CSFA Hemostasis and Wound Closure Flashcards

A retention (tension) suture is placed to prevent wound dehiscence primarily in which type of patient?

Answer: Patients with compromised wound healing such as obese, malnourished, or immunosuppressed patients

Retention sutures provide supplemental full-thickness support in high-risk patients whose primary closure may fail due to poor healing factors.

What is the purpose of applying a bolster or bumper over a tie-over dressing in skin graft surgery?

Answer: To immobilize the graft against the recipient bed, preventing hematoma and shear that disrupts neovascularization

The bolster dressing maintains uniform pressure on the graft, preventing fluid accumulation and movement that would disrupt the new blood supply.

Which clamp is most commonly used to temporarily occlude a vessel for hemostasis during vascular anastomosis?

Answer: Bulldog clamp

Bulldog clamps (and similar atraumatic vascular clamps) apply controlled, gentle pressure to occlude vessels without crushing the vessel wall.

When tying a surgeon's knot, how does the first throw differ from a standard square knot?

Answer: The first throw wraps twice around the needle holder (double throw) for added friction to prevent slipping

A surgeon's knot starts with a double throw (two wraps) on the first pass, creating extra friction that holds the loop in place while the second throw is placed.

Which hemostatic clamp is used to control bleeding from medium-to-large vessels and has transverse serrations along its full jaw length?

Answer: Rochester-Pean clamp

The Rochester-Pean clamp is a large hemostat with full-length transverse serrations, designed for clamping larger tissue bundles and vessels.

Subcuticular (intradermal) closure technique is chosen primarily because it:

Answer: Eliminates suture tracks, producing a more cosmetically acceptable scar

Subcuticular sutures run within the dermis without penetrating skin, avoiding the suture-track marks that cause scarring with percutaneous sutures.