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Questions and Answers
A cutting needle has a triangular cross section and is used for sutures in the skin.
A cutting needle has a triangular cross section and is used for sutures in the skin.
True
Eyeless needles have the capability to be threaded with a separate thread.
Eyeless needles have the capability to be threaded with a separate thread.
False
The purpose of aspiration in abscess treatment is to allow for drainage.
The purpose of aspiration in abscess treatment is to allow for drainage.
False
General anesthesia is commonly used during surgical procedures such as lithotomy.
General anesthesia is commonly used during surgical procedures such as lithotomy.
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A rounded needle is primarily used for suturing skin.
A rounded needle is primarily used for suturing skin.
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Active drains are used to withdraw fluids in a surgical setting.
Active drains are used to withdraw fluids in a surgical setting.
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The term 'cold abscess' refers to abscesses treated with drainage only.
The term 'cold abscess' refers to abscesses treated with drainage only.
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In cases of potential rupture, it is recommended to perform drainage immediately.
In cases of potential rupture, it is recommended to perform drainage immediately.
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Closed drains function by apportioning tissue to avoid potential space under suction.
Closed drains function by apportioning tissue to avoid potential space under suction.
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The cubital fossa is treated with a vertical incision.
The cubital fossa is treated with a vertical incision.
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Study Notes
General Principles of Surgical Operations
- Suture Materials are classified into absorbable and non-absorbable categories.
Types of Absorbable Sutures
-
Natural Absorbable Sutures:
- Plain Catgut: Derived from sheep's intestine, absorbed within one week by phagocytosis; limited use due to severe reactions.
- Chromic Catgut: Modified with chromium salt, less irritant; absorption time extended to three weeks.
-
Synthetic Absorbable Sutures:
- Dexon (Polyglycolic Acid): Multifilamentous, good tensile strength; absorbed in four months.
- PDS (Polydioxanone): Monofilamentous, ideal for contaminated wounds; absorbed in six months.
- Vicryl (Polyglactin): Multifilamentous, used for gastrointestinal anastomosis; absorbed in four months.
- Monocryl (Polyglecapron 25): Monofilament with high tensile strength; absorbed in three to four months.
Non-Absorbable Sutures
-
Natural Non-Absorbable Sutures:
- Surgical Silk: Multifilamentous, rich in protein causing significant tissue reaction; requires removal if infection occurs.
-
Synthetic Non-Absorbable Sutures:
- Nylon (Ethilon): Polyamide, available in mono or multifilament, good tensile strength.
- Prolene (Polypropylene): Monofilamentous, strong tensile strength, difficult to knot.
- PTFE: Minimal tissue response with good handling.
- Others: Recently introduced staplers, adhesive tapes, and stainless steel.
Suture Characteristics
- Monofilament Sutures: Single strand, less organism harboring, suitable for vascular surgery.
- Multifilament Sutures: Composed of several filaments, greater tensile strength.
- Tensile Strength: Required strength to keep tissues in proper apposition.
Types of Stitches
- Simple Stitch
- Mattress Stitch: Vertical and transverse (horizontal) variants.
- Lembert Suture: Second row inverting sutures.
- Tension Sutures: Include simple overhead, blanket, quilted, Lembert's, and Connell's (loop on mucosa).
Suture Removal Times
- Face: 5-7 days
- Scalp: 10 days
- Trunk & Upper Extremities: 10-14 days
- Lower Extremities: 14-21 days
- Early removal reduces risk of marks, infection, and tissue reaction.
Suture Removal Process
- Clean and sterilize skin.
- Elevate suture gently with forceps.
- Cut one side and grasp the knot, pulling towards the suture line.
Alternative Closure Methods
- Steri-Strips
- Staplers
- Tissue Adhesive
- Barbed Sutures
Types of Suture Needles
- Straight Needles: Used for superficial structures, e.g., skin.
- Curved Needles: Variants include 3/8, 1/2, 5/8 circles.
Needle Variants
- Rounded Needle: Circular cross-section, suitable for organs and mucosa.
- Cutting Needle: Triangular cross-section, sharp edges for skin sutures.
- Eyeless Needle: Threaded within; common in plastic, vascular, neuro-surgery.
- Eyed Needle: Traditional, with a small opening, limited reuse.
Surgical Techniques
- General Anesthesia: Used for various surgical procedures.
- Incisions: Specific techniques based on anatomy, e.g., transverse for neck, vertical for axilla.
Abscess Management
- Important Sites: Parotid, breast, pulp, peri-anal abscesses require immediate intervention.
- Cold Abscess Treatment: Use anti-T.B. drugs, prefer aspiration over drainage unless secondary infections or impending rupture occurs.
Surgical Drains
- Classification: Open, closed, active, passive.
- Uses: Withdrawal of fluids and tissue apposition to remove potential spaces via suction.
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Description
Test your knowledge on general principles of surgical operations with a focus on absorbable sutures. Explore various types of suture materials and their characteristics, including natural options like plain and chromic catgut. This quiz covers essential information for surgical practice.
