Chp 55 Drapes Sutures Needles
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Created by:
Sarathaimoon on March 12, 2012
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24 terms
Terms | Definitions |
|---|---|
 Disposable surgical drapes | - are available in several diff. materials and sizes and typically have an opening (fenestration) for the operative site. - the drape is placed over the operative area using sterile technique after the pts skin preparation has been completed. This procedure is in chp 56. |
| Fenestration | opening |
| Sutures | - the word suture is used as both a noun and a verb. - a noun it refers to a surgical stitch or the material used to close a wound. - as a verb - it is the act of stitching. - 1865 LISTER - made antisepsis and the disinfection of suture materials. PURPOSE: to hold the edges of a wound together until natural healing can occur. ** sutures are sized according to the USA Pharmacopoeia (USP) scale. - a suture may also be used as a LIGATURE. |
| Suture Materials (in past) | - precious metals - horse hair - animal tendons - cotton and linen cord. - catgut |
| Ligature | - is a strand of suture material used to tie off a blood vessel or to strangulate tissue. - if a ligature is used to tie off an internal tubular structure, it must last permanently or long enough for the structure itself to disintegrate. |
| Ideal Suture Material - 4 ideas | - easy to handle and makes a secure knot - does not induce a localized tissue reaction and is nonallergenic - has adequate strength w/out cutting through tissue - can be sterilized. |
| physicians preferrence | - based on specific properties - desirable rate of absorption or nonabsorbable - natural or synthetic - absorbable - nonabsorbable. - suture size and packing. |
| Absorbable Sutures | - is dissolved by the bodys enzymes during the healing process - is used when deep incisions or lacerations require inner layers of sutures to close the wound - used in areas where suture removal is difficult such as oral surgery - ex) catgut, made from pig, sheep, cattle intestine. - plain catgut - used in tissues that heal most rapidly such as mucosa and subcutaneous tissues. |
| plain catgut - absorbable | - used in tissues that heal most rapidly such as mucosa and subcutaneous tissues. - breaks down in 1 week. |
| Chromic catgut -absorbable | - is coated with chromic salts which delays the absorption of the suture material up to 80 days. |
| catgut - absorbable | - was once the suture material of choice but has been replaced by Vicryl. |
| Vicryl - absorbable | - is a synthetic absorable suture made of polyglactin. |
| other materials absorbable | - Dexon, PDS, Maxon. - remain stable longer than natural catgut. - up to 11 weeks - allowing the wound to heal completely before absorption. |
| Nonabsorbable Suture | - is left in the wound site until healing is complete - frequently used in minor surgical procedures. - most suturing is superficial. - in areas where sutures can be removed after healing has taken place. |
| silk - non-absorb | - is stron and is easy to tie. it is treated with a coating to prevent tissue drag and flaking. |
| polyester non-ab | such as Dacron and Prolene, are among the strongest non-ab sutures in league with surgical steel. fine filaments are braided and have great tensile strength. |
| nylon - non-ab | is strong and has a high degree of elasticity - it is primarily used for skin closure. - owing to elasticity and stiffness, many knots must be used b/c the knots tend to untie if placed incorrectly. |
| Surgical staples non ab | - skin closure. - they are made of stainless steel - made of titanium - made in multi sizes. - inserted and removed with tools. |
| Steri-Strips non ab | - which are self adhesive tapes that are placed over the wound, pulling the wound ends together. - can be used to support a wound if there is a potential tension at the site. - or for superficial wounds such as a laceration of the forehead. |
| Tissue adhesives | similar to glue can be used for superficial wounds. |
| Suture Size and Packaging | - suture material comes in a variety of diameters and lengths. diameter - of the suture strand determines its size, with the smaller gauges numbered below 0 (pronounced AUGHT) and the larger gauges identified with numbers above 0. ex) 2-0 is thinner than size 0, which is thinner than size 2. - the sizes from 2-0 to 6-0 are used most frequently in the medical office. - the length - of suture varys but strands precut in 18, 24, 54, and 60 inch lengths. |
| ZERO / 0 | Aught |
| Needles | - are chosen according to area in which they are used and the depth and width of the desired suture. they are classified according to: - shape - straight/curved - most sutures are applied with curved needles because they allow the phy to penetrate the surface then come back up again on the other side. - the sharper the curve of the needle, the deeper the surgeon can pass into the tissue. - needle point can: - taper - or cutting edge - a taper is used on delicate tissues. - a cutting edge - is used on the skin, it lacerates the skin as the needle is passed through, advantageous on tougher tissues like connective tissue. * most needles are made with the thread attached or SWAGED. * atraumatic needles do not have an eyelet and cause the least amount of tissue trauma as they are used. * packaged as a single, individual pack, or multipack. ****The most common needle type used for minor skin repair is the curved, cutting - edged, swaged, needle. |
| Suture Sizes | 6-0 = .07mm 5-0 = .10 mm 4-0 = .15 mm 3-0 = .20 mm 2-0 = .30 mm 0 = .35 mm 1 = .40 mm 2 = .5 mm |
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