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Textbook
1. Medical assistant
2. Electronic records
3. Medical terminology and anatomy
4. The fundamentals of infection control
5. Introduction to vital signs
6. The patient interview and history
7. The physical examination
8. Appointment scheduling
9. Insurance billing
10. Diagnostic coding and the ICD-10-CM System
11. Procedural coding
12. Medical billing and reimbursement essentials
13. Assisting with medical specialties
14. Assisting with the musculoskeletal system
15. Assisting with the cardiovascular system
16. Assisting with the respiratory system
17. Assisting with the nervous system
18. Anatomy and physiology of the urinary system
19. Assisting in obstetrics and gynecology
20. Assisting in endocrinology
21. Assisting in ophthalmology & otolaryngology
22. Assisting in gastroenterology
23. Assisting in the immune & lymphatic systems
24. Assisting in pediatrics: the developmental stages and care
25. The medical assistant’s role in caring for the older patient
26. The role of the medical assistant in physical therapy examination and assessment
27. Preparing for minor surgery: room, solutions, and supplies
27.1 Assisting in surgery
27.2 Surgical instruments: cutting and grasping
27.3 Drapes and sutures
27.4 Autoclave loading/unloading, chemical sterilization, and professional responsibilities
27.5 Surgical asepsis, instrument care, and the utility room
27.6 The autoclave process: operation, wrapping, and quality assurance
27.7 Dressings, bandages, and professional conduct
27.8 Introduction to minor office surgery and technology
27.9 Specialized procedures and preoperative preparation
27.10 Sterile technique and intraoperative assistance
27.11 Completing surgery and postoperative care
28. Introduction to the clinical laboratory
29. Urinalysis
30. Blood collection
31. Analysis of blood
32. Electrocardiography and heart structure
33. The principles of pharmacology
34. Essential calculations and measurement systems
35. Solid, liquid, & solutions medication doses
36. Administering medications
37. Metabolism and core nutrient roles
38. Medical emergencies in the healthcare setting
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27.3 Drapes and sutures
Achievable CCMA
27. Preparing for minor surgery: room, solutions, and supplies
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Drapes and sutures

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Drapes, sutures, & other closure material

Drapes are used during a minor surgical procedure for a variety of reasons. They can provide a sterile field around the surgical site and also provide modesty for the patient. Sutures and other closure materials are used when a surgical incision or other wound needs to be closed. The following sections \ discuss drapes and closure materials.

Drapes

Disposable surgical drapes are available in several materials and sizes. These typically have an opening (fenestrated) for the operative site. The drape is placed over the operative area using sterile technique after the patient’s skin preparation has been completed. If a fenestrated drape is not available, multiple non fenestrated drapes can be used to create a sterile field around the surgical site.

Sutures

The word suture is used as both a noun and a verb. As a noun, it refers to a surgical stitch or the material used to close a wound. As a verb, it refers to the act of stitching. The primary purpose of a suture is to hold the edges of a wound together until natural healing occurs.

A suture may also be used as a ligature. This is a strand of suture material used to tie off a blood vessel or strangulate tissue. If a ligature is used to tie off an internal tubular structure, it must last permanently or long enough for the structure itself to disintegrate. The ideal suture material has certain characteristics:

  • Easy to handle and makes a secure knot
  • Does not cause a localized tissue reaction and is nonallergenic
  • Has adequate strength without cutting through tissue
  • Can be sterilized

The provider will request a certain type of suture based on the specific properties of the suture material, such as rate of absorption, size of the suture, and type of needle. Both natural and synthetic suture materials are available. Sutures may be classified as either absorbable or nonabsorbable. Many suture materials are available, each having its advantages and disadvantages. Suture materials commonly used in minor surgical procedures are described in the following paragraphs.

Absorbable sutures

Absorbable sutures are dissolved by the body’s enzymes during the healing process. They are used when deep incisions or lacerations require inner layers of sutures to close the wound. Absorbable suture material is also used in areas where suture removal is difficult (e.g., oral surgery). Catgut (sheep, cattle, or pig intestine) was once the absorbable suture material of choice, but it has largely been replaced in recent years by synthetic absorbable suture material (e.g., Vicryl). Other synthetic absorbable suture materials include Dexon, polydioxanone (PDS), and Maxon. These materials remain stable longer than natural catgut (up to 11 weeks), allowing the wound to completely heal before absorption occurs.

