PHARMACEUTIS II NOTE

1. Surgical products and medical
appliances
Phr.Nirmal Raj Marasini

2. SURGICAL PRODUCTS
• Surgical Products are materials used for surgery to
diagnose, prevent or for the treatment of disease or
other injury conditions.
• Such products should not show chemical action
with the body or physiology of the patients
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3. Suture And Ligature
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4. SUTURES AND LIGATURES
Surgical sutures are the sterile threads, strings or strands
especially used in surgery.
Sutures may be prepared from intestinal tissues and tendons
of animals and birds; vegetable fibers; camel hair; human
hair; synthetic threads.
Application of suture is generally done using a needle with
an attached length of thread. They are used for sewing
tissues together to bring the edges of the wound in position
for a proper union.
Ligature : In surgery, a filament or thread used to tie a blood
vessel to prevent it from bleeding
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5. Characteristics
• Tensile Strength
• Durability
• Reactivity
• Handling Characteristics
• Knot-security
• Consistent uniform diameter
• Sterile
• Must not have wick-effect
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6. Classification of suture
• Natural or Synthetic
• Absorbable or non-absorbable
• Mono-filament or braided/twisted
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7. Classification on Basis of Source
• Natural: Silk, lenin, catgut
• Synthetic: Polypropylene, polyester, polyamide
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8. Classification on Basis of Absorption
• Based on digestion in the tissues of the body.
Absorbable sutures
• Absorbable sutures are made of materials which are broken
down in tissue after a given period of time (generally ten
days to four weeks).
• The fact that it disappears is an advantage, as there is no
foreign material left inside the body and no need for the
patient to have the sutures removed.
• They are used in many of the inner tissues of the body.
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9. Absorbable sutures
• Some are absorbed rapidly while others are treated or chemically
structured to lengthen absorption time.
• May also be impregnated or coated with agents that improve their
handling properties and colored
• E.g. Natural: Catgut
• Synthetic: Polydioxanone, Polyglycolic acid
• Natural absorbable sutures are digested by body enzymes which
attack and breakdown the suture threads
• Synthetic absorbable sutures are hydrolysed.
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10. Absorbable Suture
• During the absorption process, tensile strength diminishes
followed by loss of suture mass.
• Suture can lose tensile strength rapidly and yet be absorbed
slowly or it can maintain adequate tensile strength through
wound healing followed by rapid absorption.
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11. Non-Absorbable
• Not metabolized by the body.
• Made of non-biodegradable materials
• Within the body cavity, where they will remain permanently
encapsulated in tissue (fibroblast).
• Applications:
• Are used on exterior skin wound closure where the sutures
can be removed after a few weeks.
• In some inner tissues in which absorbable sutures are not
adequate. In the heart and in blood vessels, whose rhythmic
movement requires a suture which stays longer than three
weeks, to give the wound enough time to close.
• Other organs like the bladder, contain fluids which make
absorbable sutures disappear in only a few days, too early for
the wound to heal.
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12. Non-Absorbable Suture
• They are made from the natural or synthetic material.
• Natural: Silk, silk encased in a coat of gelatin or other
protein, cotton or linen.
• Synthetic material includes nylon, polyester fiber,
polybutylester, etc.
• Such sutures are resistant to the digestion by the normal
tissue fluids or enzymes.
• These sutures are cheaper ,easy to handle ,easy to sterile
,have smooth surfaces & knot securely with the ends.
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13. Types of ligature
1. Free tie ligature
single strands of suture material used to ligate a
vessel duct,or other structure
2. Stick tie ligature
a strand of suture material attached to a needle
to ligate a vessel duct or other structure
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14. 1.Contact lens
• Contact lenses are small, light weight plastic
devices worm on the eye that correct refractive
errors in vision.
• A lens is corrective , cosmetic, or therapeutic lens
usually placed on the cornea of the eye .
• It is also known as contact.
• While they appear to be worm in direct contact with
the cornea they actually float on a layer of tears that
separates them from the cornea.
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15. • Contact lenses usually serve the same corrective
purpose as conventional glasses, but are lightweight
and virtually invisible.
• Many commercial lenses are tinted a faint blue to
make them more visible when immersed in cleaning
and storage solutions. Some cosmetic lenses are
deliberately colored for altering the appearance of
the eye
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16. 2.ADHESIVE TAPES
It consist of a backing membrane coated on one side
with an adhesive mass ( Acrylic, hydrocolloid,
hydrogels, polyurethane, rubber-based adhesive)
The backing material may be fabric or a plastic film.
