PNLE COMPREHENSIVE REVIEW UST CON BATCH 2022

INTRAOPERATIVE NURSING
LECTURER: Assoc. Prof. Gian Carlo Sy Torres

___________________________________________________________________________________________________________
PERIOPERATIVE NURSING − Pain meds:
○ Narcotics (check RR) hold the dose if
NURSING PROCESS
RR is <12/min.
● Assessment = Purpose of narcotics is to increase
● Diagnosis the pain threshold.
→ Know your priorities, physiologic or psych. = Check the BP aside from the RR.
→ It’s always physiologic over psychologic ○ Diphenhydramine have anticholinergic
→ Refer to Maslow’s Hierarchy of Needs (Physiologic effect and sedative effect. Check the VS,
needs) ask the pt to Void, instruct him about
● Planning DBEs, Health teachings about Postop
→ SMART (Objective) care.
→ Note that if your kidneys are perfused, you have an ○ Diazepam
adequate tissue perfusion. ○ Medazolam
● Implementation ○ Dormicum
→ Dependent, Independent → MENTAL
■ Consent
PREOPERATIVE − Full disclosure has been given
● Patient decided to have the surgery to OR − No coercion
● Preparation of patients − Age: 18 yo
● Aspects of Patient Preparation: − Emancipated minor – pregnant minor/teens
→ PHYSICAL − Nurse’s role is to act as a witness
■ Involves the preliminary lab works and screenings ■ Health Teachings
■ Basic screenings (CBC, NA, Urine analysis) − Process Information – teachings about what to
■ CBC – Hgb, Hct, RBC, WBC, Platelets expect during the surgery (to also lessen the
− Inc Hgb – polycythemia anxiety of the patient)
− Dec. Hgb – implication on surgery → − Procedural information – things patient have to
oxygenation is affected → issue on tissue do postop (positions, splinting exercises, DBEs,
perfusion. leg mobility, ambulation)
− Inc. Hct. → diluted → Overloaded yung → SOCIAL / EMOTIONAL
patient→ rales, crackles or electrolyte ■ Involves the role of Social workers.
imbalances ■ Refer any special needs to the social worker
− Dec. Hct → bleeding or dehydrated (logistics, financial, family health, family support,
− RBC (oxygen carrier) needs for support groups)
− WBC (fights BACTERIAL infections) → SPIRITUAL
− Platelets (responsible for the clotting ■ Point person is the Chaplain/Pastoral Care Services.
mechanisms)
■ Urine analysis INTRAOPERATIVE PHASE
− Normal urine color – straw amber transparent ● OR TO PACU
■ Older patients (>45yo): requires CP
(Cardiopulmonary) clearance: CXR, 12L ECG. OPERATING ROOM SETTING
■ ECG: Atrial flutter, Atrial fibrillation, Vtach, VFib, ● Areas in the OR:
Asystole, Heart blocks (know the management for
each) Non-restricted Area
■ NPO is usually required for pts undergoing General ■ Includes the lobby, family rooms, waiting areas
Anesthesia (initiated at least 6-8 hrs before ■ Street clothes are allowed, OR personnel can
procedure). stay without the smack gown (if beyond the
■ Bowel preparation – 3-day prep, starts full-diet non-restricted → smack gown needed)
soft diet general liquids clear liquids.
− Neomycin decreases the possible bacterial Semi-restricted Area
flora in the GI tract. ■ Clean scrub suit, OR shoes, Bonnet, No Face
■ If diabetic patient is NPO, usually hooked in an IV Masks (pre-pandemic)
line (D5 containing: D5LRS)
− If not diabetic, usually PNSS. Restricted Area
■ Pt prior to surgery: ■ Scrub suits, bonnets, OR shoes, surgical masks
− Adult: gauge 18 (largest – green) ■ Sterile person – need to wear the gown (not
− G20 – Pink needed for Circu nurse)
− G22 – blue; antibiotic ■ Scrub team: Surgeon, Asst. Surgeon, Scrub
− G24 – Yellow; baby nurse → STERILE)
■ Shaving prior is not encouraged as it’s said that it − Non-sterile: Circu, Anesthesiologist
increases microorganism growth. Sa OR na mismo
nagtritrim.
− Usually, patients are instructed to take a bath REASONS FOR SURGERY
prior. Diagnostic Removal and study Breast Biopsy
■ No nail polish prior of tissue to make a
− A SpO2 is attached to the patient for diagnosis
assessment. Exploratory More extensive Exploratory
■ Patient gown, remove underwear means to Laparotomy
− Sometimes, catheters may be inserted. diagnose; Exploration of
■ Prosthesis/dentures, contact lenses, jewelries exploration of body abdomen for
removed cavity or use of unexplained pain
− Management: if patient’s belongings are lost scopes inserted
endorsed to the family members. thru small incision
■ Medications: Curative Removal or Cholecystectomy
− Anticholinergics: decreases GI motility, replacement of Hip replacement
salivation, lesser risks of N/V.

