Procedures & Suturing

Question 1

Fast-absorbing Gut indications

Answer 1

• epidermis
• absorbable
• 5-7 days tensile strength
• facial lacerations

Question 2

Vicryl indications

Answer 2

• 2-3 mos absorption
• tensile strength 3-4 weeks
• under casts/splints, single layer closure of tongue/oral mucosa, nailbeds

Question 3

Chromic Gut indiciations

Answer 3

• rapid absorption
• tensile strength 10-14 days
• under casts/splints, tongue/oral mucosa, nailbeds

Question 4

Plain Gut indications

Answer 4

• from sheep/cattle intima
• tensile strength 5-7 days
• absorbable

Question 5

Nylon (ethilon/dermilon) indications

Answer 5

• nonabsorbable
• high tensile strength

Question 6

Silk indications

Answer 6

• nonabsorbable
• not as strong as other synthetics
• secures percutaneous lines and tubes

Question 7

polypropylene (prolene, surgilene) indications

Answer 7

• nonabsorbable
• accommodates stretching

Question 8

Simple interrupted sutures

Answer 8

• most used in clinic/ED
• easy, less risk if one suture fails

Question 9

simple running suture

Answer 9

• rapid percutaneous closure of longer wounds (even distribution of tension)
• removal or breakage is difficult
• use for wounds at low risk of infection with edges that easily align

Question 10

Simple buried suture

Answer 10

this also exists, idk lots about it and the slides don’t have any info lol

Question 11

vertical mattress sutures

Answer 11

• recommended for wounds under tension or inverting edges
• deep and superficial closure

Question 12

horizontal mattress suture

Answer 12

• wound eversion in areas of moderate to high tension
• good for palms and soles but can strangulate tissue if too tight

Question 13

subcuticular running suture

Answer 13

• used by surgeons for straight lacerations
• best for linear wounds under little tension
• good cosmetic outcomes but can separate under tension

Question 14

Tissue adhesives

Answer 14

• non-mucosal lacerations
• <8cm in length
• nail bed repair
• after deep suture

Question 15

staples - characteristics

Answer 15

• simple and quick
• everts edges
• less tension
• less inflammation
• clean, long, linear wounds
• best on scalp, torso, proximal extremities

Question 16

Cryotherapy

Answer 16

Destruction of tissue by freezing
- convenient, fast
- minimal pain and scarring
- cost effective

• possible pigment change, destroy hair follicles

Question 17

shave biopsy

Answer 17

indicated for lesions that are predominantly epidermal w/o extension to the dermis

Question 18

punch biopsy indication

Answer 18

indicated for lesions requiring dermal or subQ tissue for diagnosis (incisional or excisional)

Question 19

excisional biopsy

Answer 19

indicated for lesions that are larger and require removal with adequate borders

Question 20

Appropriate lesions for superficial shave biopsy

Answer 20

• warts
• papillomas
• skin tags
• superficial BCC or SCC
• seborrheic keratoses or actinic keratoses