14 Sutures and Wound Repair I.docx

Sutures and Wound Repair 1 1\. Which of the following men discovered that the body absorbs sutures made from animal tissues? A. Ambroise Paré B. Philip Syng Physick C. Joseph Lister D. William Stewart Halsted Correct answer: B. Philip Syng Physick Explanation: Philip Syng Physick discovered t...

Sutures and Wound Repair 1 1\. Which of the following men discovered that the body absorbs sutures made from animal tissues? A. Ambroise Paré B. Philip Syng Physick C. Joseph Lister D. William Stewart Halsted Correct answer: B. Philip Syng Physick Explanation: Philip Syng Physick discovered that the body absorbs sutures made from animal tissues. This discovery was a significant advancement in surgical techniques, allowing for the development of absorbable sutures that don\'t require removal after the wound has healed. 2\. Which of the following suture materials is not absorbed but remains as a living tissue in the body? A. Nylon B. Fascia lata C. Cargile membrane D. Ribbon gut Correct answer: B. Fascia lata Explanation: Fascia lata is a type of autograft suture material, which means it\'s taken from the patient\'s own body. Unlike synthetic or other biological sutures, fascia lata remains as living tissue in the body after implantation, becoming integrated into the surrounding tissues rather than being absorbed or remaining as a foreign material. 3\. The space caused by the separation of wound edges which have not been closely approximately by sutures is called: A. Dehisced space B. Palmar space C. Dead space D. Intervillous space Correct answer: C. Dead space Explanation: Dead space refers to the area within a wound where the edges have not been brought together closely, often due to inadequate suturing. This space can potentially fill with fluid or blood, increasing the risk of infection and delayed healing. Proper wound closure techniques aim to minimize dead space. 4\. An interrupted suture, which is placed through the tissue from one side of the tissue from one side of the wound to the other and then back through the tissue again, is called: A. Interrupted B. Buried C. Purse-string D. Mattress Correct answer: D. Mattress Explanation: A mattress suture is a type of interrupted suture that passes through the tissue from one side of the wound to the other and then back again. This creates a more secure closure and distributes tension more evenly along the wound edges, making it particularly useful in areas of high tension or for deep tissue closure. 5\. Suture material which, during the healing process, becomes encapsulated by fibrous tissue is called: A. Fascia lata B. Absorbable suture C. Ribbon gut D. Fascia lata Correct answer: D. Fascia lata Explanation: While the question seems to have a repeated option, fascia lata is indeed the correct answer. Fascia lata, when used as a suture material, becomes encapsulated by fibrous tissue during the healing process. This encapsulation integrates the fascia lata into the surrounding tissue, providing long-term support to the wound closure. 6\. In the presence of infection, the absorption rate of surgical gut is: A. Immediately terminated B. Decreased C. Increased D. Not affected Correct answer: C. Increased Explanation: In the presence of infection, the absorption rate of surgical gut is increased. This is due to the inflammatory response and elevated enzyme activity associated with infection, which accelerate the breakdown of the absorbable suture material. This faster absorption can potentially compromise wound closure if the infection is not controlled. 7\. Which of the following sutures may be used in the presence of infection? A. Cotton B. Nylon C. Polypropylene D. Silk Correct answer: C. Polypropylene Explanation: Polypropylene is a synthetic, non-absorbable suture material that can be used in the presence of infection. It is monofilament and has a smooth surface, which makes it less likely to harbor bacteria compared to multifilament sutures like silk or cotton. This property makes polypropylene a suitable choice for contaminated or infected wounds. 8\. A suture in which short lateral stitches are taken beneath: A. Mattress B. Subcuticular C. Traction D. Blanket Correct answer: B. Subcuticular Explanation: A subcuticular suture involves taking short lateral stitches beneath the skin surface. This technique provides a cosmetically appealing closure as the suture is not visible on the skin surface. It\'s commonly used in areas where minimal scarring is desired, such as facial wounds or cosmetic surgeries. 9\. The healing process in which a wound is purposely left open and allowed to heal from the bottom upward is called: A. Primary intention B. Interrupted intention C. Secondary intention D. Third intention Correct answer: C. Secondary intention Explanation: Secondary intention healing is a process where a wound is intentionally left open to heal from the bottom up. This approach is often used for infected wounds, large wounds, or those with significant tissue loss. It allows for drainage and granulation tissue formation, gradually filling the wound from the base to the surface. 