Term
| Maximum stress that a material can withstand while being stretched or pulled before necking, which is when the specimen's cross-section starts to significantly contract |
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Definition
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Term
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Definition
1.Obliteration of dead space
2. Even distribution of tension along deep suture lines
3. Maintenance of tensile strength across the wound until tissue tensile strength is adequate
4. Approximation and eversion of the epithelial portion of the closure |
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Term
| Essential suture Characteristics |
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Definition
Sterility
Uniform diameter and size
Pliability for ease of handeling and knot securtiy
Uniform Tensile strength by suture type and size.
Freedom from irritants or impurities that would elicit tissure reaction |
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Term
| What causes Scarring with suturing? |
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Definition
The suture material is a foreign body in the human tissue and can cuase a reaction.
Porr suture selection and or poor technique can cause excessive tension across wound leading to hypertrophic scars, wide scars and wound dehiscence. |
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Term
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Definition
Collagen
Synthetic absorbable
Nonabsorbable |
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Term
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Definition
more zeroes = smaller strand diameter 4-0 0000 is larger than a 5-0 00000
smaller the suture the less tensile strength of the strand. |
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Term
| Collagen sutures are used for? |
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Definition
it is called plain gut (bovine)
used for short term epidermal use ONLY
Not recommended for internal use |
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Term
| Synthetic Absorbable is used for? and what kinds are there? |
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Definition
Used for General soft tissue and vessel ligation. causes minimal tissue reaxn.
Vicryl, Monocryl and Copolymer of polyglactin...... Dexon II is similar |
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Term
| At suture that is self anchoring and knots are not required for wound closure. |
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Definition
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Term
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Definition
silk-made of raw silk spun
coated silk with beeswax or silicone
surgical cotton
surgical steel
Nylon Polyester fiber |
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Term
| Preserve tensile strength of absorbable surture: |
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Definition
surgical gut have to be rinsed before use and kept wet
synthetic absorbable: must be kept dry
donot test strand stregth
Do not resterilize |
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Term
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Definition
smallest suture that adequately holds healing wound edges together
Tensil strength of suture should never exceed tensile strength of tissue
as wound heals relative loss of suture strength overtime should be slower than the gain of tissue tensile strength |
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Term
| Deep dermal or buried sutures should be what type: |
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Definition
Absorbable Sutures
Vicryl Dexon Monocryl, PDS |
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Term
| Superficial sutures monofilament |
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Definition
Nylon (ethilon)
Polypropylene (Prolene) |
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Term
| Needle has 3 sections: name them |
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Definition
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Term
In Cutaneous surger there are 2 main types of needles?
which is used more often |
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Definition
cutting and reverse Cutting
Reverse Cutting |
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Term
| Incorrect placement of needle in needle holder may result in |
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Definition
bent needle
difficult penetration
undisirable angle of entry |
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Term
| Needle holder is held how? |
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Definition
| thumb and 4th finger with index finger on the fulcrum |
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Term
| Forceps are used in suturing to do what? |
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Definition
| stabilize the tissue to allow suture placement, grasping the needle as it exits the tissue, |
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Term
| Needles what is used most the time: curvature and needle tip |
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Definition
| 3/8 reverse cutting needle |
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Term
| suture size what is used for superficial facial lesions? |
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Definition
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Term
Suture Size?