TRANS: GERMANO & GOMEZ Page 1 of 8

 defective tissue to ● Choledocho – Common bile duct
restore function ● Chondro – cartilage
Palliative Relief of symptoms Resection of tumor ● Colo – Large intestine, Colon
or enhancement of to relieve pressure ● Colpo – vagina
function without and pain ● Costo – Rib
cure ● Cranio – skull
Cosmetic Correction of Rhinoplasty ● Cysto – bladder
defects; Cleft lip repair ● Esophago – esophagus
Improvement of ● Gastro – stomach
appearance; ● Glosso – tongue
Change in physical ● Hepar – liver
feature ● Hyster – Uterus
● Lapar – Abdomen
CATEGORIES OF SURGERY BASED ON URGENCY: ● Lipo – Fat
Emergency Immediate Severe bleeding ● Mast/Mammo – Breast
Condition Gunshot wound ● Nephro – Kidney
life-threatening ● Oculo – Eye
Surgery at once ● Oophor – Ovary
● Orchi – Testis
Urgent Within 24-30 hrs Kidney stones
● Osteo – Bone
Required prompt Gallbladder
● Oto – Ear
attention infection
● Phlebo – Vein
Fractured Hip
● Pneumo – Lungs
Required Planned for a few Cataracts
● Procto – Rectum
weeks or months BPH
● Pyelo – Renal Pelvis
after decision
● Rhino – Nose
Required surgery
● Salpingo – Fallopian tube
at some point
● Thoraco – Chest
Elective Client will not be Scar removal ● Urano – Palate
harmed if surgery ● Uretero – Ureter
not done but will
benefit if done OPERATING ROOM MEMBERS
Optional Personal Cosmetic surgery
● Surgeon
preference
→ Head of the surgical team
● Assistant Surgeon
PREFIXES → Assist either to retract, suture, cut, dissect tissues,
● A - without, absence provide better visualization in the surgical site
● Ecto - external, outside ● Anesthesiologist
● Infra - below → Monitors the overall hemodynamic stability of the patient
● Inter - between → If pt is in pain even after admin of meds, nurse should
● Intra - within refer this to the Anesthesiologist.
● Pan - all ● Scrub Nurse
● Peri - around → Should always be one step ahead, anticipates the needs
● Poly - many of the surgeon
● Pseudo - False → Prepares the sterile field (inc. tools)
● Retro - behind, posterior → If there’s a missing surgical tool → inform the Circulating
● Supra - above Nurse initially → then notify the Surgeon
→ Start of Counting → Closure of the Peritoneum (first
SUFFIXES layer)
● Centesis – puncture ● Circulating nurse
● Copy – to view → Attends to everyone’s needs.
● Ectomy – surgical removal ● Pathologist
→ Appendectomy (removal of appendix) → Responsible for the clinical histopathology, autopsy
● Itis – inflammation → Labeling of the Specimen: Name, Age, Sex, Specimen
● Lith – stone or calculus location, Surgeon, Pathologist
● Lithotomy – removal of stones → Frozen section – requires a fresh specimen (properly
→ Nephrolithotomy – stones kidneys labeled plastic)
● Lysis – destruction, dissolution, loose ■ determines whether the specimen is benign or
● Oma – tumor malignant
● Ostomy – opening into ■ Labeling of the specimen should include: name,
→ Colostomy age, sex, specimen location, surgero
● Otomy – procedure → Histopath – specimen is in a diluted formalin solution.
→ Craniotomy – procedure of opening a hole in the skull ● Others
→ Craniostomy → Blood Bank
● Plasty – surgical formation (enhancement) → Intern
→ rhinoplasty → Clinical Histopathology
● Pexy – fixation → OR Technician – the one who set up like laparoscopic
● Rrhapy – suturing of, repair procedures.
● Tripsy – crushing of stones
WHO GUIDELINES FOR SAFE SURGERY:
ROOT WORDS
TEN (10) ESSENTIAL OBJECTIVES FOR SAFE SURGERY:
● Adeno – gland
1) The team will operate on the correct patient at the correct
● Ano – anus
site
● Arthro – joint
a. Verify Patient Identity: Ask pt his name, ID
● Angio – blood or lymphatic vessel
band, pt identifiers
● Blephar – Eyelid
b. Correct Surgical Site ensure surgical site
● Broncho – Bronchus
marking especially for areas with laterality (ex:
● Cardio – heart
arms, legs); Arrow mark or Circle (Not “X” sign),
● Cephalo – head
markers are not used on neonates and infants
● Cerebro – brain
(as it may cause permanent marks)
● Chelio – lip
2) The team will use methods known to prevent harm from
● Chole – Gall, bile
administration of anesthetics, while protecting the patient
● Cholecyst – gall bladder
from pain