10\. Surgical gut is made from the: A. Connective tissue of the small intestines of cats B. Dissected tendons of young calves C. Peritoneum of beef cattle D. Submucosa layer of sheep\'s intestines Correct answer: D. Submucosa layer of sheep\'s intestines Explanation: Surgical gut, also known as catgut (despite not being derived from cats), is made from the submucosa layer of sheep\'s intestines. This layer is rich in collagen, which provides the strength and absorbable properties of the suture. The term \"catgut\" is thought to be a corruption of \"kitgut,\" referring to the small fiddle strings once made from sheep intestines. 11\. Which of the following is most inert in tissue? A. Cotton B. Wire C. Silk D. Nylon Correct answer: B. Wire Explanation: Among the options given, wire is the most inert in tissue. Inertness refers to the material\'s tendency not to react with biological tissues. Wire, typically made of stainless steel or other metals, has minimal tissue reactivity. This property makes it useful in certain surgical applications where long-term stability and minimal tissue reaction are required. 12\. A stay suture does not pass through: A. Subcutaneous tissue B. Rectus muscle C. Mesentery D. Fascia Correct answer: C. Mesentery Explanation: A stay suture is typically used to provide temporary support or traction during a surgical procedure. It usually passes through more substantial tissues like muscle, fascia, or subcutaneous tissue to provide strong anchoring. The mesentery, being a delicate and highly vascularized tissue that supports the intestines, is not typically used for stay sutures due to its fragility and the risk of causing intestinal complications. 13\. The spitting open or gaping of a wound is called: A. Evisceration B. Dehiscence C. Herniation D. Eventration Correct answer: B. Dehiscence Explanation: Dehiscence refers to the partial or complete separation of wound edges after they have been surgically closed. This \"spitting open\" or gaping of a wound can occur due to various factors such as infection, poor wound healing, excessive tension on the wound, or premature removal of sutures. It\'s a serious complication that requires immediate medical attention. 14\. Which of the following is used to stop bleeding and oozing on the surfaces of severed bones? A. Hot packs B. A mixture of waxes (chiefly beeswax) C. A powder made from beef blood D. A gelatin sponge Correct answer: B. A mixture of waxes (chiefly beeswax) Explanation: Bone wax, primarily composed of beeswax, is commonly used to control bleeding from bone surfaces during surgery. When applied to the cut surface of bone, it acts as a mechanical barrier, sealing off the small blood vessels in the bone and stopping bleeding. This is particularly useful in procedures involving the skull or other bones where traditional methods of hemostasis may be less effective. 15\. The protrusion of bowel through the separated edges of an abdominal wound closure is called: A. Dehiscence B. Evisceration C. Wound disruption D. Secondary suture line Correct answer: B. Evisceration Explanation: Evisceration refers to the protrusion of abdominal organs, typically the bowel, through a wound in the abdominal wall. This is a severe complication of abdominal surgery, often resulting from wound dehiscence. It\'s a medical emergency requiring immediate surgical intervention to prevent infection, organ damage, and other life-threatening complications. 16\. Silk is not recommended for use in the gallbladder, kidney, or bladder because: A. It causes necrosis of tissue B. Bite and urine dissolve it C. It may become the nucleus for stone formation D. It loses its tensile strength in bite and urine Correct answer: C. It may become the nucleus for stone formation Explanation: Silk sutures are not recommended for use in the gallbladder, kidney, or bladder due to their potential to serve as a nidus for stone formation. The rough surface of silk can accumulate minerals and other substances present in bile or urine, potentially leading to the formation of gallstones or urinary calculi. This risk makes synthetic, monofilament sutures a preferred choice in these organs. 17\. Most braided or twisted nonabsorbable sutures should not be used in the presence of active infection because: A. They cause strangulation of the tissue B. Infection causes decomposition of sutures C. They are difficult to remove D. The sutures become a breeding placed infection Correct answer: D. The sutures become a breeding placed infection Explanation: Braided or twisted nonabsorbable sutures have a multifilament structure that provides spaces between the fibers. In the presence of active infection, these spaces can harbor bacteria, providing them with a protected environment to multiply. This can make it difficult to clear the infection and may even exacerbate it. For this reason, monofilament sutures are generally preferred in infected or potentially infected wounds. 