✔️14 - Case Study: SA Wounds & Suture Knowledge 🟢

they believe that it implies that you do not believe them or that you are questioning their integrity

Some owners will resent the use of the word "claims" in your medical records. Why?

claims

-State or assert that something is the case, typically without providing evidence or proof

-An assertion of the truth of something, typically one that is disputed or in doubt

neither one is a good idea!

Diagnosing patients by phone and text message is a little like learning to be a veterinarian by correspondence course.....

intra-abdominal pressure

Vomiting involves a significant increase in _____

1. Length of time the suture will be required to help strengthen the wound or tissue

2. Risk of infection

3. Effect of the suture material on wound healing

4. Dimension and strength of the suture required

What are the 4 considerations for suture selection?

1. Linea alba

2. Subcutaneous

3. Subcuticular

4. Skin

What are the 4 layers we close when doing an abdominal wall closure?

simple continuous

_____ sutures:

-Do NOT increase the risk of dehiscence

-Less suture material

-Faster

-Rapid closure

-Secure knots (6 throws = 3 square knots at each end of the suture line)

1. Sutures placed in External Rectus Sheath

2. Simple Continuous or interrupted

3. Slowly absorbable, monofilament suture

4. Cutting/reverse cutting needle

Describe the closure of the linea alba

1. Simple Continuous

2. Little to no holding strength

3. Leave a small pocket at each end to facilitate burial of the knots at each end of the subcuticular closure

4. Monofilament suture, absorbable

5. Taper needle

Describe the closure of the Subcutaneous layer

1. Simple Continuous

2. Monofilament suture, absorbable

3. Cutting/reverse cutting needle

Describe the closure of the Subcuticular layer

Aberdeen Knot

What could you replace the three square-knots with at the end of your simple continuous suture pattern?

Aberdeen Knot

-An alternative to the square knot at the end of a continuous line, when the surgeon is left with a loop and a free end.

-Knot volume is 32 to 56 per cent of traditional square knots

-Knot holding capacity is 24 per cent greater than traditional square knots

1. Do you want to close the skin?

2. What method do you want to use?

3. What suture and pattern do you want to use?

4. Patient personality/behavior

5. Owner compliance

6. Ability to follow-up on the case

7. Who will remove what you put in?

What are things that you will consider/ask yourself when making decisions about closing the skin? (7)

Monofilament, nonabsorbable, cutting/reverse cutting needle

What suture and needle do we use for skin closure?

true

T/F - Absorbable suture in skin isn't absorbable

1. Tighten suture enough to appose tissues

2. Incorporate full thickness bites if on midline

3. Use external rectus sheath if off midline

4. Use an absorbable suture in a simple continuous

pattern in subcutaneous tissue

5. Reappose the prepucialis muscle fibers in males

6. Use nonabsorbable skin sutures or staples

What are the "dos" when closing? (6)

1. Don't strangulate tissues with suture

2. Don't damage tissues with forceps

3. Don't incorporate falciform ligament between fascial edges

4. Don't include muscle when closing external rectus sheath

5. Don't attempt to include peritoneum

What are the "donts" when closing? (5)

1. A line block is performed with 2% lidocaine HCl.

2. An injectable NSAID is given for pain and a 3-5-day supply dispensed for oral administration

3. Cefazolin (22 mg/kg) slow, IV Intraoperatively, every 1 ½ to 2 hours

What was done for Ginger for pain and to prevent infection? (3)