Show:
Suture
Needles
Wound Healing
Catheters-Tubes-Drains
Sutures
100
Point-honed to the configuration and sharpness desired for specific type of tissue Body- shaft Eye- where suture strand is attached
What are parts of the needle
100
Infection rate 1-5% Heals 1st intention Incision under ideal circumstances Primary closure No drain No breaks in sterile technique GI, GU respiratory or oral-pharyngeal cavity not entered
What is Class I- Clean Wound
100
Placed in trachea to maintain airway during loss of consciousness Used to administer anesthesia
What is endotracheal tube
100
The tough connective tissue layer covering muscles-is support of abdominal wall-must close securely-heals slowly and has lots of wound stress
What is fascia
200
Vicryl, Monocryl, Chromic, Plain, Dexon, PDS
What is types of absorbable suture
200
Used for friable tissue such as liver, kidney or spleen
What is blunt needle
200
The separation of wound edges with protrusion of internal organs- will take patient to OR- close with retention sutures
What is evisceration
200
Used to instill contrast media (Dye) in diagnostic studies. r)
What is Taut cholangiogram catheter
200
Suture placed around a lumen and tightened drawstring fashion to close a lumen
What is a purse string suture
300
Packaged and used dry Don’t soak or dip in water-moisture will decrease tensile strength Is smooth and soft and will retain pliability
What is how to handle synthetic absorbable suture
300
Used for tough tissue that is hard to penetrate- skin, tendons, sclera of eye Types are reverse, conventions, and side
What is a cutting needle
300
Age Allergic Response Disease Immunosuppressed Patients Nutritional Status Obesity Smoking
What is factors affecting wound healing
300
Inserted through the mouth then extends through the oral pharynx. It maintains the airway by preventing patients tongue from falling back into the throat- patient is not conscious
What is an oral airway
300
Type of closure for the layer of tough connective tissue just below the skin- this closure is used to minimize scarring and uses fine absorbable suture such as (4-0) on small cutting needle-and Steri-Strips
What is subcuticular skin closure
400
Monofilament absorbable suture made from polyester Useful in tissue where slow healing is anticipated- fascia Useful where extended wound support is desirable-elderly
What is PDS
400
Clamp body of needle in an area 1/3 the distance from swage to point Never clamp over swaged area= weak part of needle Place needle near tip of needle holder
What is proper placement of needle in needleholder
400
Handle tissue as gently and as little as possible Incision should be long enough Preserve nerves and vessels Moisten instruments and sponges to decrease trauma Pad retractors –don’t pull too hard
What is proper tissue handling
400
Used to evacuate hemothorax, pneumothorax, hemopneumothorax and to drain pleural abscesses or emypema These are always connected to an underwater sealed drainage system which may be connected to suction
What is chest tube.
400
Used to reract a structue that is not easily retracted-to secure or hold structures in place
What is traction stitch
500
Ethilon, Prolene, Surgilon
What is types of nonabsorbable suture
500
Tends to push tissue aside rather than cut it These needles are used on soft delicate tissues such as intestines-GI, peritoneum, lung, SQ, dura, nerves,muscles
What is taper needle
500
8-11% infection rate Primary closure- Drain used Minor break in technique occurred Controlled entry into GI, GU, respiratory or oropharyngeal cavity No unusual spillage or contamination Hysterectomy, colon resection, appendectomy, gallbladder w/o infection
What is Class II- Clean-Contaminated Wound
500
Are usually inserted intraoperatively by the surgeon Are usually placed in a cavity and exteriorized through a separate wound called a stab wound (stab incision) and are secured to the patient’s skin with a nonabsorbable suture on a cutting needle- typically a 4-0.
What is a drain
500
Handle tissues gently Control hemorrhage carefully Preserve blood supply Observe strict aseptic technique Minimize tissue tension Appose tissues accurately Eliminate dead space
What is Halstead’s Principles