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Chapter 11

Terms in this set (80)

Which suture is MOST inert in tissue?
stainless steel
chromic gut
surgical silk
plain gut
stainless steel
What kind of wound is a sacral decubitus ulcer?
contusion
closed
chronic
clean
chronic
What is the term for a type of suture that has the strand of suture material inserted into the hollowed-out needle end?
swaged
French-eye
crimped
closed eye
swaged
Tissue trauma is minimized by using which type of suture-needle combination?
suture loaded on a French-eyed taper needle
threaded suture on a closed-eye Keith needle
threaded suture on a closed-eye taper needle
suture permanently swaged on an eyeless needle
suture permanently swaged on an eyeless needle
Which tissue layer of the abdominal wall provides the greatest strength and support of the wound?
skin
fascia
subcutaneous fat
peritoneum
fascia
Which type of suture needle is used on friable tissue such as liver or kidney?
taper
cutting
trocar
blunt
blunt
What would be the type of suture placed temporarily in the tongue to hold it out of the way in a maxillofacial procedure?
retention
purse-string
traction
suture ligature
traction
A surgeon's choice of suture to be used is based on the surgeon's training, the condition of the patient, the type of wound, and the conditions surrounding the surgical intervention.
True
False
True
If tissue is approximated too tightly, it can result in:
granulation
ischemia
keloids
adhesions
ischemia
The tensile strength of suture material should equal the tensile strength of the tissue into which suture is placed.
True
False
True
Which phase of healing for wounds closed by first intention begins within minutes of the incision or injury?
proliferation
inflammatory
granulation
maturation
inflammatory
Which suture technique involves making a knot in the suture outside of the body and then pushing it inside through a cannula?
extracorporeal method
intracorporeal method
figure-of-eight stick tie
secondary suture line
extracorporeal method
Which type of suture is often used to create a vascular anastomosis?
synthetic, nonabsorbable, monofilament with double-armed taper needles
synthetic, absorbable, multifilament on a 3/8 circle cutting needle
synthetic, nonabsorbable, multifilament on a 1/2 circle taper needle
synthetic, absorbable, monofilament on a Keith straight needle
synthetic, nonabsorbable, monofilament with double-armed taper needles
Which suturing technique would be used to close the stump of the appendix in an open appendectomy?
vertical mattress
retention
purse-string
horizontal mattress
purse-string
Which absorbable suture provides for the MOST extended wound support?
Monocryl
PDS Plus
Vicryl
Polysorb
PDS Plus
To achieve the goal of leaving as little foreign material in a wound, the ideal suture selected should have:
a large diameter gauge
tightly braided fibers with capillarity
high-tensile strength and small diameter
an antibacterial coating over it
high-tensile strength and small diameter
Approximation is bringing two sides of a wound together closely with sutures, wound zippers, or special adhesives so that the wound can heal from side to side.
True
False
True
Which needle has the cutting edge on the outside curvature of the needle body?
reverse
spatula
Keith straight
conventional
reverse
Which wound classification would be assigned to a vaginal hysterectomy with anterior and posterior colporrhaphy?
Class IV
Class I
Class III
Class II
Class II
Primary union wound healing occurs:
side to side
top to bottom
bottom to top
end to end
side to side
Sutures with memory, such as chromic, plain, nylon, or other monofilaments, should be stretched tightly to remove any kinks in the strand before being handed to the surgeon.
True
False
False
Which of the following interweaves its fibers during the maturation phase of wound healing and increases its tensile strength?
enzymes
protein
fibrin
collagen
collagen
Which of the following surgical needles is a solid bore (not hollow) type of needle?
Dorsey
heparin
Keith
Tru-cut
Keith
Which type of needle is preferred for suturing of skin?
taper
cutting
spatula
blunt
cutting
How will the surgeon manipulate skin edges of a wound before the surgical technologist places an approximating skin staple?
rotate the edges slightly
invert the edges inward
overlap the edges tightly
evert the edges outward
evert the edges outward
Which statement is CORRECT regarding monofilament sutures?
They have high capillarity.
They cause increased tissue drag.
They may be used in infected wounds.