Nonabsorbable sutures

Nonabsorbable suture material is left in place until healing is complete. It frequently is used in minor surgical procedures performed in the medical office because most of the suturing required is superficial. It can be used in areas where sutures can be easily removed after healing has taken place. Silk is a common nonabsorbable suture material because it is strong and easy to tie. It is treated with a coating to prevent tissue drag and flaking. Polyester fiber sutures (e.g., Dacron and Prolene) are among the strongest nonabsorbable sutures, along with surgical steel. These fine filaments are braided and have great strength. Nylon suture is strong and has a high degree of elasticity. It is used primarily for skin closure. Due to its elasticity and stiffness, many knots must be used because they tend to untie if placed incorrectly.

Suture sizing and packaging

Suture material is available in a variety of diameters and lengths. The diameter of the suture strand determines its size; the smaller gauges are numbered below 0 (pronounced aught), and the larger gauges are identified with numbers above 0. For instance, 2-0 suture is thinner than size 0, which is thinner than size 2. The sizes from 6-0 to 2-0 are used most frequently in the medical office. The length of the suture material may vary, with strands precut in 18-, 24-, 54-, and 60-inch lengths.

Suture sizes

Suture Size Diameter
6-0 0.07 mm
5-0 0.10 mm
4-0 0.15 mm
3-0 0.20 mm
2-0 0.30 mm
0 0.35 mm
1 0.40 mm
2 0.50 mm

Drapes

  • Provide sterile field and patient modesty
  • Fenestrated drapes have an opening for the operative site
  • Non-fenestrated drapes can be used in multiples to create a sterile field

Sutures

  • Hold wound edges together until healing occurs
  • Can also be used as ligatures to tie off blood vessels or tissues
  • Ideal suture: easy handling, secure knot, nonallergenic, strong, sterilizable

Absorbable Sutures

  • Dissolved by body enzymes during healing
  • Used for deep/incision closure or hard-to-access areas
  • Synthetic types: Vicryl, Dexon, PDS, Maxon
    • Last longer than natural catgut (up to 11 weeks)

Nonabsorbable Sutures

  • Remain until removed after healing
  • Used for superficial closures, easily removed sites
  • Common materials: silk (strong, easy to tie), polyester fibers (Dacron, Prolene), surgical steel, nylon (elastic, requires multiple knots)

Suture Sizing and Packaging

  • Size determined by diameter; smaller numbers below 0 (e.g., 6-0), larger above 0 (e.g., 2)
    • 6-0: 0.07 mm, 2: 0.50 mm
  • Most common sizes: 6-0 to 2-0
  • Precut lengths: 18, 24, 54, 60 inches

Ophthalmologic and Otolaryngologic Instruments

  • Krause nasal snare: removes nasal polyps
  • Metal tongue depressor: oral exams
  • Hartmann “alligator” ear forceps: removes foreign bodies/polyps
  • Laryngeal mirror: examines larynx/postnasal area
  • Ivan laryngeal applicator: swabs/sponges throat, removes pharyngeal foreign bodies
  • Buck ear curette: removes ear canal debris
  • Sharp ear dissector: removes ear canal debris
  • Wilde ear forceps: angled, packs/removes foreign bodies from ear/nose

Biopsy Instruments

  • Cervical biopsy forceps: obtain cervical specimens
  • Rectal biopsy punch: used with proctoscope/sigmoidoscope for rectal tissue
  • Silverman biopsy needle: split cannula for needle biopsy, no incision needed

Needles

  • Chosen by area, depth, width of suture
  • Shapes: straight or curved (curved most common)
    • Sharper curve for deeper tissue
  • Points: taper (delicate tissue), cutting edge (skin, tough tissue)
  • Swaged (atraumatic) needles: suture attached, less tissue trauma
  • Most common for skin: curved, cutting-edge, swaged

Genitourinary Instruments

  • Foley catheter: indwelling, balloon inflated to hold in bladder, sizes 8–32 French (1 French = 1.32 mm)
  • Red Robinson catheter: temporary drainage/specimen collection
  • Coudé-tip catheter: curved tip for navigating obstructions (e.g., enlarged prostate)
  • 12-mL Luer-Lok syringe: inflates catheter balloon, injects >5 mL

Wound Care with Sutures

  • Suture removal timing:
    • Face: 5–7 days
    • Neck: 7 days
    • Scalp: 10 days
    • Trunk/upper extremities: 10–14 days
    • Lower extremities: 14–21 days
  • Care instructions:
    • Keep area clean/dry first 24–48 hours
    • Gently wash around site, avoid direct rubbing
    • Replace bandage if needed, use antibiotic ointment as directed
    • Return for removal as scheduled

