definition
5in to 59in
Term
Physical Characteristics of a suture include:
Definition
Configuration, Capillarity, Ability to absorb fluids, and size
Term
Physical characteristics of a needle are
Definition
The point (sharp end), The body, the Swage (the blunt tip end), and the suture material
Term
Tensile strength should equal
Definition
Tissue strength
Term
****Knot Strength
Definition
Is measured by the force in pounds that the suture strand can withstand before it breaks
Term
Elasticity of sutures
Definition
Helps healing because it adapts to changing tissue such as swelling without cutting into the tissue
Term
Memory of suture
Definition
The tendency to return to its original shape after being deformed by tying
Term
****Size of the suture indicates
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
Term
****Which suture sizes are typically used for aortic anastomosis?
Definition
4-0 and 5-0
Term
****Which sutures are used frequently for closure of orthopedic wounds and abdominal fascia?
Definition
Sutures 1 and 0
Term
****Which sutures are used for smaller vessel anastomoses such as on the coronary and carotid arteries?
Definition
6-0 and 7-0
Term
Which sutures are used for microvascular and eye procedures?
Definition
8-0 through 11-0
Term
Which sutures are used for subcuticular skin closures?
Definition
3-0 and 4-0
Term
Controlled release (CR) suture needles are designed to:
Definition
POP off
Term
****Plain gut suture made from collagen of beef intestine or submucosa of sheep intestine
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
Term
Chromic gut sutures
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
Term
Polydioxanone (PDSII) Polyester polymer suture
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  
Term
Poliglecaprone 25 (Monocryl) Copolymer of glycolide and epsilon-caprolactone suture
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
Term
Polyglactin 910 (Vicryl)
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 
Term
Nylon (Ethilon by Ethicon; Dermalon and Monosof by Syneture) Synthetic fiber polyamide polymer of coal, air, water
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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