They are braided, twisted, and coated.
They may be used in infected wounds.
Ethicon sutures may be available with a designation of "plus" for some sutures, which means they:
are longer strands than the original versions
have a heavier gauge needle for thicker tissues
are impregnated with an antibacterial coating
have more than one needle in the package
are impregnated with an antibacterial coating
Which of the following is a natural, multifilament suture classified as nonabsorbable but loses much of its tensile strength in a year and is undetectable in tissues after 2 years?
polyester
surgical silk
stainless steel
polypropylene
surgical silk
Natural absorbable sutures are broken down in the body by:
metabolic factors
enzymatic digestion
capillarity
granulation
enzymatic digestion
A way in which the surgical technologist can assist the surgeon by keeping the suture strand out of the way during a continuous running closure is by:
pulling
tagging
following
tracking
following
What is the term for tissue that is easily torn or shredded?
adhesive
dehisced
eviscerated
friable
friable
What is the chemical name for Dermabond™ or Indermil™?
polymethyl methacrylate
cryoprecipitate
cyanoacrylate
fibrin glue
cyanoacrylate
Ligatures are use to:
approximate tissue layers
eliminate dead space
occlude the lumen of a blood
vessel
prevent evisceration
occlude the lumen of a blood vessel
Which of the following wounds would be assigned a Class I?
inguinal hernia repair with no breaks in technique
gunshot wound to the abdomen
compound femoral fracture
appendectomy with no major intestinal spillage
inguinal hernia repair with no breaks in technique
A patient undergoing chemotherapy and radiation therapy for cancer might experience prolonged wound healing due to:
hyperactive immune response
Class I, primary union wound
vascular proliferation
immunosuppressed statu
immunosuppressed status
Some multifilament sutures are coated to:
provide smooth passage through tissue
increase the capillarity
prevent knot slippage
decrease the absorption rate
provide smooth passage through tissue
A wound that is not sutured and that gradually fills in by granulation heals by which intention?
first
fourth
third
second
second
Which internal stapling device fires a circular double row of staples to reanastomose the colon?
linear stapler
intraluminal stapler
ligating clip applier
linear cutter
intraluminal stapler
Which of the following is NOT correct about the structure/design of suture needles?
They may be eyed or eyeless.
They may be straight or curved.
They are classified according to the eye, point, and body.
They range from 1/2 circle curvature to 5/8 circle curvature.
They range from 1/2 circle curvature to 5/8 circle curvature.
Which type of suture ties has an attached needle?
ligature reel
free tie
suture ligature
tie-on-a-passer
suture ligature
Which of the following statements is TRUE regarding natural absorbable sutures?
They are packaged wet.
They are packaged dry.
They are braided multifilament strands.
They have less tissue reaction than synthetics.
They are packaged wet.
Which type of synthetic mesh is absorbable?
polypropylene
polyester fiber
polyglactin 910
PTFE
polyglactin 910
Small, white, mature surface scar seen in differentiation phase of healing
Cicatrix
Capability of suture material to retain tissue fluids and bacteria that can communicate along the length of a continuous suture line
Capillarity
Process of breaking down synthetic polymer chains by water from tissues
Hydrolysis
Traumatic cut or tearing of skin or soft tissues
Lsceration
Intentional cut through intact tissue for purposes of exposing underlying tissues
Incision
Traumatic injury from friction forces causing scraping of epidermal layer
Abrasion
Closed traumatic wound; also called a bruise
Contusion
Abnormal connection between two epithelial surfaces, open at both ends
Fistula
Abnormal tract between two epithelial surfaces, open at one end only
Laceration
Biological material for tissue repair; made from porcine submucosa; leaves a collagen matrix
In-growth mesh
Evisceration of an abdominal wound is:
protrusion of viscera through all tissue layers
filling in of a wound from bottom up
single- or multi-layer separation of wound edges
excessive scar formation after surgery
protrusion of viscera through all tissue layers
Which type of needle is preferred for suturing skin?
taper
spatula
cutting
blunt
cutting
What is the primary reason bolsters are used with retention sutures?
to prevent dressings from touching the suture line
to facilitate easy postop suture removal
to prevent sutures from cutting into the skin
to stabilize heavy dressings without use of tape
to prevent sutures from cutting into the skin
What is the term that describes the measure of how much a suture strand can be stretched before breaking?
gauge
capillarity
tensile strength
drag coefficient
tensile strength
What is the chemical name of Gore-Tex suture?
polybutester
polypropylene polytetrafluoroethylene
polyglactin 910
polytetrafluoroethylene
Which historic figure in medicine is credited with creating principles of proper tissue handling and suturing?
