Principles of Veterinary Surgery – Surgical Instrumentation, Sutures & Patterns

Comprehensive Q&A flashcards covering surgical instruments, handling techniques, suture materials, needle types, suture patterns, and knot tying for VSURG 4300.

Into which 7 major categories are standard surgical instruments classified?

Scalpel, scissors, needle holders, tissue forceps, hemostat forceps, retractors, and miscellaneous instruments.

Which scalpel handle is paired with blades #10, #11, #12, and #15?

3 Bard-Parker handle.

Which scalpel handle and blades are commonly used for large-animal surgery?

4 Bard-Parker handle with blades #22 and #23.

For ophthalmic or microsurgery, which scalpel system is used and which blades fit it?

The Beaver scalpel with blades #64 and #65.

Describe the fingertip grip for holding a scalpel and its advantage.

The entire handle is held by the fingertips without resting in the palm; it provides excellent control for long skin incisions.

When are pencil grip and palm grip preferred for scalpels?

Pencil grip – short precise incisions; Palm grip – long incisions that need more force.

Name the three basic types of scissor point configurations.

Sharp–sharp, blunt–blunt, and sharp–blunt.

What is the primary use of Mayo scissors?

Cutting heavy fascia and connective tissue.

Which scissors are reserved for delicate tissue such as bowel or fat?

Metzenbaum scissors.

What unique feature distinguishes Iris scissors and where are they often used?

Very small, straight or curved blades; used in ophthalmic procedures.

List the three common methods of cutting with scissors.

Standard scissor cutting, push cutting, and blunt dissection.

Which needle holder combines scissor blades with the holding jaws?

Olsen-Hegar needle holder.

Which needle holder is spring-loaded with a latch and is popular in ophthalmic surgery?

Castroviejo needle holder.

Which grip on needle holders offers the greatest precision for delicate suturing?

Thumb–ring finger grip.

What is the main purpose of tissue (thumb) forceps during surgery?

Manipulate tissues and needles with minimal trauma, effectively acting as the surgeon’s fingers.

Which thumb forceps have multiple fine intermeshing teeth for delicate but secure grasping?

Brown–Adson forceps.

De-Bakey thoracic forceps are specifically designed for what?

Atraumatic manipulation of vessels and fragile tissues.

Which intestinal forceps are non-crushing and used to temporarily occlude bowel lumen?

Doyen intestinal forceps.

Name two small, straight or curved forceps used to occlude small vessels with full transverse serrations.

Mosquito hemostat forceps.

What jaw serration pattern characterizes Rochester–Carmalt forceps and their common use?

Longitudinal serrations with cross-striations at the tip; used to clamp ovarian pedicles during OVH.

Differentiate between hand-held and self-retaining retractors.

Hand-held retractors require an assistant to hold them; self-retaining have a ratchet or spring that holds tissues apart without assistance.

Which self-retaining retractor has rake tips and a ratchet, available with blunt or sharp ends?

Weitlaner retractor.

What is the purpose of towel clamps such as the Backhaus?

Secure drapes to the patient’s skin and occasionally hold tissue.

State the two recommended methods for cleaning surgical instruments before sterilization.

Ultrasonic cleaning or manual cleaning followed by antimicrobial, water-soluble lubrication.

Give three critical factors considered when selecting a suture material for a given tissue.

Tissue healing time required, tissue type/strength, and the patient’s overall health status.

Contrast absorbable and non-absorbable sutures regarding strength loss and degradation mechanism.

Absorbable lose tensile strength over time and are degraded (phagocytosis for natural, hydrolysis for synthetic); non-absorbable retain strength indefinitely and are not intended to degrade quickly.

Name two natural absorbable sutures and their degradation mechanism.

Plain or chromic catgut; degraded by proteolytic enzymatic digestion (phagocytosis).

How long does chromic catgut typically retain significant tensile strength?

Approximately 10–15 days.

Which braided synthetic absorbable suture resists bacterial growth and can be used in contaminated wounds?

Polyglactin 910 (Vicryl).

Which monofilament absorbable suture retains strength for months and is fully absorbed by ~182 days?

Polydioxanone (PDS II).

List the non-absorbable sutures from highest to lowest initial tensile strength.

Stainless steel, polyester (Ethibond/Mersilene), polymerized caprolactam (Vetafil), nylon (Ethilon), polypropylene (Prolene), silk.

Why should polyester sutures be avoided in infected or contaminated areas?

They incite a severe inflammatory reaction and have high tissue drag, potentiating infection.

Which synthetic monofilament non-absorbable suture has the best knot security and little tissue drag?

Polypropylene (Prolene).

Explain the main advantage of a swaged-on needle versus an eyed needle.

Swaged needles are less traumatic and remain securely attached to the suture, eliminating the need to thread and preventing unthreading during use.

What type of needle point is preferred for suturing skin?

Conventional (regular) cutting needle.

When suturing friable tissue such as liver, which needle point is advised?

Blunt point needle.

Define 'ought' in suture sizing and give an example.

'Ought' (0) designates progressively smaller diameter sutures; e.g., 3-0 is smaller than 0.

State two advantages and two disadvantages of surgical stapling.

Advantages – speed and consistent hemostasis; Disadvantages – higher cost and potential failure if applied improperly.

What is a common modern material for vascular ligating clips besides metal?

Polymeric (e.g., Hem-o-lok) clips.

Cyanoacrylate tissue adhesive should NEVER be placed where?

Between skin layers or inside body cavities (internal tissues).

Classify suture patterns based on 3 main criteria.

Interrupted vs. continuous, appositional/everting/inverting, and simple vs. tension-relieving.

Which suture pattern most rapidly approximates tissues and promotes fastest healing?

Appositional patterns (e.g., simple interrupted or continuous).

Give one key advantage and one disadvantage of a simple interrupted pattern.

Advantage – if one knot fails, the rest remain intact; Disadvantage – requires more time and suture material.

What continuous pattern provides more security if a portion breaks and is popular for skin?

Ford interlocking (reinforced continuous).

Name two commonly used inverting patterns for closing hollow viscera.

Lembert and Cushing patterns.

Which tension-relieving pattern overlaps tissue edges and is used in herniorrhaphy?

Mayo mattress (vest-over-pants).

Describe the near-far-far-near suture pattern’s purpose.

A tension-relieving technique that redistributes stress away from the wound edge by using staggered deep and superficial bites.

What distinguishes a vertical from a horizontal mattress in terms of skin blood supply?

Horizontal mattress can compromise blood supply more than vertical mattress; vertical is generally preferred when eversion with less ischemia is needed.

List the three basic surgical knots.

Square knot, surgeon’s knot, and slip knot.

How many throws constitute a secure knot for most non-absorbable monofilaments in interrupted patterns?

At least four throws (additional throws for continuous patterns).

What additional step makes a surgeon’s knot different from a square knot?

An extra wrap (double throw) on the first throw to increase friction and prevent loosening before the second throw is placed.

Which suture knot provides the greatest initial security but can slip if not followed by opposing throws?

Slip knot (half-hitch).

Explain the three-forceps method for tissue ligation.

Two forceps isolate the vessel and a third places the ligature; ensures vessel control and precise suture placement while minimizing blood loss.