Assisting with Surgery Part 3 PDF

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Part Three on Assisting with Surgery for CMA certification....

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●Nonabsorbable •Absorbable Sutures –Digested by tissue enzymes and absorbed by the body tissues –Do not have to be removed –Absorption usually occurs 5 to 20 days after insertion –Used for internal organs such as the bladder and intestines, subcutaneous tissue, and ligating or tying off blood vessels –Plain catgut ●Used in areas where rapid healing takes place such as highly vascular areas of the and tongue –Surgical catgut ●Used on tissues that are fast healing such as the vaginal area –Chromic catgut ●Has a slower absorption rate and can be used to hold tissue together longer, such a muscle repair •Nonabsorbable Sutures –Used on skin surfaces where they can easily be removed after incisional healing take place –This type of suture material, such as nylon, cotton, silk, Dacron, and stainless steel, not absorbed by the body –Black silk is the most commonly used nonabsorbable suture •Suture Material –Silk suture ●Most expensive; also considered the most dependable

●An all-purpose suture; widely used and easy to tie –Nylon suture ●Has elasticity and strength that makes it ideal for use in joints and for skin closure ●Disadvantage is the difficulty in forming a tight knot –Polyester Suture ●Second strongest of all the standard suture materials, and steel is the strongest ●Used in ophthalmic, cardiovascular, and facial surgery, which all require a strong, unbreakable suture –Steel Suture ●Used in staples, as well as nonabsorbable suture wire that is composed of 316L stainless steel ●Most widely used suture material in major surgery ●Strongest of all suture material –Cotton Suture ●With less strength than other suture materials, is no longer widely used –Linen Suture ●Created from natural flax fiber •Size of the suture material –0 is the thickest and 6-0 (000000) is the smallest –Sizes 2-0 through 6-0 are most commonly used –Delicate tissue, on areas such as the face and neck, would be sutured with 5-0 to 6-0 suture material; fine sutures leave less scarring

–Heavier sutures, such as 2-0, would be used for the chest or abdomen –Physician determines size –Refer to Table 41-2 in student text •Suture Needles –Available in differing shapes depending on where they are used –Have either a sharp cutting point used for tissues that provide some resistance, or noncutting point used for more flexible tissue such as peritoneum •Straight Needle –Used when the needle is pushed and pulled through the tissue without the use of a n holder –Has an eye that is threaded with the suture material –The suture material thickness will be double when threaded through the needle becau enter the eye from one side and come out the other •Curved Needle –Allows the surgeon to go in and out of a tissue when there is not enough room to m straight needle –Requires a needle holder •Swaged Needle –A swaged needle and suture materials are combined in one length –Offers the advantage of the suture material not slipping off the needle because it i –Will contain a label indicating the gauge, type of needle point (cutting or noncutting) and length of the suture material •Other Wound Closure Materials –Steri-Strips

–Nonallergenic and available in a variety of widths –Used instead of sutures when not much tension is to be applied to a wound such as small facial cut •Staples –Made of stainless steel –Applied with a surgical stapler •Skin Adhesives –Composed of Cyanoacrylate adhesives that react with water to create an instant, st flexible bond –Composition is similar to Superglue –Used to close lacerations or small surgical incisions •Guidelines for Handling and Care of Instruments –Instruments should be cleaned after use –Handle carefully –Avoid allowing instruments to become tangled –Sharp instruments should remain separated from others –Instruments with ratchets should be stored open –Check all instruments for defects before sterilizing them •Guidelines for Handling and Care of Instruments –Disposable instruments ●Dispose of in sharps containers or biohazardous containers –Reusable instruments ●Presoak used instruments in an appropriate solution

●Gently clean them of debris ●Lubricate if needed ●Autoclave to sterilize them Surgical Assisting •Scrub assistant, scrub technician, or operating technician: –Applies sterile gloves and hands instruments to the surgeon –Uses transfer forceps to bring additional supplies as needed –Holds the vial of local anesthetic while the surgeon draws up the correct dosage int syringe –Applies dressings •Nonsterile assistant, floating assistants, circulating assistants, circulators, or floaters: –Anyone not in sterile attire and assisting with a procedure •A good assistant is able to: –Anticipate the needs of the physician –Use care in handing instruments efficiently –Use care that injury does not occur –Account for all materials and instruments used during the procedure •Scrub Assistant –Performs all procedures in sterile protective clothing using sterile technique –Arranges the surgical tray to meet the operating physician's preferences –Hands instruments to physician –Swabs bodily fluids away from operative site –Retracts incision area –Cuts suture materials...