Surgical Assisting 1 – Questions And Answers (Pass!) Type 1 "Clean" Wounds Correct Ans - 1-5% Risk of infection Non-traumatic No Inflammation present No break in technique
Example: elective groin hernia repair, laproscopic
Type 2 clean-contaminated wounds Correct Ans - 3-11% risk of infection Non-sterile body region entered under controlled conditions and without unusual contamination (GI or Gu tract, biliary tract, respiratory tract, oropharynx) Minor breaks in technique Type 3 Contaminated Wound Correct Ans - 10-17% risk of infection Major break in sterile technique Gross spillage from gastrointestinal (GI) tract Infected GI, urinary or biliary tract Fresh traumatic wound (through unprepped skin) Type 4 Dirty or Infected wounds Correct Ans - Infection risk: >27% Wounds associated with perforated viscus; cross clean tissue to drain pus
Traumatic wounds with:
Imbedded foreign body Delayed presentation( > 12-24 hours for face and scalp; > hours elsewhere) Primary Closure (primary intention) Correct Ans - Wound edges are brought together so that they are adjacent to each other
Example: Normal surg. incision, well-repaired lacerations, well reduced bone
fractures, healing after flap surgery Secondary Closure (secondary intention) Correct Ans - Wound is left open, and closes naturally through granulation ex. tooth extraction sockets, poorly reduced fractures tertiary closure. (delayed primary closure). Correct Ans - wound is left open for a number of days and then closed if it found to be clean ex. healing of wounds by use of tissue grafts, traumatic wounds 1 / 3
Criteria for suture materials Correct Ans - 1. Tensile strength
- Good knot security
- Workability in handling
- Low tissue reactivity
- Ability to resist bacterial infection
How are sutures sized? Correct Ans - 3 to 12-0 Numbers without zeros indicate larger sutures, numbers followed by zeros indicate smaller sutures Non-absorbable suture are used for what? Correct Ans - Skin repair when wanting removal Fasica under tension Vascular (blood vessel) repairs -Nylon -Prolene -Stainless steel -Silk When is absorbable suture used? Correct Ans - Subcutaneous repair Intraoral mucosa (including tongue) Fascia not under tension -Vicryl -Monocryl -PDS -Chromic -Cat gut What are the two different types of suture material? Correct Ans - Monofilament Multifilament Monofilament Correct Ans - Single strand of suture material Minimal tissue trauma Smooth tying but need more knots needed Resists harboring organisms Nylon, monocryl, prolene, PDS 2 / 3
Multifilament (braided) Correct Ans - Fibers are braided or twisted together More tissue resistance Easier to handle Fewer knots needed Vicryl (braided), silk (braided), chromic (twisted) What are some examples of multifilament? Correct Ans - Vicryl, silk, chromic What are some examples of monofilament? Correct Ans - Nylon, monocyrl, prolene, PDS What are 2 basic configurations for curved needles? Correct Ans - 1.
Cutting: cutting edge can cut through tough tissue, such as skin
2. Tapered: no cutting edge, used for softer tissue inside the body
Simple interrupted closure Correct Ans - Most commonly used, good for shallow wounds without wound tension Place knot off to side to reduce tension Continuous Closure (running sutures) Correct Ans - Good for hemostasis (scalp wounds) and long wounds with minimal tension Locking continuous Correct Ans - Usedful in wounds under moderate tension or those requiring additional hemostasis Subcuticular Correct Ans - Good for cosmetic results Vertical mattress Correct Ans - useful in maximizing wound eversion, reducing dead space, and minimizing tension across the wound Far far near near Horizontal mattress Correct Ans - good for fragile skin and high tension wounds Percutaneous (deep) closure Correct Ans - Good to close dead space and decrease wound tension
- / 3