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 3) The team will recognize and effectively prepare for → Should not be removed or transferred, if you’ll change it,
life-threatening loss of airway or respirator function. remove everything
nsidered stil
a. Patients who have sleep apnea, snores, short ● Gowns ~
necks, obese → Waist up, 2 inches above the elbows
4) The team will recognize and effectively prepare for risk of → Axillary part not included; axilla and back part are
high blood loss unsterile
a. Adult: >500mL anticipated blood loss → you ● Gloves
have to have a blood reservation → If butas → ideal palitan but double gloving is also
b. Baby: >7mL/kg BW accepted.
5) The team will avoid inducing an allergic or adverse drug ● Room Disinfection
reaction for which the patient is known to be at significant → You have to wipe the lights properly as glaring can occur
risk which can disturb the visual field of the surgeon.
a. Check the patient for known allergies.
6) The team will consistently use methods know to minimize MEDICAL AND SURGICAL INSTRUMENTS AND SUPPLY
the risk for surgical site infection CATEGORY:
a. Antibiotic → given at least 1 hour prior to the
cutting time
b. Verifying the sterility of all the items that we’ll be Category 1: → Items that come in contact with the
using. CRITICAL blood vessels and non-intact
7) The team will prevent inadvertent retention of Items mucosa
instruments and sponges in surgical wounds. → Must be sterilized
8) The team will secure and accurately identify all surgical → Clams, knives, scissors
specimens.
9) The team will effectively communicate and exchange Category II: → Come in contact with your intact
critical information for the safe conduct of the operation SEMI-CRITICA mucosa and non-intact skin
10) Hospitals and public health systems will establish routine L Items → Sterilization is preferred BUT
surveillance of surgical capacity, volume, and results. Disinfection is acceptable

