Ch 11 Surgical Technology for the Surgical Tech

Created by rafrench58 

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65 terms · Wound healing, sutures, needles, & stapling devices

Ground-point wire needle

Has a point with sharp edges, but the round body of a tapered needle

Ligation Clip

Used to occlude a single small structure, such as a blood vessel or duct

Linear Stapler

Inserts 2 straight, staggered, evenly spaced, parallel rows of staples

Polypropylene Mesh

A relatively inert material that can be used in the presence of infection

Linear Cutter

Delivers double line of staples; the blade passes between to divide the tissue

Trocar Points

Has 3 sharp cutting edges that end in a sharp cutting tip

Polyester Fiber Mesh

Least inert of synthetic meshes; should NEVER be used in presence of infection

Ligating Cutter

Ejects 2 ligating clips dividing tissue dividing tissue between clips with single activation

Intraluminal Staple

Fires double row of staples with knife located within the head used for trimming

Herniation

Abnormal protrusion of tissue through an opening

Dead Space

Separation of wound layers that have not been closely approximated

Anastomosis

Surgical formation of a passage between 2 normally disconnected organs

Keloid

Raised scar due to excessive collagen formation

Immunosuppressed

Patient with a weakened immune system due to congenital or acquired condition

Adhesion

Abnormal attachment of two surfaces that typically are separated

Bolsters

Plastic or rubber tubing that is threaded over the retention suture ends

Chronic Wound

Wound that persists for an extended period of time

Ligation

Procedure used to tie blood vessels

PTFE

Sort, flexible material that is not absorbable

Vessel Loops

Isolation/retraction device for vessels, nerves, or ducts

Fistula

Tract between two epithelium-lined surfaces that are opened at both ends

Devitalized

Weakened or compromised

Side-cutting needle

Used mainly for ophthalmic procedures, as they don't penetrate deeper tissue

Polytetrafluoroethylene Mesh

Soft, flexible material, not absorbable, not used in the presence of infection

Conventional Cutting Needle

Consists of three cutting edges, directed along the inner curve of the needle

French-eyed Needle

Loaded by pulling the taut strand into a V-Shaped area just above the eye

Closed-eyed Needle

Round or square hole; loaded by inserting suture material through the hole

Polyglactin 910 Mesh

An absorbable material that provides temporary support during healing

Controlled-release Needle

A needle that pops off the suture strand by tugging

Blunt Points

Has a round shaft that end in a blunt tip

Tapered-point needle

Has a round shaft without a cutting edge, penetrating tissue without cutting it

Reverse-cutting needle

Consists of opposing cutting edges that extend to the full length of the shaft

Stainless Steel Mesh

A material that is rigid and hard to apply, resulting in discomfort for the patient

Which of the following methods would be used to tie off deep bleeding vessels that have been occluded with a hemostat clamp?

A Tie-On-A-Pass

Sterile technique must be employed in dressing changes with the first

48 hours

A patient arrives at the emergency room with a stab wound to the left thigh that occurred 1 hour previously. What wound class does this injury belong to?

Class III

To replace the mesh covering the facial defect created by an inguinal hernia that is infected, a surgeon may use

Polypropylene (Prolene) mesh

A tract between two epithelium-lined surfaces that is open at both ends is called what?

Fistula

Which phase of wound healing begins within minutes of injury and is manifested by heat, redness, swelling, pain, and loss of function?

Lag phase

Stainless steel suture is sized by

commercial wire gauge numbers

Ligature reels are radiolucent (Black) and are not part of the count. T or F

False - they are radiopaque (White) and ARE part of the count.

Dehiscence

Partial or total separation of a layer or layers of tissue after closure of the wound

Herniation

Abnormal protrusion of an organ or other body structure through an opening in a covering membrane or muscle.

Primary Suture Line

Main suture that approximates the wound edges for first intention healing to occur.

Secondary Suture Line

Sutures placed to support and ease the tension on the primary suture line; reinforcing the wound closure.

Third Intention (Delayed Primary Closure)

Healing that occurs when two granulated surfaces are approximated; also referred to as delayed primary closure.

Phases of Wound Healing by First Intention (Primary Union)

Phase 1: Lag Phase or Inflammatory Response Phase
Phase 2: Proliferation Phase
Phase 3:Maturation or Differentiation Phase

Second Intention (Granulation)

Healing that occurs when a wound fails to heal by primary union or wound is left open and allowed to heal inside out.

First Intention (Primary Union)

Type of healing that occurs with primary union that is typical of an incision opened in ideal conditions. 70%-80% of original strength.

During which phase of wound healing is the strength of the wound limited to the suture holding it together?

Lag phase (inflammatory)

Bridge

Plastic devices that "bridge" the closed incision

1st Intention, Phase 1: Lag Phase or Inflammatory Response Phase

This stage begins within minutes of injury and lasts approximately 3-5 days.

1st Intention, Phase 2: Proliferation Phase

This stage begins on approximately the third postoperative day and continues for up to 20 days. 25%-30% of its original tensile strength.

1st Intention, Phase 3: Maturation or Differentiation Phase

This stage begins on the 14th postoperative day and lasts until the wound in completely healed (up to 12 months)

Order of occurrence in which primary intention healing occurs:

Lag phase: Inflammation occurs, with heat, swelling, pain, redness, loss of function

Class I: Classification of Surgical Wound

Clean (Infection Rate 1-5%)
-Incision made under ideal surgical conditions
-No break in sterile technique during procedure
-Primary closure
-No wound drain
-no entry to aerodigestive or genitourinary tract

Class II: Classification of Surgical Wound

Clean Contaminated (Infection Rate 8-11%)
-Primary closure
-Wound drained
-Minor break in sterile technique occurred
-Controlled entry to aerodigestive (includes biliary tract) or genitourinary tract

Class III: Classification of Surgical Wound

Contaminated (Infection Rate 15-20%)
-Open traumatic wound (less that 4 hours old)
-Major break in sterile technique occurred
-Acute inflammation present
-Entry to aerodigestive (includes biliary tract) or genitourinary tract with spillage

Class IV: Classification of Surgical Wound

Dirty/Infected (Infection Rate 27-40%)
-Open traumatic wound (more than 4 hours old)
-Microbial contamination prior to procedure
-Perforated viscus

Closed wound

The skin remains intact, but underlying tissues suffer damage

Open wound

The integrity of the skin is destroyed. Includes 4 different types of wounds-Simple, complicate, clean, contaminated

Simple wound - form of open wound

The integrity of the skin is destroyed. There is no loss or destruction of tissue and there is no foreign body in the wound.

Complicated wound - form of open wound

Tissue is lost or destroyed, or a foreign body remains in the wound.

Clean wound - form of open wound

Wound edges can be approximated and secured. A clean wound is expected to heal by first intention.

Contaminated wound - form of open wound

Contamination occurs when a dirty object damages the integrity of the skin. A contaminated wound can become infected within a short period of time. Debridement or excision of infected and/or necrosed tissue may be necessary, followed by thorough irrigation of the wound to further clean the wound and wash out the contaminants.

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