Sx Skills- Suture material and surgical needles 2

untimely's version from 2015-05-06 21:48

Surgical needles / alternatives to suturing

Question Answer
what are the three parts of a needle?point, body (shaft), and swaged end (where the suture goes inside)
what are the 4 charateristics you should know about a needle?(1) suture attachment (2) shape (3) point + cross section (4) size
what are the two types of suture attachments on a needle?(1) swaged (2) eyed
explain the structure of a swaged needle, and what its pros and cons areIt is an eyeless needle, with suture affixed to end of needle. PROS: dec tissue trauma (needle size is apprx suture size), it is easy to use, and it is sterile out of the package. CON: more expensive
explain the structure of an eyed needle, and what its pros and cons aresuture must be threaded through eye. PROS: Cheap, needle can be reused CONS: reuse may make needle dull, increased tissue trauma (needle size 3-4X suture size)
what is a straight needle aka? when would you use it?aka Keith needle. Typically hand held, and used in easily accessible places (like the side of a cow) (keith is a straight needle, even though it doesnt sound like a straight name)
what are the two criteria for selecting needle curvature?(1) diameter of wound (2) depth of wound
how do the curve and the depth of the tissue relate?deeper wound/tissue, needs a more curved needle.
name the six kind of needle point/cross sections(1) taperpoint (2) tapercut (3) regular cutting (4) reverse cutting (5) spatula point (6) blunt point (check out slide 33 for great cross-sectional views)
what is a taperpoint needle used for?hollow organs
what is a tapercut needle used for?muscle and tendon
what is a regular cut needle used for?skin
what is a reverse cutting needle used for?skin
what is a spatula point needle used for?cornea (eye)
what is a blunt point needle used for?parenchymal organs (like liver, kidney, etc)
what needle would you use for hollow organs?taperpoint
what needle would you use for mm and tendon?tapercut
what needle would you use for skin?regular cut OR taper cut
what needle would you use for dissecting layers of the cornea?spatula
what needle would you use for paranchymal organs?blunt point
you'd select the needle POINT based on... the tissue type (its strength and penetrability)
you'd select the needle shape/curvature based on...the depth of the tissue being sutured
you'd select the needle size based on...projected size of bites to be taken
what are the two major alternatives to suturing?glue and staples
Tissue adhesives (“tissue glue”)--> what are these made of? how long does it take to set/ limitations?made of Cyanoacrylates, Sets in <1 minute (adhesion impaired or delayed when application area is moist) (so area must be dry!)
what are some good applications of tissue adhesives/glue?close short skin incisions, small skin lacerations, declaw, tail dock
**when should you NEVER use tissue glue?Never use on bite wounds or other heavily contaminated wounds, puncture or deep wounds, lacerations >5cm; do not use on mucous membranes, near the eye or in subcutaneous tissues
what are the advantages of surgical stapling?decreased surgery time, secure + reliable hemostasis, can reach areas with minimal accessibility
if you are going to staple the skin, how should you hold the skin for stapling?apply to skin with wound edges slightly everted
vascular staples are aka, are are used on what KIND of (size) vessels?aka Hemoclips®, Ligaclips. used for ligation of vessels less than 11mm (3/8”) in diameter (1-1 looks like two sides of the staple)
what is a TA stapler used for?thoracoabdominal sx (ie. lung or liver lobe resection)
what is a GIA stapler used for?gastrointestinal anastomosis
what is a EEA stapler used for?end-to-end anastomosis
look at slide 40 for how to read the suture packageexpiratory date, needle curvature, needle type, needle length, needle shape and size, length of suture, suture size, suture material type, needle curvature
what's the chord length?from tip of needle to other tip (swaged end)..basically the diameter of the half circle
what would you consider the needle length?the circumfrence of the half circle, curved length from tip to swaged end

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