Hemostasis and Tissue Management Flashcards

Which absorbable hemostatic agent is derived from oxidized regenerated cellulose and works by absorbing blood to form a gel clot?

Answer: Surgicel (oxidized regenerated cellulose)

Surgicel is made of oxidized regenerated cellulose which, when wet with blood, forms a dark gelatinous mass that promotes clot formation and is absorbed within 1–2 weeks.

When applying electrosurgical coagulation to a bleeding vessel, the CRNFA should use which technique for optimal hemostasis?

Answer: Grasp the vessel with forceps and touch the active electrode to the forceps briefly

Coaptive coagulation — grasping the vessel with metal forceps and briefly touching the active electrode to the forceps — concentrates energy at the vessel and produces reliable hemostasis.

What is the primary risk of placing an ESU dispersive pad over a bony prominence or scar tissue?

Answer: Increased impedance causing inadequate current return and burns under the pad

Bony prominences and scar tissue have poor contact area, increasing impedance at the dispersive pad, which can cause current to concentrate and produce a burn under the pad.

The CRNFA notes active arterial spurting from a 3 mm vessel during dissection. The MOST appropriate immediate action is to:

Answer: Apply direct digital pressure immediately and notify the surgeon

Direct digital pressure is the safest and most immediate first response to control active arterial bleeding while preparing for definitive hemostasis with the surgeon.

Which suture technique is most appropriate for ligating the pedicle of the appendix at its base?

Answer: Simple ligation with a free tie

The appendiceal stump is typically managed with a simple free tie (ligation) or endoloop at its base to secure the mesoappendix vessels and prevent bleeding.

Microfibrillar collagen hemostats (e.g., Avitene) work by which mechanism?

Answer: Activating the intrinsic pathway by attracting and aggregating platelets on collagen fibers

Microfibrillar collagen attracts and aggregates platelets on its surface, activating the intrinsic clotting cascade and forming a platelet plug reinforced by fibrin.