Sx Skills - Suture Materials & Surgical Needles 2

fazakalo's version from 2017-06-22 08:56

Surgical needles / Alternatives to Suturing

Question Answer
What are the 3 parts of a needle?Point
Body (shaft)
Swaged end (where the suture goes inside)
What are the 4 characteristics you should know about a needle?(1) Suture attachment
(2) Shape
(3) Point + cross section
(4) Size
What are the 2 types of suture attachments on a needle?(1) Swaged
(2) Eyed
(Do NOT need to know the different kinds pictured below)
Explain the structure of a swaged needle & what its pros & cons areIt is an eyeless needle, w/ suture affixed to end of needle
PROS: ↓ tissue trauma (needle size is apprx suture size), it is easy to use & it is sterile out of the package
CONS: More expensive
Explain the structure of an eyed needle & what its pros & cons areSuture must be threaded through eye
PROS: Cheap, needle can be reused
CONS: reuse may make needle dull, ↑ 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 & used in easily accessible places (like the side of a cow) (Keith is a straight needle, even tho it doesnt sound like a straight name)
What are the 2 criteria for selecting needle curvature?(1) Diameter of wound
(2) Depth of wound
How do the curve & the depth of the tissue relate?Deeper wound/tissue, needs a more curved needle.
Name the 6 kind of needle point/cross sections(1) Taper point
(2) Tapercut
(3) Regular cutting
(4) Reverse cutting
(5) Spatula point
(6) Blunt point
What is a Taper Point needle used for?Hollow organs
What is a Tapercut needle used for?Muscle & tendon
What is a Regular Cutting 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?Taper Point
What needle would you use for mm & tendon?Tapercut
What needle would you use for skin?Regular Cutting OR Reverse Cutting (Reverse Cutting shown here)
What needle would you use for dissecting layers of the cornea?Spatula Point
What needle would you use for parenchymal organs?Blunt point
You’d select the needle POINT based on...The tissue type (its strength & 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 2 major alternatives to suturing?Glue & 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 (must be < 5cm)
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?↓ Sx time, secure + reliable hemostasis, can reach areas w/ minimal accessibility
If you are going to staple the skin, how should you hold the skin for stapling?Apply to skin w/ wound edges slightly everted
Vascular staples are aka, 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 2 sides of the staple)



What is a TA stapler used for?ThoracoAbdominal Sx (i.e. lung or liver lobe resection)
What is a GIA stapler used for?GastroIntestinal Anastomosis
What is an EEA stapler used for?End-to-End Anastomosis
What information is present on the outside of the suture package?Expiratory date
Needle curvature
Needle type
Needle length
Needle shape & 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 length across from swage to tip (not length of the needle)
What would you consider the needle length?The circumference of the half circle, curved length from tip to swaged end