Category III: → Clean, intact skin

NON-CRITICAL
Items

STERILIZATION PROCEDURES
● Physical Sterilization
→ Moist Heat (Autoclaving – steam under pressure)
■ Autoclaving: 121-125°
− Ideal temp: 121-123C 15-30 mins
− Time: 15-30 mins
15-17 PST,
− Pressure: 15-17 PSI
→ Dry Heat (dry heat autoclaving)
● Chemical Sterilization
→ Ethylene Oxide
■ Can take 16-18 hrs for sterilization
→ Plasma hydrogen peroxide gas (Sterrad)
■ Can sterilize in 30 minutes

ASEPSIS & PRINCIPLES OF STERILE TECHNIQUE

■ -
Limitation: Bawal yung liquids or wet items, lumix

DEFINITION OF TERMS DISINFECTION PROCEDURES

● Asepsis – absence of microorganisms ● High level Disinfection
● Disinfection – reduction of pathogenic microorganisms → Activated glutaraldehyde 20 mins
without destroying the spores → Prolonged exposure (24 hours in the past, nowadays 20
● Contaminated - soiled with microorganisms mins)
● Infection – Invasion of the body by pathogenic -
→ Rinsing solution used: Sterile water
microorganisms ● Intermediate Level Disinfectant
● Spores – are inactive but viable state of a microorganisms → 70% alcohol, Iodine Compounds
● Sterile – free from microorganisms including spores → Chlorhexidine
● Surgical conscience – involves the concept of ● Low Level Disinfectant
self-inspection and moral obligation involving scientific and → Phenolic compounds, Chlorine compounds
intellectual honesty. → Panlinis ng surroundings.
→ Ex: spill of blood all around use of bleach or chlorine
SOURCES OF CONTAMINATION as it is effective and low-cost.
● Skin
● Respiratory tract STERILIZATION AND DISINFECTION
● Articles used in the procedure ● Labels
● Circulating Air → Processed date, expiration date
● Scrub team/patient’s hair ● Wrappers
→ Do not shave ONLY hair clipper/depilatory cream but ● Shelf life
needs patch test or allergy test → The Method of Sterilization determines the shelf life.
Sterile field Gloves
● Indicators
items
PRINCIPLES OF ASEPSIS Traffic Steile → items that would change in color once they’re exposed to
● Sterile items Drapes passing a certain situation/circumstance.
● Sterile field GOORS → The change in color only tells you that the item
→ Back table – level of the waist; usual table level; any underwent the process (but the correct time, temp,
items that fall below this (either from the back table or pressure can only be verified by the person who
adjustable mayo table) are considered unsterile. performs the sterilization)
→ Adjustable mayo table → Chemical Indicators
● Traffic ■ What does the change in color tell you?
→ Should be maintained only by the primary members only ■ Ex. White color indicator under pressure went into
(surgeon, asst. surgeon, scrub and circu nurse) dark brown/black color
→ Should be kept to a minimum ■ white → black
● Drapes ■ Red → yellow
■ Yellow → blue

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- > ->

-
 → Biologic Indicators ■ Desflurane (Suprane)
■ Has live spore in the test tube then dadaan sa ■ Isoflurane (forane)
process if may spore pa din then unsterile ■ Halothane (fluothane)
● Intravenous
ANESTHESIA → Drugs that may produce hyposis, sedation, amnesia and
FACTORS THAT DETERMINE THE CHOICE OF ANESTHESIA or analgesia is administered via IV
→ Common anesthetics:
● Physical and mental condition of patient
■ Thiopental Na (Pentothal)
● Age and weight of patient
■ Propofol
● Operation to be performed
■ Ketamine
→ If the surgical site isOabove the nipple line, anesthesia to
be used is General Anesthesia.
→ C Below the nipple line → Regional or Local anesthesia *Inc cellular activity → inc metabolism → (by product) heat &
● Type and probable duration of operation carbon dioxide → The heat will explain the malignant
→ Epidural – used in longer operations hyperthermia.
● Patients preference
● Laboratory findings *Inc metabolism→ Elevated CO2 & Heat→ inc CO2 → blood
● Any known idiosyncrasies becomes acidic → blood becomes blackish or brownish in color