DeBakey
Cushing
Kocher
Halsted
Halsted
Which organization specifies diameter ranges for sutures?
U.S. Food and Drug Administration (FDA)
American National Standards Institute (ANSI)
U.S. Pharmacopeia (USP)
Brown and Sharpe (B&S)
U.S. Pharmacopeia (USP)
Which nonsuture needle is used for insufflation of carbon dioxide into the abdomen for laparoscopy?
spinal
hypodermic
arterial
Veress
Veress
What is the term for removal of foreign material or contaminated debris from a wound?
desiccation
denuding
dehiscence
debridement
debridement
Another name for a suture ligature is a:
free tie
ligature reel
stick tie
tie-on-a-passer
stick tie
Which of the following tissues is NOT part of the abdominal wall closure when retention sutures are placed?
fascia lata
peritoneum
mesentery
subcutaneous fat
mesentery
Which type of healing occurs in an aseptic wound with good approximation and ideal surgical conditions?
first intention
fourth intention
third intention
second intention
first intention
What is used to close the epidermal layer when a subcuticular wound closure has been done for good cosmesis?
suture anchors
suture bridge
split lead shots
skin closure tapes
skin closure tapes
Which of the following is synthetic, monofilament, nonabsorbable, and the most inert synthetic suture used frequently in cardiovascular and ophthalmology procedures?
polyterephthalate
polypropylene
polytetrafluoroethylene
polybutester
polypropylene
Which suture gauge would be MOST appropriate for ophthalmic surgery?
#5
8-0
0
3-0
8-0
Which of the following sutures would be contraindicated in a chronic infected wound of an immunosuppressed patient?
polydioxanone
stainless steel
plain gut
polypropylene
plain gut
Which of the following sutures has comparatively inconsistent tensile strength and rapid absorption rate in vivo with moderate tissue reaction?
polydioxanone
plain surgical gut
polyglyconate
poliglecaprone
plain surgical gut
The suturing technique MOST appropriate for wounds likely to become infected or suffer potential stress is:
blanket
interrupted
purse-string
simple continuous
interrupted
In general, a monofilament suture would require ____________ knot throws for security than a multifilament suture.
fewer
more
the same number of
more, but only if coated
more
Which postoperative wound complication would require immediate surgical treatment?
fistula
adhesions
infection
evisceration
evisceration
By which intention would a purulent wound treated by debridement and placement of medicated packing, then sutured after resolution of the infection heal?
second intention
first intention
primary union
third intention
third intention
All of the following are techniques for eliminating dead space in a wound EXCEPT:
electrical nerve stimulation
pressure dressings
placement of wound drain
careful approximation of tissues
electrical nerve stimulation
What is the name of a raised, hypertrophic scar due to excessive collagen formation in some darker-skinned individuals?
cicatrix
seroma
granuloma
keloid
keloid
Which layer of the abdominal wall must be approximated securely, even if the other layers are not?
subcutaneous fat
skin
fascia
peritoneum
fascia
A continuous suturing technique that places sutures in the endothelial layer of the skin in short, lateral throws is called a:
purse-string suture
subcuticular suture
mattress suture
traction suture
subcuticular suture
Suture gauge can range from #5 (being the smallest) to 11-0 (being the heaviest) diameter.
True
False
False
Which of the following types of vessel loops are NOT available for use?
blue colored for veins
red colored for arteries
yellow colored for nerves
green colored for bile ducts
green colored for bile ducts
Inflammation can BEST be described as:
a normal protective response to tissue injury
an exaggerated immune system response
an abnormal physiologic response to tissue injury
a disease process accompanied by fever
a normal protective response to tissue injury
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