Surgical Needles, Staples, Clips, Adhesives & Mesh

Surgical steel

What material are suture needles made from?

Straight

___________ suture needles requires more hand motion and is used mostly in skin

Curved

______________ suture needles required in small or deep surgical fields

Long

Suture needles should be ___________ enough to penetrate both edges of the wound in one bite

Non-cutting (taper)

Suture needle that is used in delicate tissue because it minimizes tissue trauma

Cutting

Suture needle used in dense tissue

Conventional cutting

Cut edge lies on the concave surface; more likely to cut through tissue

Concave

Conventional cutting needles have the cut edge on the _____________ surface

Reverse cutting

Cut edge lies on the convex surface; less likely to cut through tissue

Convex

Reverse cutting needles have the cut edge on the ______________ surface

Conventional

(Conventional or reverse) cutting needles are more likely to cut through tissue

Tapered cutting

Round shaft with reverse cutting point; meant for dense, but delicate tissue

Swaged (eyeless)

Suture and needle are one continuous unit; less traumatic

Non-swaged (eyed)

Suture and needle are two separate units; reusable needle but traumatic and requires more intraoperative handling

Concave

You should load non-swaged (eyed) needles from the _________ surface to reduce suture pull out

Swaged (eyeless)

ID

Non-swaged (eyed)

ID

Laser swaged needle

Suture is crimped in a hole drilled in the body of the needle

Channel swaged needle

Suture crimped in depression in the body of the needle

1/2 to 2/3

You should grip the needle _________________ from the point

1. Absorbable

2. Titanium

3. 316 L stainless steel

What material are surgical staples made from?

Eversion

Surgical staples cause tissue (inversion or eversion)

Need to engage all layers of the tissue

When choosing staple height, what is important to keep in mind?

Linear stapling devices

Delivers 2-3 staggered linear rows of staples

Thoracoabdominal (TA) stapler

Type of linear stapling device used for cutting something out commonly

B

T or F: The TA stapler cuts

A

T or F: The GIA and ILA staplers cuts and divides

Circular stapling device

Double staggered circular row of staples

Placement of purse string

What is required for use of circular stapling devices?

Hemostasis

What is the purpose of vascular clips?

1/3, 2/3

When using vascular clips, vessel diameter should be > _________ but < ____________ clip length

1. Skeletonize vessel

2. Vessel diameter >1/3 but <2/3 clip length

3. Apply several mm from cut edge of vessel

4. Clip vein and artery separately

What are the application principles for vascular clips?

1. Defect closure

2. Buttress for primary repair

What are surgical meshes used for?

1. Metal

2. Synthetic polymers (woven, knitted, expanded polymer)

3. Biologic tissue

What can surgical meshes be made from?

Warp

Filaments set lengthwise

Weft

Filaments woven under and over the warp at a perpendicular angle

A. Woven synthetic polymers

B. Woven synthetic polymers

C. Knitted synthetic polymers

Using woven synthetic polymers or knitted synthetic polymers, ID which has greater:

A. Strength

B. Stiffness

C. Porosity

Course

Row of loops

Wale

Column of loops

Wale

What provides the strength of knitted synthetic polymers?

A

T or F: Knitted synthetic polymers are anisotropic

Macroporous

Allows vessel and tissue ingrowth = tissue incorporation

Microporous

Limits vessel and tissue ingrowth = tissue encapsulation

Porcine small intestinal submucosa (SIS)

What is the most commonly used biologically derived surgical meshes?

Length of alkyl derivative

The strength of skin glue is related to what?

A

T or F: You want a LONG alkyl derivative for skin glue

High moisture areas or contaminated wounds

Skin glue should not be used in what?