sutures

Surgh techs do what when handling sutures

store, handle and martian sutures

count and track

what is the #1 injury in OR

needle stick injury

where should a exposed needle NEVER be

on back table or mayo

suturing instruments

needle holders, forceps, and suture scissors

needle holder selection

appropriate length of needle holder for wound depth

techniques for passing suture

needle should be 1/3 from swaged edge

drape loose suture over your hand

what do you use to cut sutures

straight mayos or suture scissors

suture removal

provide straight or curved hemostat with towel so it doesn’t be dropped back in wound

Stick-tie

suture on needle: not a tie

tie on pass

place the suture on instrument (no needle)

suturing/closure techniques

used to tie bleeding vessels or sutures to tie two sutures together

halsted technique

cut suture to close knot

never mix silk and surgical gut

-causes increase of infection

used 10l per case

continuous (running) suture

one suture used over and over

running sutures advantages

tension evenly distributed

disadvantage of running suture

bacteria travel lengths of suture

continuous suture

“buried”, placed under epithelial layer of skin

other names for continuous suture

purse string and closure of peritoneum

advantages of continuous suture

if one breaks , remains suture holds wound together

retention sutures

placed on tissue on each side of the primary suture line to reduce suture tension on it

traction suture

suture used to retract tissue to the side of the operative shield

nonabsorbable

drain stitch

surgeon will need a drain stitch to hold drain in place

bridges and bolsters

retention devices

peritoneum

absorbable, not all surgeons close

fascia

tough tissue

interrupted stitch

subcutaneous fat

surgeons don’t close bc doesn’t tolerate suture well

interrupted stitch

skin

suture or staples

mattress or sub cuticular stitch

wound zipper

zipline

through-and-through closure

all layers closed at once using a running stitch

if wound is contaminated