CSFA Hemostasis and Wound Closure Flashcards

Gelatin sponge (Gelfoam) achieves hemostasis primarily by which mechanism?

Answer: Providing a scaffold for platelet aggregation and clot formation

Gelfoam acts as a physical matrix that absorbs blood and provides a surface on which platelets aggregate and fibrin polymerizes.

Which layer of the abdominal wall is closed with a running or interrupted suture using a heavy delayed-absorbable or permanent suture for fascial strength?

Answer: Anterior rectus fascia / aponeurosis

The fascial layer (anterior rectus sheath/aponeurosis) bears the primary tension of abdominal closure and requires strong, long-lasting suture material.

When using bipolar electrosurgery, what is the key advantage over monopolar electrosurgery?

Answer: Current travels only between the two bipolar forceps tips, limiting tissue spread

Bipolar current passes only between the two tines of the forceps, confining electrical energy to the grasped tissue and protecting surrounding structures.

What is the correct needle holder technique when driving a curved needle through tissue?

Answer: Follow the arc of the needle's curvature with a pronating wrist motion

A curved needle must be driven in the direction of its arc; pronating the wrist follows the curve naturally, preventing tissue tearing.

Which absorbable suture retains tensile strength the longest, making it suitable for slow-healing tissues like fascia?

Answer: Polydioxanone / PDS (4–6 weeks)

PDS (polydioxanone) retains approximately 70% tensile strength at 2 weeks and 50% at 4 weeks, making it ideal for fascial repair.

Intraoperatively, the surgical first assistant notes persistent oozing from a parenchymal liver surface. Which topical hemostatic agent is most appropriate?

Answer: Oxidized regenerated cellulose (Surgicel)

Oxidized regenerated cellulose (Surgicel) promotes clotting through a low-pH environment and provides a physical mesh; it is commonly used on solid organ surfaces.