STAGES OF ANESTHESIA IESS *Dantrium sodium – antidote of malignant hyperthermia

Stage 1 (Induction/Stage of Analgesia) REGIONAL ANESTHESIA

● Epidural Anesthesia

Pungprocedures
→ Starts from induction period until patient loses → Used for Long Procedures below the Thoracic level
->

consciousness -> LOC → Used for post op management of pain

→ Patient may appear drowsy or dizzy induction → Uses an epidural Catheter (perifix)
→ Keep the room quiet → Common Anesthetic:
■ Bupivacaine (Sensorcaine Isobaric, Marcaine)
Stage 2 (excitement/delirium) ■ Levobupivacaine (Chirocaine)
■ Lidocaine (for testing)
→ Lasts from the time the patient loses consciousness → Usually patients have urinary catheter.
until he loses certain reflexes such as swallowing, gag ● Subarachnoid Block
reflex… LOC.reflexes
→ Commonly termed as spinal anesthesia
→ Effects usually last 2-3 hours → can be prolonged by
administering ephedrine or epinephrine → can last up to
Stage 3 (Surgical anesthesia)
3 hours. 2-3hs
→ For short cases below the thoracic level shirt
→ From the period the patient lost certain reflexes and → Uses spinal needle gauge 22, 25, or 27
respiratory paralysis occurs ⑦reflexes - Respi, paralysis
→ Common Anesthetics:
→ Patient with regular respiration, constricted pupils, ■ Bupivacaine hyperbaric (sensorcaine Heavy)
jaws relax, and auditory sensation is lost ■ PDE (Tetracaine (pontacaine), Dextrose, Ephedrine)
■ To prolong give epinephrine/ephedrine
Stage 4 (Stage of Danger) (vasoconstricting) kaya slow daan ng gamot
→ Hydration – preload of at least 1 liter prior to the injection
→ Reached when too much anesthesia has been given of the anesthetic.
and the patient has not been observed carefully. ● Nerve Blocks
→ ⑳
Death may result from respiratory and or⑳ cardiac → Anesthetizing surrounding tissues (field) or group of
C
arrest unless resuscitated properly nerves (nerves) at a given point
→ Patient is not breathing with little to no heart beat. → Common Anesthetics:
■ Bupvacaine Isobaric (sensorcaine, Marcaine)
TYPES OF ANESTHESIA unipple low the ripple
line ■
■
Lidocaine
These agents can induce toxicity
− Slurred speech, arrhythmias, seizures, metallic
General Anesthesia Regional Anesthesia
taste (lasang kalawang).
● Field Block/Local Infiltration
→ Brain is affected → Depresses
→ Agent is injected into the tissues around incision site
→ Association -
superficial nerves
→ Anesthetics: Lidocaine
pathways are broken and interferes with
● Topical
in the cerebral cortex the conduction of
→ Agent applied directly into a mucosa or surface
to produce mor eor pain impulses from
→ Ex: Lidocaine spray
less lack of sensory certain area or
and motor region
OTHER MEDICATIONS UNDER ANESTHESIA
perception → Pain is controlled
→ Pain is controlled by without loss of ● Premedications:
general insensibility, consciousness; one ○ Midazolam (Dormicum)
the patient is region or an area of ○ Diazepam (Valium)
unconscious, he the body is ● Opioid Narcotic:
cannot hear, feel or anesthetized. ○ Fentanyl (Sublimaze)
move his whole ● Muscle Relaxants:
body. ○ Succinyl Choline (Anectine)
→ Used in operations ○ Rocuronium Bromide (Esmeron)
above the Thoracic ○ Atracurium (Tracrium)
level. ○ Pancuronium Bromide (Pavulon)
→ Inc GABA = brain is ○ Vecuronium Bromide (Norcuron)
depressed ● Anticholinergics
● Acetylcholinesterase Inhibitors

