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65 terms

Ch 11 Surgical Technology for the Surgical Tech

Wound healing, sutures, needles, & stapling devices
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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.