CFA Hemostasis & Suture Techniques 3 — Questions and Answers
Question 1: Which of the following suture materials has the LONGEST absorption time in tissue?
- Plain gut
- Chromic gut
- Polyglycolic acid (Dexon)
- Polydioxanone (PDS) (Correct answer)
Correct answer: Polydioxanone (PDS)
PDS (polydioxanone) retains tensile strength for approximately 6 weeks and is fully absorbed over 6 months, the longest of these options.
Question 2: The first assistant's role during vessel ligation includes:
- Applying the ligature independently while the surgeon retracts
- Maintaining exposure and passing ties so the surgeon can ligate efficiently (Correct answer)
- Selecting the appropriate suture gauge without surgeon input
- Applying electrocautery simultaneously with ligation
Correct answer: Maintaining exposure and passing ties so the surgeon can ligate efficiently
The first assistant maintains exposure, retracts surrounding tissue, and passes suture material to facilitate the surgeon's accurate ligature placement.
Question 3: Bipolar electrosurgery differs from monopolar primarily because:
- It uses higher voltage to coagulate larger vessels
- Current passes only between the two tips of the forceps, limiting spread (Correct answer)
- It requires a grounding pad placed on the patient
- It produces a cutting effect superior to monopolar
Correct answer: Current passes only between the two tips of the forceps, limiting spread
In bipolar electrosurgery current flows only between the two forceps tips, confining energy to the grasped tissue and minimizing collateral thermal injury.
Question 4: A suture labeled '5-0' compared to a suture labeled '2-0' is:
- Thicker and stronger
- Thinner and weaker (Correct answer)
- The same diameter but longer
- Thicker but less durable
Correct answer: Thinner and weaker
In the USP suture sizing system, higher numbers beyond 0 indicate smaller diameter and lower tensile strength (e.g., 5-0 is finer than 2-0).
Question 5: During laparoscopic surgery, which hemostatic energy device uses ultrasonic vibration to coagulate and cut tissue simultaneously?
- LigaSure
- Harmonic scalpel (Correct answer)
- Argon beam coagulator
- Radiofrequency ablation probe
Correct answer: Harmonic scalpel
The Harmonic scalpel uses ultrasonic energy at 55,000 Hz to vibrate a blade, generating frictional heat that denatures protein and achieves hemostasis while cutting.
Question 6: Gelfoam (absorbable gelatin sponge) achieves hemostasis primarily by:
- Activating factor XII through surface contact
- Providing a physical matrix that absorbs blood and promotes platelet aggregation (Correct answer)
- Releasing vasoconstrictor chemicals into the wound bed
- Crosslinking fibrin with exogenous thrombin it contains
Correct answer: Providing a physical matrix that absorbs blood and promotes platelet aggregation
Gelfoam is a physical hemostatic agent that absorbs blood up to 45 times its weight, creating a scaffold for platelet aggregation and clot formation.
Question 7: When performing a continuous running suture for bowel anastomosis, the first assistant should:
- Cut each suture after each throw to ensure security
- Maintain consistent tension on the running strand as the surgeon advances (Correct answer)
- Hold the needle in place while the surgeon ties each stitch separately
- Apply topical thrombin between each pass of the suture
Correct answer: Maintain consistent tension on the running strand as the surgeon advances
The first assistant maintains steady, gentle tension on the running suture strand to prevent puckering and ensure even tissue approximation as the surgeon advances.
CFA Hemostasis & Suture Techniques 3
Which of the following suture materials has the LONGEST absorption time in tissue?