GENERAL ANESTHESIA INCISION, POSITION & DRAPING

● Inhalation LAYERS OF ABDOMEN
→ With the use of volatile gases and vapors ● Skin
→ Either per mask or Endotracheal tube ● Fascia
→ Common Anesthetics: ● Muscle
■ Nitrous oxide ● Peritoneum
■ Sevoflurane (sevorane)

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9 REGIONS OF THE ABDOMEN SKIN PREPARATION (Special Considerations)
● Determine the area and the extent to be prepared including
proposed incision.
● Practice modesty and privacy
● Examine area to be prepared
● In abdominal operation focus on the umbilicus
● In shaving follow the direction of the hair growth while the
-

other hand exerts an opposite force -

● If a wound is present, start from the clean area first before the
dirty area.

INSTRUMENT CLASSIFICATION
● Clamping/Hemostats
● Grasping/Holding
● Retracting Instruments
● Cutting/Dissecting
TYPES OF INCISION ● Suturing Instrument
● Right subcostal (Kochers) – for gallbladder
PARTS OF AN INSTRUMENT
● Median Upper ABD
● Median Lower ABD ● Clamping/Hemostats
o “Para” median – side (para = side) ○ For blood vessels (to stop it from bleeding)
● Mc Burney’s Incision – appendectomy ○ Kelly
● Inguinal Incision – hernia ○ Mosquito
● Transverse Suprapubic (Pfannensteil) - cesarean ○ Tonsils
○ Mixter - used to dissect lymph nodes
● Grasping/Holding
MISCELLANEOUS INCISIONS: ○ pick up instruments
● Collarline (curvilinear incision) ○ Thumb - for delicate tissue
->

o Used for Thyroidectomy ○ DeBakey - for blood vessels BV

● Coronal, Butterfly Incisions ○ Tissue
o Craniotomy ○ Russian
● Thoracotomy Incision ○ Adson - dressing forceps
O
-

o Anterolateral or Lateral Posterothoracic ○ Allis - with teeth, for tough tissues, lifting fascia
● Lumbotomy Incision ○ babcock - holding delicate tissue (such as organs,
-

o Kidney surgery tissues, and bones)

● Limbal Incision ○ towel clip
o Cataract Extraction ○ Ochners
● Elliptical Halsted Incision ○ Sponge holder
o Radical Mastectomy ● Retracting Instruments
● Post/Pre Aural Incision ○ promote better visualization of the site
● Caldwell Luc ○ Army navy
○ Richardson
○ Meyerding / Sennretractor
POSITIONING ○ Self Retaining / Balfour
● Choice of position is made by the surgeon and positioning is ○ Malleable
done by the members of the surgical team ○ Deaver
● Factors to Consider: ○ Weilaner
→ Length of the Procedure ● Cutting/Dissecting
→ Site of the Procedure ○ Metz - for delicate tissue
→ Pain upon moving ○ Mayo straight - for cutting materials
→ Kind of anesthetic ○ Mayo curve - for tough tissue
○ Iris 4 c0
QUALIFICATIONS OF A GOOD POSITION ○ Knife Handle 4 - for blade 20 only 10-12, 15
●
●
Not interfere with respirations
Not interfere with circulation
○
○
Knife handle 3 - ten blade, fits 10,11,12,15
Knife handle 7 - fits blade 11,12,15
& 11 12,15
-

