Oral Board Study Guide Flashcards
(26 cards)
What is the bleeding situation for the SURGICEL family?
Continuous Oozing: Bleeding that will not stop with compression packing, solution is more time consuming than difficult.
What is the Mechanism of Action for the SURGICEL family?
When SURGICEL meets moisture, the cellulose breaks down and releases glucuronic acid, lowering the pH, ultimately giving SURGICEL bactericidal and vasoconstrictive properties. As blood continues to be absorbed, it swells into a gelatinous mass which supplies a matrix that promotes adhesion and aggregation, or platelet plug formation.
What are the Indications for the SURGICEL Family?
SURGICEL is used adjunctively in surgical procedures to assist in the control of capillary, venous, and small arterial hemorrhage when ligation or other conventional methods of control are impractical or ineffective.
Describe why Surgicel is proven bactericidal against a range of gram positive and gram negative organisms in vitro.
Under normal conditions, pH of blood is 7.4, moisture causes cellulose in SURGICEL break down, releasing glucuronic acid (pH of 2.5). The release of glucuronic acid decreases the pH of blood below 4.4 locally at the surgical site which means bacteria cannot proliferate in low pH environments and will die.
What are the key features and benefits of SURGICEL Powder compared to ARISTA AH?
-SURGICEL Powder offers 89% faster time to hemostasis compared to ARISTA AH as demonstrated in vitro.
-Powder induces vasoconstriction
-Demonstrated in-vitro Powder can penetrate the source of the bleed resulting in a durable clot that can be irrigated easily
-ARISTA floats at the surface and powder penetrates for ARISTA particles are round
-Powder is the worlds #1 trust brand of hemostat with over 50 years proven in safety
-Powder demonstrated in vitro bactericidal activity against most common pathogens
What is the bleeding situation for SURGIFLO?
Difficult to access: bleeding that occurs in tight and irregular spaces and you cannot see the source of the bleed.
What is the Mechanism of Action for SURGIFLO?
-When used with thrombin, has both mechanical and biological hemostatic properties.
-Provides a matrix for platelet adherence, accelerating the formation of the platelet plug and when used with thrombin, aids in fibrin clot formation.
What are the Indications for SURGIFLO?
Indicated in surgical procedures as an adjunctive hemostat (not ophthalmic) when use of conventional methods to control bleeding by ligature is impractical or ineffective.
What is the bleeding situation for VISTASEAL?
Potential Re-Bleeding: Situation that may be address intraoperatively but could later develop into more serious complications especially in high-risk patients.
What is the Mechanism of Action for VISTASEAL?
VISTASEAL initiates fibrin clot formation through reaction of thrombin & fibrinogen to form a fibrin clot.
What are the indications of VISTASEAL?
For mild to moderate bleeding in adults when control of bleeding by conventional methods are ineffective. Is effective in heparinized patients.
What is the bleeding situation for EVARREST?
Problematic Bleeding: Problem and cannot continue without addressing the bleeding situation.
What is the Mechanism of Action for EVARREST?
The patch becomes hydrated when it touches blood. The active side with thrombin and fibrinogen create a reaction that initiates the last step in the cascade. They interact with the wound which helps form the fibrin clot. Hemostasis is achieved when the formed fibrin clot integrates with the patch and adheres to the wound surface providing a physical barrier to bleeding.
What are the Indications for EVARREST?
EVARREST is a fibrin sealant patch indicated for use with manual compression as an adjunct hemostasis in adult patients undergoing surgery when other ligation is impractical or ineffective.
What are the contraindications of EVARREST?
Cannot be used in place of suture or other forms of mechanical ligation in the treatment of major arterial or venous bleeding, and do not apply intravascularly.
What is the breaking strength retention and tissue closure application of VICRYL Plus (3-0 and larger)?
2 weeks- 75%
3 weeks- 50%
4 weeks- 25%
Tissue Closure: Ligation, General closure, Bowel, Orthopedics (GLOB)
What is the breaking strength retention and tissue closure application of MONOCRYL Plus (undyed)?
Un-Dyed: 50-60% at 1 week, 20-30% at 2 weeks
Tissue Closure: Ligation, Vaginal Cuff, Peritoneum, Bowl, Skin Repair (LVPBS)
What is the breaking strength retention and tissue closure application of PDS Plus?
2 weeks- 80%
4 weeks- 70%
6 weeks- 60%
Tissue Closure: Fascia, Pediatric CV and Ophthalmic Procedures, patients with compromised wound healing (P, W, F)
What is the antibacterial profiles of MONOCRYL and PDS?
Staph A, Staph E, MRSA, MRSE, E. Coli, Klebsiella Pneumoniae, Enterobacter Cloacae
What is the antibacterial profiles of VICRYL?
Staph A, Staph E, MRSA, MRSE
What are the key features, benefits, and claims of EVERPOINT?
Made of tungsten-rhenium, non-magnetic, 70% sharper, 38% stronger, 121% more bend resistant compared to stainless steel, and multi-layer silicone coating enabling smooth passage through tissue.
What are the key features of DERMABOND PRINEO?
-Provides a flexible 99% microbial barrier in vitro for 72 hours against bacteria for SSIs
-33% stronger than staples
-40% stronger than 4-0 Monocryl
-At removal, associated with less pain than other wound closure devices
What is the value proposition for STRATAFIX (SEC-P)?
Security: same strength interrupted closure without knots, multiple cuts in suture did not result in separation, only barbed suture for high tension areas such as fascia
Efficiency: No Knots, no need to an assistant to follow suture line, bites or passes through the tissue can be done in continuous technique to approximate the wound
Consistency: Enables surgeons to manage tension and approximation with each pass
Protection: Only barbed suture that has microbial barrier for 7 days or more
What is the initiation technique for each type of STRATAFIX?
Symmetric: Take the first pass directly adjacent to the apex. Take a pass in the intact tissue perpendicular to the initial pass to lock the stitch.
Spiral Uni: Start by taking a bite of the incision and pass the needle through the loop and cinch it. Once anchored take at least two loose passes.
Spiral Bi: Take a bite with one needle and pull with one needle until transition zone has reached tissue. Take two loose passes with each needle and cinch it.
