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Surgical Assisting 1 – Questions And Answers (Pass!)
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Surgical Assisting 1 – Questions And Answers (Pass!)
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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 Criteria for suture materials Correct Ans - 1. Tensile strength
2. Good knot security
3. Workability in handling
4. Low tissue reactivity
5. 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 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
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