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Breast biopsy frozen secion indicates cancer Wound Classification I
Laparoscopic cholecystectomy, gallbladder removed with endobag Wound Classification II
Cystoscopy with retrograde pyelogram (RPG); no stones found Wound Classification II
Scheduled bowel resection; scrub observes bloody hole in glove; regloved Wound Classification III
Emergency bowel resection; Feces noted during anastomosis Wound Classification IV
Laparoscopic assisted vaginal hysterectomy; purulent left ovary Wound Classification IV
Hernia repair; mesh utilized Wound Classification I
Open reduction internal fixation (ORIF) open fracture Wound Classification III
Incision & drainage of groin. STAT gram stains indicates gram-negative rods. Wound Classification IV
Gunshot wound to abdomen; bowel resection & liver laceration repaired Wound Classification III
Released from the damage cells to cause the inflammatory response Histamine
Normal wound healing occurs side to side
Five signs of the inflammatory response pain heat redness swelling loss of function
3 phases of normal (primary intention) wound healing phase 1: Lag; inflammatory; last 3-5days phase 2: proliferation; up to day 20 phase 3: maturation/remodeling; up to 12 mos.
Granulation tissue occurs from inside-out and bottom-upward 2nd intention
Incision opened under ideal conditions; minimal scar 1st intention
Delayed closure 3rd intention
Produces a weak union with a wide irregular scar 2nd intention
Wound debrided then closed 4-6 days later to heal 3rd intention
Used for dirty wounds, produces intermediate scar/TS 3rd intention
Incision made with rapid wound healing to 70%-80% original streangth 1st intention
Routine negative breast biopsy closure (mammogram) 1st intention
Which type of healing is most likely used for debucutis ulcer 3rd intention
Which type of healing is most likely to be used initially for a ruptured appendix 1st intention
Describe the appropriate tissue handling techniques that should be utilized during any case -length & direction of incision -dissection technique -duration of surgery -elimination of dead space -amount of tissue handling -achievement of hemostasis -precise tissue approximation -suture wound closure
Five causes of wound dehiscence 1.friable tissue 2.abdominal distention 3.too much tention on the wound 4.inappropriate type/strength of suture material 5.improper suturing technique
difference between dihiscence and eviseceration dehiscence is partial or total separation of wound evisceration is total separation & protrusion of viscral organs
most likely to be a factor in the cause of dehiscence vertical incisions
Measures the STSR can take to prevent wound infections -use scrupulous sterile technique -close dead space -handle tissue carefully -remove gross material -respond proactively to propable intective agents
Measures the STSR can take to prevent wound dehiscence -avoid long paramedian incision -provide careful, adequate closure -retention suture on intra-abdominal pressure
when cutting suture for the surgeon on a monofilament suture for skin closure with a "tag", you would typically cut the suture approx. _________from the knot 1/4 ends
when cutting suture for the surgeon on a multifilament suture inside the wound with a "tag", you would typically cut the suture approx. _________from the knot 1/8 ends
large vessels are typiclly occluded with suture ligatures or ____________ to prevent hemorrhage stick-tie
the most common sizes of suture ligatures are ______ and ______ and are made of _______ suture material 2-0 3-0 silk
when passing ligature reels, check the size by the number of holes on the side of the reel & always pull the strand approx. ____ inch away from the reel 1
the needle should be clamped approx. ___ of the distance from the swaged end of the needle. if tough tissue is anticipated, the needle should be clamped at the ___ mark of the needle 1/3 1/2
Always wet ______ sutures prior to passing to the surgeons cotton
If a muscle has been transversly incised and must be approximated, you would be prepared to supply the surgeon with an _______ suture absorbable
the skin is usually closed with an interrupted or continuous _________,_________ suture on a ______cutting needle monofilament nonabsorbable cutting
the preferred method of skin closure is _______ suture line to prevent bacteria and tissue from traveling the length of the wound interrupted
skin closure tapes reinforces subcuticular stitch-skin must be dry
stapler approximation with noncrushing B-shaped steal
traction suture nonabsorbable suture placed into a structure to retract
bridge or bolsters device prevents pressure from secondary suture line loop
pursestring suture circular stitch placed to close an opening or invert tissue
vessel loop used for isolation, retention, temporary occlusion of vessels
umbilical tape premoistened and loaded onto hemostat
button device used for tendon repair
preknotted endoscopic suturing
describe tensile strength & identify what factors affect the tensile strength of the suture the maximum strength a material can with stand factors: type of suture, pressence of infection, tissue sites, absorbtion
identify one suture with very strong tensile strength stainless steel
describe pliability how easily they pass through tissue how easily they tie and how secure the knots are
describe how to remove memory sutures should be drawn between gloved fingers
identify one suture with memory polyglycolic acid (dexon)
The type of stapler that delivers two double staple lines and contains a knife to transect tissue is called a linear cutter
A device used to anastomose tubular structures such as the colon is called a(n) intraluminal (circular) staples
synthetic material used for fascia defects as a reinforcement or bridge between structures is called polypropelene mesh
when using ______eyed needles, pull the suture into a v-shaped area; however, there is more tissue damage than with use of a swaged needle french
a suture with a needle on each end of the suture strand is called a double arm attachment
a suture designed to be removed with a quick pull is called eyeless needle
when using a needle on the skin, you would typically use a _______ needle cutting
when using a needle on delicate gastrointestinal tissue, you would typically use a ________needle tapered
when using a needle on friable tissue such as the liver or kidney, you could use a ________ needle blunt
the most common used body shape is the _______ circle 1/2
the most commonly used body shape for skin closure is the ____ circle 3/8
Created by: E.Ochoa
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