18\. The Halsted Technique consists mainly of: A. Interrupted silk sutures B. Continuous sutures C. Widely spaced sutures D. Interrupted surgical gut Correct answer: A. Interrupted silk sutures Explanation: The Halsted Technique, named after the American surgeon William Stewart Halsted, primarily involves the use of interrupted silk sutures. This technique emphasizes meticulous tissue handling and precise wound closure. Halsted advocated for the use of fine silk sutures placed individually (interrupted) rather than in a continuous fashion, believing this method promoted better healing and reduced the risk of infection. 19\. Another name for a stick tie or transfixion suture is: A. Interrupted suture B. Suture ligature C. Tension suture D. Stay suture Correct answer: B. Suture ligature Explanation: A stick tie or transfixion suture is also known as a suture ligature. This technique involves passing a suture through a structure (such as a blood vessel or tissue pedicle) before tying it off. It\'s particularly useful for securing large blood vessels or tissue bundles where a simple tie might slip off. The suture ligature provides more security and helps prevent slippage of the ligature. 20\. Bumpers or guards are used on tension sutures to: A. Allow for the easy removal of the sutures B. Equalize tension on the wound edges C. Prevent the heavy suture from cutting into the skin D. Designated the sutures which are removed first Correct answer: C. Prevent the heavy suture from cutting into the skin Explanation: Bumpers or guards are used on tension sutures to prevent the heavy suture material from cutting into the skin. Tension sutures are often used in situations where there\'s significant force pulling the wound edges apart. The bumpers, typically made of soft material like rubber or silicone, distribute the pressure of the suture over a wider area of skin, reducing the risk of tissue damage or suture \"cheese-wiring\" through the skin. 21\. Tissue trauma will be kept to a minimum by using: A. Suture threaded through an eyed needle B. Sutured swaged to a needle C. Heavy gauge suture material D. Suture threaded on a French eye needle Correct answer: B. Sutured swaged to a needle Explanation: Tissue trauma is minimized by using sutures swaged to a needle. In a swaged needle, the suture material is permanently attached to the needle, creating a smooth transition between the needle and the suture. This design reduces the size of the hole created in the tissue as the needle passes through, causing less trauma compared to eyed needles or those with larger gaps between the needle and suture. 22\. The amount of weight or pull necessary to break the suture or ligature material is called: A. Yield power B. Gauge C. Tensile strength D. Temper Correct answer: C. Tensile strength Explanation: Tensile strength refers to the maximum amount of weight or pull that a suture or ligature material can withstand before breaking. This property is crucial in selecting appropriate suture materials for different surgical applications. Higher tensile strength is necessary for sutures used in areas of high tension, while lower tensile strength may be sufficient for delicate tissues or cosmetic closures. 23\. Which of the following would have a weakening effect on suture? A. Soaking it in saline B. Testing its tensile strength C. Straightening it D. All of the above Correct answer: D. All of the above Explanation: All of the mentioned actions can potentially weaken suture material: 1\. Soaking in saline can affect certain suture materials, particularly absorbable ones, potentially accelerating their degradation. 2\. Testing tensile strength involves applying stress to the suture, which can weaken it even if it doesn\'t break during testing. 3\. Straightening sutures, especially those designed to be curved or kinked, can damage their structure and reduce their strength. These actions can compromise the integrity of the suture material, potentially affecting its performance in wound closure. 24\. Which of the following synthetic nonabsorbable suture material is least reactive in tissue? A. Polypropylene B. Polyester fiber C. Nylon D. TEFLON impregnated polyester Correct answer: A. Polypropylene Explanation: Polypropylene is considered the least reactive synthetic nonabsorbable suture material among the options given. It is a monofilament suture that elicits minimal tissue reaction and has a very low affinity for bacteria. This low reactivity makes it an excellent choice for permanent sutures, especially in contaminated wounds or when long-term suture retention is necessary. Its inert nature also reduces the risk of suture granulomas or other inflammatory reactions. 25\. What type of suture would be used when closing the anus for the perineal stage of an abdominal perineal resection? A. A tension suture B. A purse-string suture C. A traction suture D. A mattress suture Correct answer: B. A purse-string suture Explanation: A purse-string suture is the most appropriate type for closing the anus during the perineal stage of an abdominal perineal resection. This type of suture involves placing a continuous suture around a circular opening and then drawing it tight, much like closing a drawstring bag. In the context of an abdominal perineal resection, the purse-string suture effectively closes the anal opening, preventing contamination and facilitating the removal of the rectum and anus during the procedure.