Other Closure Materials

  • Surgical staples: stainless steel/titanium, remain 7–14 days, require specific instruments
  • Adhesive skin closure strips:
    • Self-adhesive, used for superficial/low-tension wounds
    • Tincture of benzoin improves adhesion
    • Reduce infection risk, no suture scars, often used on face
    • Can be applied by medical assistant, remain until fall off or wound heals
  • Tissue adhesives (e.g., Histoacryl, Dermabond, SurgiSeal):
    • Glue-like, for superficial wounds, especially in pediatrics
    • Advantages:
      • Saves time, water-resistant, no removal needed
      • Better cosmetic outcome (no suture scars)
      • Useful for needle-phobic patients and larger wounds with subcutaneous sutures

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Drapes and sutures

Drapes, sutures, & other closure material

Drapes are used during a minor surgical procedure for a variety of reasons. They can provide a sterile field around the surgical site and also provide modesty for the patient. Sutures and other closure materials are used when a surgical incision or other wound needs to be closed. The following sections \ discuss drapes and closure materials.

Drapes

Disposable surgical drapes are available in several materials and sizes. These typically have an opening (fenestrated) for the operative site. The drape is placed over the operative area using sterile technique after the patient’s skin preparation has been completed. If a fenestrated drape is not available, multiple non fenestrated drapes can be used to create a sterile field around the surgical site.

Sutures

The word suture is used as both a noun and a verb. As a noun, it refers to a surgical stitch or the material used to close a wound. As a verb, it refers to the act of stitching. The primary purpose of a suture is to hold the edges of a wound together until natural healing occurs.

A suture may also be used as a ligature. This is a strand of suture material used to tie off a blood vessel or strangulate tissue. If a ligature is used to tie off an internal tubular structure, it must last permanently or long enough for the structure itself to disintegrate. The ideal suture material has certain characteristics:

  • Easy to handle and makes a secure knot
  • Does not cause a localized tissue reaction and is nonallergenic
  • Has adequate strength without cutting through tissue
  • Can be sterilized

The provider will request a certain type of suture based on the specific properties of the suture material, such as rate of absorption, size of the suture, and type of needle. Both natural and synthetic suture materials are available. Sutures may be classified as either absorbable or nonabsorbable. Many suture materials are available, each having its advantages and disadvantages. Suture materials commonly used in minor surgical procedures are described in the following paragraphs.

Absorbable sutures

Absorbable sutures are dissolved by the body’s enzymes during the healing process. They are used when deep incisions or lacerations require inner layers of sutures to close the wound. Absorbable suture material is also used in areas where suture removal is difficult (e.g., oral surgery). Catgut (sheep, cattle, or pig intestine) was once the absorbable suture material of choice, but it has largely been replaced in recent years by synthetic absorbable suture material (e.g., Vicryl). Other synthetic absorbable suture materials include Dexon, polydioxanone (PDS), and Maxon. These materials remain stable longer than natural catgut (up to 11 weeks), allowing the wound to completely heal before absorption occurs.

Nonabsorbable sutures

Nonabsorbable suture material is left in place until healing is complete. It frequently is used in minor surgical procedures performed in the medical office because most of the suturing required is superficial. It can be used in areas where sutures can be easily removed after healing has taken place. Silk is a common nonabsorbable suture material because it is strong and easy to tie. It is treated with a coating to prevent tissue drag and flaking. Polyester fiber sutures (e.g., Dacron and Prolene) are among the strongest nonabsorbable sutures, along with surgical steel. These fine filaments are braided and have great strength. Nylon suture is strong and has a high degree of elasticity. It is used primarily for skin closure. Due to its elasticity and stiffness, many knots must be used because they tend to untie if placed incorrectly.

Suture sizing and packaging

Suture material is available in a variety of diameters and lengths. The diameter of the suture strand determines its size; the smaller gauges are numbered below 0 (pronounced aught), and the larger gauges are identified with numbers above 0. For instance, 2-0 suture is thinner than size 0, which is thinner than size 2. The sizes from 6-0 to 2-0 are used most frequently in the medical office. The length of the suture material may vary, with strands precut in 18-, 24-, 54-, and 60-inch lengths.