Other superficial skin lesions not on the face:
low skin tension areas
higher skin tension areas |
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Definition
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Term
| What is the largest suture size? |
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Definition
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Term
| Suture size for skin of Foot or deep tissure of Chest, abdomen, back |
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Definition
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Term
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Definition
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Term
| Wound eversion is essential why? |
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Definition
| to maximize the lielihood of good epidermal approximation: minimize scar depression secondary to tissue contraction during healing |
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Term
| Why is inversion not desirable? |
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Definition
| bc it probably does not decrease the risk of hy[ertrophic scarring in an individual with a propensity for hy[ertrophic scars |
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Term
Rule of Halves
what is it and why do we do it? |
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Definition
| matches wound edges better, avoids dog ears, rule may vary when too much tensiono across wound |
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Term
| How do you follow the needle arc and why |
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Definition
rotate your wrist to follow arc when you take bite
minimize trauma to the skin
follow path of least resistance |
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Term
| Horizontal Matress is used when? |
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Definition
| For closure of gaping or high-tension wounds or wounds on fragile skin, the horizontal mattress technique may be preferred because it spreads the tension along the wound edge |
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Term
| Vertical Mattress used when |
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Definition
| In areas that tend to invert, such as the posterior aspect of the neck or concave skin surfaces, the vertical mattress technique allows eversion of the wound edges |
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Term
| Half Buried suture used when? |
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Definition
| A variation known as the half-buried mattress (corner) suture is ideal to close a triangular edge because it does not compromise the blood supply and may therefore reduce necrosis of the tip |
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Term
| Running suture used when? |
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Definition
1. Long, low-tension wounds are best treated with a running ("baseball") suture
2. Small lacerations on the face or in other low skin-tension areas where cosmesis is an important consideration should be treated with a subcuticular running suture
3. Although the ends of this suture do not have to be tied, they may be secured with slip knots or tape |
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Term
| Suturing: finishing touch |
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Definition
1. After sutures placed, clean the site with normal saline
2. Apply a small amount of Bacitracin and cover with a sterile non-adherent dressing |
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Term
| Removal times for Scalp Face Ear Chest/abdomen |
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Definition
| face 4-5 days Ear 4-5 days Scalp 6-8 days Chest/abdomen 8-10 days |
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Term
| removal of suture times Back Arm/leg Hand Fingertip Foot |
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Definition
| Arm/leg 8-10 days Hand 8-10 days fingertip 10-12 days foot 12-14 days Back 12-14 days |
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Term
Presence of a condition delaying wound healing (chronic corticosteroid use, DM)
suture removal timing should be? |
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Definition
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Term
| Any suture with pus or signs of infections should be? |
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Definition
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Term
| Process for suture removal? |
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Definition
1.clean with antiseptic
2.pick one end of suture with forceps.. cut as close to skin where suture enters the skin
3.to prevent infection suture should be removed without pulling any portion that has been outside the skin back through the skin
4. collect suture material on a 4x4 |
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Term
A sterile liquid topical skin adhesive
reacts with moisture on skin surface to form a strong flexible bond
only for easily approximated skin edges of wounds |
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Definition
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Term
Lidocaine with Epi
does what? |
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Definition
Vasoconstiction
decreased bleeding
prolongs duration
strength .5% and 1%
max dose 7mg/kg or 500mg |
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Term
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Definition
| anesthetic solution slow onset long duration strength .255%, .55, .75% max dose 2mg/kg or 400mg |
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Term
| antiseptic Injection technique |
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Definition
check allergies
insert needle at the inner wound edge
inject agent into tissue slowly avoid burning
wait
after anesthesia has taken effect suturing may begin |
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Term
| what is a complicated wound? |
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Definition
wounds or lacerations with nerve, tendon, major vessel involvement
wounds or lacerations of the Eye, Eyelids, Bites, severely contaminated wounds
wounds entering the thoracic or abdominal cavities |
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Term
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Definition
time of incident
size of wound
depth of wound
tendon/nerve involvement
bleeding at site |
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Term
| Contraindications to suturing |
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Definition
Redness
Edema of the wound margins
Infection
Fever
Puncture wounds
animal bites
Tendon nerve or vessel involvement
Wounds more than 12 hours old |
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Term
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Definition
Most important step for reducing the risk of wound infection
Remove all contaminants and devitalized tissue before wound closure:
irrigate with saline
remove dead, fragmented tissue
If not, the risk of infection and of a cosmetically poor scar are greatly increased |
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Term
| Methods for mechanical wound closure include |
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Definition
| Staples, tape, adhesive and sutures |
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Term
| Does suture closure permit pimary or secondary wound healing? |
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Definition
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Term
| tissue reactivity to sutures peaks? |
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Definition
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Term
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Definition
monofilament (less risk of infection)
Braided multifilament ( easier to handle and tie) |
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Term
| Knot strength of suture is: |
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Definition
| force required for a knot to slip |
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Term
| High memory suture means what? |
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Definition
| stiff suture that can untie easilty |
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