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73 terms

SUR-100 Chapter 11 needles, staples, and layer closure

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characteristics of needles
eye, point, body, shape
cutting needle is used on
tough tissue (skin or joint capsule)
conventional cutting, reverse cutting, and side cutting
types of cutting needles
cutting needles typically used for what types of surgery?
orthopedics and general
needle that is used on delicate tissue (bowel and artery) and GYN procedures
tapered needle
needle that dilates as it goes through the tissue
tapered needle
also known as a liver needle
blunt needle
typically the needle is large, skinny, and long
blunt
CP
cutting point
circle taper
CT
circle taper extra large
CTX
CV
cardiovascular
for skin
FS
FSL
for skin large
Keith Straight
KS
mayo
MO
orthopaedic surgery
OS
PS
plastic surgery
renal artery bypass
RB
spatula
S
SH
small half (circle)
tetralogy of fallot
TF
urology
UR
have a round shaft that ends in a blunt tip
blunt points
consists of three cutting edges that are directed along the inner curve of the needle
conventional cutting needle
consist of opposing cutting edges in a triangular configuration that extend into the full length of the shaft
reverse cutting needle
used primarily for ophthalmic procedures because they will not penetrate into deeper tissues
side cutting needles
have a round shaft without a cutting edge so they penetrate tissue without cutting it
tapered point needles
have round or square holes and are loaded by inserting the end of the suture material through the hole
closed-eyed needles
portion of the needle where the suture strand is attached
eye
suture gauges are what percent smaller with each size down
35%
7-0
strain of hair
10-0
eyelash
11-0
microscopic surgery
short suture is approx. how long
18"
long suture is approx. how long
60"
long tie suture is approx. how long
30"
closure for abdominal wounds
peritoneum~fascia~muscle~subcutaneous~subcuticular~skin
fast healing thin membrane
peritoneum
may not require suturing, but if it does continuous 3-0 absorbable suture is typically used (SH needle, Vacryl/chronic)
peritoneum
lines the abdominal cavity, lying beneath the posterior fascia
peritoneum
heals slowly and brunt of wound stress
fascia
though connective tissue covering the body's muscles, and supports soft tissue
fascia
heavy-gauge, non-absorbable suture with monofilament , running
fascia
mesh may be needed along with slow absorbing suture
fascia
if incised should be loosely approximated with interrupted PDS or Vacryl sutures
muscle
doesn't tolerate suture material well
muscle
typically not closed, and is retracted or separated most of the time
muscle
close muscle for gallbladder surgery
subcostal
adipose layer of dermis
subcutaneous
doesn't tolerate suture well, but when they are used 3-0 Vicryl or plain gut are preferred
subcutaneous
few interrupted sutures are placed in this layer in order to prevent dead space
subcutaneous
subcuticular
tough connective tissue just below the skin and above the subcutaneous
closure of this layer minimizes scarring
subcuticular
short lateral stitches are placed in a continuous fashion just under the epithelium (nice for plastic surgery closure)
subcuticular
skin closure tapes are used in conjunction with the preferred sutures (Vicryl, Monocryl, or Prolene)
subcuticular
may be closed with interrupted or continuous monofilament, non-absorbable sutures, or staples
skin
prolene or nylon preferred, but the sutures can eventually be removed
skin
wound scars more than subcuticular closure
skin
standard skin stapler
35 regular and 35 wide
when working with skin staplers what instruments are used?
2 Adson with teeth
when an endoscopic procedure is being done what is an additional step taken?
add an extra row of staples
staples but no cut
linear staples
linear staples open
two rows of staples, no cut
linear staples laparoscopic
three rows of staples, no cut
commonly used to staple across the stomach or to close an area where no cut is needed
linear staples
most common in vascular surgery and is generally the doctor's preference
disposable hemaclip applier
linear cutter
varies by length and staples come in different sizes
consist of two rows and a knife
linear cutter
allows for end to end anastamosis of the bowel or end to side on a gastroduodenal
EEA
allows end of staple to bend and rotate and is commonly used to resect on lower anterior bowel
roticulating
six rows of staples with cut in the middle
laparoscopic
four rows of staples with cut in the middle
open