Surgical needles, staples, clips, adhesives, and mesh

1/3-2/3

grip the needle with needle holders __________ from the point

TITANIUM, absorbable, 316 L stainless steel

What are some of the materials used for surgical staples?

tension, subQ closure

Surgical staples should not be used in a place of ______ and usually you need a ________ beforehand

eversion

Surgical staples are used for tissue [apposition, inversion, eversion]

decreased time, decreased cost, less pain, increased tissue oxygenation

What are some advantages of surgical staples?

infection (questionable), less cosmetic, difficult removal, less strength

What are some disadvantages to staples over sutures?

linear stapling devices

______: deliver 2-3 staggered LINEAR rows of staples

thoracoabdominal stapler

Which type of stapler does NOT cut, just staples?

gastrointestinal anastomosis stapler (GIA), intestinal linear anastomosis stapler (ILA)

Which types of staplers cut and divide tissue after applying staples?

(they have side to side rows of anastomosis and then dividde in the middle to combine a lumen)

end to end

A circular stapling device provides what type of anastomosis?

double staggered circular, purse string

a circular stapling device provided end to end anastomosis by using a ___________ row of staples, and does require a _______ be put in place beforehand

hemostasis, application, security

Vascular clips are used for ________, and have faster _______ but less ______ compared to suture.

skeletonize

Before placing a vascular clip, you must _________ the vessel (strip the tissue from around it)

1/3, 2/3, separately

a vessel closed by a vascular clip must be greater than _____ but less than ______ the length of the clip.

The clip has to be sever mm from the cut edge of the vessel, and arteries and veins should be clipped [together/separately]

decreased surgery time, decreased contamination, decreased tissue trauma, increased strength

What are the advantages of using a surgical staple in an -ectomy or -otomy operation?

stomal diameter, adhesions, leakage

What are the disadvantages of using a surgical staple in an -ectomy or -otomy operation?

What is used as an aid for the suture when there is a defective closure or when areas that need closing (like hernias) may not have the strength to stay closed when just being held by suture?

metal, synthetic polymers, biologic tissue

what are the types of materials used in surgical mesh

woven synthetic fibers

which surgical mesh struggles to incorporate with the body and is often not porous enough and may be seen as a foreign body

hella (+++), hella (+++), not (-)

How strong is woven synthetic polymer?

How Stiff?

How porous?

(The notes on this are only in plus and minuses... so bear with the answers on this one)

woven synthetic polymers

What type of mesh is this?

warp, weft, 90 degrees

What is the yellow yarn called?

What is the blue one called?

I dunno what bias is... but describe it for this mesh

knitted synthetic polymers

Which type of mesh is one filament in a continuous intermeshing loop patter?

knitted synthetic polymers

what type of mesh is this?

wale

What are columns of loops called?

coarse

what are rows of loops called?

anisotropic

knitted synthetic polymers are ________ meaning they have different properties in different directions (wale vs coarse)

kinda (+), kinda(+), decent (++)

What is the strength of a knitted synthetic polymer?

What is the stiffness?

What is the porosity?

macroporous

if a surgical mesh is ________ it allows vessel and tissue ingrowth and is better for tissue incorporation

microporous

if a synthetic mesh is __________ is limits vessel and tissue ingrowth and leads to tissue encapsulation

porcine small intestinal submucosa

What is the most commonly used biologically derrived surgical mesh?

true

true/false: when applying mesh to a surgical wound, trim the mesh to fit, overlap the edges with the wound, and suture to secure

failure, infection

what are the two forms of complications for surgical mesh?

skin glue

what is cyanoacrylate?

anions, polymerization, tensionless

When you use liquid skin glue, the _____ on the applied surface kick off _____ and tissue bonding, leading to __________ apposition.

LONG alkylderivative

the strength of the skin glue and seal relies on a _______________________

n-butyl-2-cyanoacrylate, octo-2-cyanoacrylate

What are some examples of LONG alkyl derivatives

time, cost, antibacterial, no removal

What are the advantages of skin glue?

low strength, cant be used in high moisture or contaminated wounds

What are the disadvantages of skin glue?