● Not cause pressure on any nerve ○ blade 11 -⑳ stab knife

■ for incision and drainage
"
● Provide total accessibility for administration of anesthesia
and surgery ○ Blade 12
● Reflect proper body alignment, resulting in no undue post ■ ⑧ hook knife
operative discomfort ○ Blade 15 15small belly
● Patient safety ■ - small belly knife
■ used for minor operations
COMMON POSITIONS ● Suturing Instrument
● Dorsal/supine ○ to put body parts together
● Fowlers, Sitting Position ○ Needle holder
● Lithotomy - perineal operations
● Trendelenburg/reverse Trendelenburg OTHER DEVICES/EQUIPMENTS USED:
o to lower down other organs, so it does not ● Gas Tanks / Gas cylinders Os
distract area of operation Green - oxygen CO2
● Prone – back surgeries ○ Gray - carbon dioxide
○ Yellow - -compressed air Nitrogen
● Sims, Knee-chest position – proctoscopy
● Kidney position ○ Blue - nitrous oxide compressed Air
Nitrous oxide
● Chest position ○ Black - nitrogen
○ Brown - helium Helium
COMMON INJURIES RELATED TO POSITIONING ● Cautery Machine
● Brachial plexus injury ○ Monopolar cautery - there should be ground
● Ulnar/radial nerve injury pad
● Saphenous and Peroneal nerve injury ■ used for Neurosurgery
● Integumentary damage ○ Bipolar cautery - no need for ground pad
● Eye and facial injury ○ There should be good muscle mass, and good
area of perfusion in order to use cautery.

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 ○ Do not place in areas where it may get wet,
places with keloids and scars, hairy (poor return
of electricity), places near electric implants
● Suction
● Heart lung machine / ECMO
● X-Ray / Radiologic Devices
○ There should be lead gown or shield to be worn
to prevent risk of radiation exposure
● Endoscopic devices
● Laparoscopic devices

Rules of Proper placement of Grounding pad:

- Good muscle mass, good area of perfusion

Don’ts:
-
- -
Areas that are wet
Areas with keloids or scars (keloids and scars are not
good conductors of electricity)
- Hairy areas
-

PICTURES OF SURGICAL INSTRUMENTS:

S A
⑧

Meyerding

weitlaner

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COMMON SUTURES (ABSORBABLE): ● Stay or tension suture – sutures placed at the incision to act
as reinforcement
SUTURE PACKA THREAD TYPE USES ● Tensile strength – amount of tension of pull that a strand will
GE COLOR withstand.
COLOR

Chromic Brown Brown Natural, Mucosa, general CRITERIA FOR A GOOD SUTURE:
Gut Absorbable purpose
● Versatility
● Ease of handling
Plain Gut Yellow Yellowish Natural, SQ, mucosa, ● Minimal tissue reaction and inability to create a favorable
Tan Absorbable small vessels environment for infection and tissue rejection
● High tensile strength
Vicryl Purple Violet / Synthetic, Same as other ● Easy to thread, easy to sterilize, non-capillary, non allergenic
White Absorbable absorbable and non carcinogenic materials
sutures ● absorbed with minimal tissue reaction
PDS Gray Purple Synthetic, Same as other USES OF SUTURE:
Absorbable absorbable
sutures
● Ligating
● Suturing
● Closing
Monocryl Pink Pink / Synthetic, Same as other
White Absorbable absorbable
sutures TYPES OF SUTURE:
● Natural/Synthetic
→ Synthetic – less tissue reaction
SURGICAL NEEDLES: → Natural – higher tissue reaction
● Three Basic Sections: ● Absorbable or Non-absorbable
→ Point ● Monofilament or Multifilament
→ Body or Shaft → one strand only (monofilament)
→ Eye → braided suture which creates more reaction
(multifilament)
POINTS:
● Taper Point KINDS OF SUTURING:
● Blunt Point ● Continuous
● Cutting Point → have greater risk in opening up the wound.
→ Tapercut → continuous stitch → 1 tie
→ Conventional cutting ● Interrupted
→ Reverse cutting → Better used in suturing
→ 1 stitch → 1 tie → repeat

---------------------------- end of notes ---------------------------

THE EYE OF THE NEEDLE:

● Atraumatic or Swaged Eyed
● French Eyed or Spring
● Controlled Release

SUTURES
● Suture – any material used to sew, stitch, or hold tissues or
body parts together
● Ligature – a tie, to ligate blood vessels
● Primary Suture line – main layers of tissues which must be
sutured
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