What is in an NUNM suture pack?
- Needle holders
- Scissors
- Forceps
- Scalpels
- Syringes
- Hypodermic needles
- Hemostats
- Suture
- Anesthetics
- Gloves
- Drapes
- Antiseptics
- Dressings
- Steri-strips
- Minor surgery tincture
- Homeopathic remedies
- Always have at least two complete, sterile MS kits ready for use
- Have a third laceration tray in reserve
What are the two types of forceps typically in an NUNM suture pack?
Adson Dressing Forceps
- No teeth
> May need extra pressure to securely grasp the wound edges, which can lead to crush necrosis
Brown-Adson Tissue Forceps
- Teeth
Babcock Forceps
- Preferred for removing cysts
What are the differences between the structure and use of needle holders vs. hemostats?
Needle Holders
- Used to hold needles
- Jaws are usually straight and short
- Have knurled (textured) jaws to keep the needle from rolling
- Examples: Webster and Halsey
Hemostats
- Typically used for:
> Retrieving foreign bodies in a wound
> Clamping bleeding vessels
> Clamping a tourniquet
> Substitute needle holder when needed
- Can be straight or curved
- Jaws have a crosshatched (toothed) surface
- Example: Halsted Mosquito hemostat
What are the typical scalpel sizes (and the configuration of the blade) and when are each used?
Non-Disposable Scalpel Handles
- # 3 or #4 handles used with #10, #11, and #15 surgical blades
- Now rarely used
- Use a hemostat to place blade on handle
Disposable Scalpels with Non-Retractable Blades
- # 15 for small lesions (most commonly used for minor surgery)
- # 10 for large lesions
- # 11 for draining abscesses
- All can be used for performing shave biopsies
What are the different types of suture materials and some typical brands?
Non-Absorbable
- Used to be cotton or silk (caused reactions), but now mostly nylon
- Nylon is inert, but slippery and difficult to tie and keep tied
- Nylon is most frequently used to close skin
- Ethilon brand nylon used in clinic
Absorbable
- Used to be sheep gut, now synthetic polymers
- Vicryl is the most widely used synthetic polymer
- Designed for internal use
> Left in and gets phagocytized
- May cause an immune reaction that can be confused with an infection
- NUNM mostly uses FS1 needles with Ethilon nylon sutures
What are the different basic types of needles and the uses of each?
Straight Suture Needle
- Used to close larger surgical wounds
- Tip has a flat (spear-like) cutting surface
Curved Suture Needle
- Typically needles are 3/8 circle
- Main manufacturers are Ethicon (FS), and Davis and Geck (CE)
- Cutting needles usually used for the skin
- Conventional cutting needle has the cutting edge facing the inside of the needle curve
- Reverse cutting needle has the cutting edge facing the outside of the needle curve
- Precision cosmetic needles are used when using 6-0 on the face
What are the correct suture sizes to use on different body areas?
- On face/head, use 5-0, 6-0, or 7-0
- On general body, use 3-0, 4-0, 5-0, or 6-0
What are the common needle sizes used for anesthetic injection in minor surgery and their applicable locations on the body?
- 25 gauge, 5/8”
- 25 gauge, 1 1/2”
- 27 gauge, 1” or 1 1/2”
- 30 gauge, 1/2” or 1” causes minimal pain, used for small lesion removal and facial or plastic surgery
