hemostasis, wound healing, and wound closure

What makes a cutting needle more appropriate for skin closure than other needle types?

Because they have triangular, sharp points that help them pass cleanly through tougher layers

why are blunt needles selected for use on organs like the liver and kidney?

Because the liver and kidneys are fragile tissue, blunt needles spread tissue rather then cutting it, reducing risk of tearing

How does a swaged needle reduce tissue trauma compared to a traditional eyed needle?

Because it comes with the suture pre attached inside the needles hollow end creating a smooth connection which causes less tissue damage

What are the differences between Plain gut and Vicryl in terms of absorption rate?

Plain gut absorbs very quickly, making it ideal for fast healing tissues, while Vicryl absorbs much slower then plain gut

Why must Plain and Chromic gut sutures be packaged wet?

To preserve flexibility

What are some characteristics of surgical silk, and why is it still considered nonabsorbable?

• natural

• Multifilament

• Considered non absorbable because it takes 2 years to become undetectable

What does it mean when a suture is labeled as “Plus”?

Indicates that the sutures contain antibacterial coating to help prevent surgical site infections

What suture gauge would typically be selected for delicate ophthalmic procedures?

8-0 or smaller, to avoid trauma

Why do monofilament sutures require more knot throws?

Because of its memory and slipperiness

Define tensile strength in the context of sutures.

Tells us how much pulling force a suture can take before it breaks

What is the purpose of everting skin edges before applying staples?

Promotes better healing and reduces scarring

When would the interrupted suture technique be used instead of continuous sutures?

When there is risk of infection, so we can take out the infected suture without having to redo the whole closure

What is a continuous subcuticular stitch, and why is it often used in skin closures?

Used for a cosmetic closure. It is placed in the dermal layer with small bites of skin to leave a smooth surface with minimal scarring

Why is the fascia layer so important in abdominal wound closure?

It is the strongest supportive structure of the abdominal wall and it must be securely closed to prevent herniation or dehiscence

What is the function of a circular stapler in GI surgery?

Internal device that places 2 concentric rows of staples and is used to reconnect sections of the colon or other tubular structures

Why is muscle usually separated and not sutured during procedures?

Because it does not require suturing for closure

What is a Keith needle, and in what situations might it be used?

Straight needles used for surface closures or in specialized areas

How are Veress needles used in laparoscopic surgery?

Used for insufflation

What is debridement and when is it performed?

Involves removing dead tissue, debris, or contaminants from a wound to support proper healing and prevent infection

Describe the formation of a keloid scar

Keloids are raised, thickened scars that result from an overproduction of collagen during healing

What is eviceration and what immediate action does it require?

Surgical emergency where abdominal contents protrude through a reopened wound- requires Immediate surgical intervention

how do incisional, deep, and nosocomial SSIs differ?

Incisional: at the skin or subcutaneous level

Deep: affecting deeper tissues like fascia or muscle

Nosocomial: hospital acquired infections that may or may not be related to the incision

What are the advantages and disadvantages of stainless steel mesh

Advantages: most biocompatible and inert, body rarely reacts to it

Disadvantages: difficult to manipulate, can be uncomfortable to the patient long term

What safety protocols are required when using surgical sponges like cottonoids and laps?

Must always be counted to prevent retained surgical items