Suture sizes

Suture Size Diameter
6-0 0.07 mm
5-0 0.10 mm
4-0 0.15 mm
3-0 0.20 mm
2-0 0.30 mm
0 0.35 mm
1 0.40 mm
2 0.50 mm
Key points

Drapes

  • Provide sterile field and patient modesty
  • Fenestrated drapes have an opening for the operative site
  • Non-fenestrated drapes can be used in multiples to create a sterile field

Sutures

  • Hold wound edges together until healing occurs
  • Can also be used as ligatures to tie off blood vessels or tissues
  • Ideal suture: easy handling, secure knot, nonallergenic, strong, sterilizable

Absorbable Sutures

  • Dissolved by body enzymes during healing
  • Used for deep/incision closure or hard-to-access areas
  • Synthetic types: Vicryl, Dexon, PDS, Maxon
    • Last longer than natural catgut (up to 11 weeks)

Nonabsorbable Sutures

  • Remain until removed after healing
  • Used for superficial closures, easily removed sites
  • Common materials: silk (strong, easy to tie), polyester fibers (Dacron, Prolene), surgical steel, nylon (elastic, requires multiple knots)

Suture Sizing and Packaging

  • Size determined by diameter; smaller numbers below 0 (e.g., 6-0), larger above 0 (e.g., 2)
    • 6-0: 0.07 mm, 2: 0.50 mm
  • Most common sizes: 6-0 to 2-0
  • Precut lengths: 18, 24, 54, 60 inches

Ophthalmologic and Otolaryngologic Instruments

  • Krause nasal snare: removes nasal polyps
  • Metal tongue depressor: oral exams
  • Hartmann “alligator” ear forceps: removes foreign bodies/polyps
  • Laryngeal mirror: examines larynx/postnasal area
  • Ivan laryngeal applicator: swabs/sponges throat, removes pharyngeal foreign bodies
  • Buck ear curette: removes ear canal debris
  • Sharp ear dissector: removes ear canal debris
  • Wilde ear forceps: angled, packs/removes foreign bodies from ear/nose

Biopsy Instruments

  • Cervical biopsy forceps: obtain cervical specimens
  • Rectal biopsy punch: used with proctoscope/sigmoidoscope for rectal tissue
  • Silverman biopsy needle: split cannula for needle biopsy, no incision needed

Needles

  • Chosen by area, depth, width of suture
  • Shapes: straight or curved (curved most common)
    • Sharper curve for deeper tissue
  • Points: taper (delicate tissue), cutting edge (skin, tough tissue)
  • Swaged (atraumatic) needles: suture attached, less tissue trauma
  • Most common for skin: curved, cutting-edge, swaged

Genitourinary Instruments

  • Foley catheter: indwelling, balloon inflated to hold in bladder, sizes 8–32 French (1 French = 1.32 mm)
  • Red Robinson catheter: temporary drainage/specimen collection
  • Coudé-tip catheter: curved tip for navigating obstructions (e.g., enlarged prostate)
  • 12-mL Luer-Lok syringe: inflates catheter balloon, injects >5 mL

Wound Care with Sutures

  • Suture removal timing:
    • Face: 5–7 days
    • Neck: 7 days
    • Scalp: 10 days
    • Trunk/upper extremities: 10–14 days
    • Lower extremities: 14–21 days
  • Care instructions:
    • Keep area clean/dry first 24–48 hours
    • Gently wash around site, avoid direct rubbing
    • Replace bandage if needed, use antibiotic ointment as directed
    • Return for removal as scheduled

Other Closure Materials

  • Surgical staples: stainless steel/titanium, remain 7–14 days, require specific instruments
  • Adhesive skin closure strips:
    • Self-adhesive, used for superficial/low-tension wounds
    • Tincture of benzoin improves adhesion
    • Reduce infection risk, no suture scars, often used on face
    • Can be applied by medical assistant, remain until fall off or wound heals
  • Tissue adhesives (e.g., Histoacryl, Dermabond, SurgiSeal):
    • Glue-like, for superficial wounds, especially in pediatrics
    • Advantages:
      • Saves time, water-resistant, no removal needed
      • Better cosmetic outcome (no suture scars)
      • Useful for needle-phobic patients and larger wounds with subcutaneous sutures

More from Preparing for minor surgery: room, solutions, and supplies

  • Assisting in surgery
  • Surgical instruments: cutting and grasping
  • Autoclave loading/unloading, chemical sterilization, and professional responsibilities
  • Surgical asepsis, instrument care, and the utility room
  • The autoclave process: operation, wrapping, and quality assurance