Wound Closure Flashcards
(40 cards)
Multifilament nonabsorbable
surgical silk
braided nylon - Nurolon, Surgilon
surgical cotton
Braided nylon
multi. nonabsorb
Nurolon, Surgilon
similar to silk but stronger and coated
Polypropylene
Mono. nonabsorb
Prolene, Surgilene - one of the most inert
useful in infection
vascular anastamosis repair
Nylon
Mono. nonabsorb
Ethilon, Dermalon
opthalmic
microsurgery
tendon repair
Polyglycolic acid
multi. absorbable
Dexon
little memory
ties easily
good knot security
Polyethylene terephthate
synthetic
Ethibond, Dacron
coated with polybutilate
used to close heart defects
tendon repair
Multifilament absorbable
polyglactin 910 - Vicryl
Polyglycolic acid - Dexon
Polyglactin 910
synthetic multi. absorbable
Vicryl
most popular
ties easily
secure knot
Surgical cotton
multi. nonabsorb
umbilical tape
vessel/duct isolation
easy secure knots
no memory
Blunt point needles
kidney/liver surgery
round shaft, blunt tip
Intraluminal staples
EEA, CEEA
Loading the suture
use right needle holder based on size, surgeon’s preference, depth of wound
1/4-1/2 distance from swage to point
Conventional cutting needle
tough tissue difficult to penetrate (ligament)
3 cutting edges on inner curve
small cut in direction of the pull of suture
Keith
straight needle
used on skin
1/2 circle
Stapling device
minimal tissue trauma
stainless steel, titanium, absorbable for anastamosis or approximation
ligation
disposable or reusable
Tapered point needles
GI
round shaft - no cutting edge
Ferguson needle - half circle delicate tapered shaft
SH shit needle
Skin closure
Polypropylene/nylon preferred
continuous locking runs across incision
interrupted or cutaneous monofilament nonabsorbable on a cutting needle
stainless steel staples
wound scars more than subQ
remove stitches
Suture ligature
stick tie
occlude large vessels to prevent suture slippage
swaged atraumatic needle on needle holder
through center of vessel after clamp
ends of suture brought around clamp to double ligate
Retention suture
large gague
interrupted nonabsorbable
lateral to primary closure
through all tissue layers
used in wounds that may be disrupted
Accessory devices
bridges + bolsters
keep retention sutures from cutting into the skin
bridges are plastic
bolsters are plastic or rubber
Pledget
exert pressure to seal bleeding
small pieces of teflon felt used to buttress sutures
when friable tissue might tear
bleeding might happen through needle hole in major vessel
Uses for pledget
cardiomyotomy
over arteriotomy sight
cardiac surgery
Traction suture
retract structures
nonabsorbable suture into or around structure
ends always clamped with hemostats
Emergency stitch
3-0 Vicryl on a SH needle