Different combinations of backing materials and
adhesive give products different permeabilities.
• Permeable- to air, water, microbes, gases
• Vapour permeable- permeable to air and water
vapour
• Occlusive-impermeable
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17. Adhesive tapes are used:
For securing dressing and appliances
As skin closure for small incisions
For covering infected wounds to prevent
contaminations
Adhesive dressings have an absorbent pad in addition
to adhesive tape. The pad may be impregnated with
a suitable antiseptic.
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19. • An ‘ideal’ adhesive is one that retains dressings
securely in place for the duration of an appropriate
wear time.
• It should allow for dressings to be removed without
causing trauma to the wound and surrounding skin,
be safe (i.e. non-irritant, non-sensitising)
• leave no residues on the skin
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20. 3.Surgical cotton
• Cotton is the basic surgical absorbent.
• It is obtained from Gossypium linnum.
Types of cotton
1. Non-absorbent cotton
2. Absorbent cotton
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21. 1.Non-absorbent
The raw cotton fiber is mechanically cleaned of dirt
and made into layer but not otherwise treated.it has
limited use for padding and covering unbroken
surfaces.
2.Absorbent cotton
Absorbent cotton is prepared from the raw fiber by
series of process that remove the natural waxes and
all impurities and foreign substance and thus render
the fibers absorbent.
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22. • Absorbent cotton for medical dressing consists of
non-woven fleeces of fine, roughly parallel, knot-
free cotton fibers, up to 3 cm in length.
• Absorbent cotton is used to produce dressing
material, padding for broken skin, etc.
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23. 4.GAUZE
• Gauze is thin, translucent fabric with a loose open
weave.
• This is used as absorbent material, also used in
compress and bandages to cover and product
wounds without preventing contact with air.
classification
1.Absorbent gauze
-surgical aid(for pre-operative preparation, for
cleansing and swabbing),for direct-wound dressing.
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24. 2.Absorbent ribbon gauze(un-medicated ribbon
gauze)
It consists of cloth of plain weave supplied in ribbon
of various widths and length. The threads are of
cotton or rayon.
Uses: It is used to pack sinus, throat, dental cavities
and open infected wounds to assist healing .
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25. 3.Gauze and cotton tissue
It consist of thick layer of absorbent cotton wool
enclosed in gauze in tubular form.
Uses: it is used as an adsorbent and protective pad
with or without an additional dressing, it is also used
as burn dressing on non-adherernt layer.
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26. 5.Bandages
• Bandages hold dressings in place by providing
pressure/support. They may be inelastic, elastic or
become rigid after shaping for immobilization.
Classification
1.Retention bandages
2.Support and compression bandages
3.Medicated bandages
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27. 1.Retention bandages
are two types
a) Non-stretch fabric
b) Stretch fabric.
a) non-stretch fabric
i) Triangle calico bandages
It consists of triangular shaped pieces of unbleached
cotton cloth of plain weave.It is clean and reasonably
free from weaving defects, cotton leaf and shell.
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28. • Uses: It is used as a sling. if the bandages is likely
to be in contact with the area of broken skin, it
should be sterilized before use.
ii).Domette bandages
It consists of fabric of plain weave in which the wrap
threads are of cotton and weft threads are of wool.
Uses: It is used mainly for orthopedics where a higher
degree of warmth ,support and protection is required .
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29. iii) Open wove bandage
It consists of cotton of plain weave.
Use: It is used for the protection and retention of
absorbent dressing supports from minor strains.
b) Stretch fabric retention bandages
i).Cotton conforming bandages
It consists of cotton of plain weave, treated to impart
some elasticity to wrap and weft.
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30. • Uses: It is used to protect dressing and hold them in
place at difficult positions such as joints.
ii) support and compression bandages:
• Crepe bandages, cotton crepe bandages, cotton and
rubber elastic bandages.
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31. 6.Syringes
• Syringes are instrument meant for injection of
parenteral preparation into the body or its cavity.
syringes are the devices used to propel drugs into
the body by various routes.
• Types
• Disposable luer
• Reusable luer, glass
• Tuberculin disposable syringe.
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32. 7.Nebulizers
• A nebulizer is a device that uses compressed air to
deliver medication to people in forms of a liquid
mist to the airways.
• It is commonly used in treating cystic fibrosis,
asthma, and other respiratory diseases.
• Parts
Nebulizers have three main parts
-cup that holds the medication
-mouthpiece or mask attached to a “T” –shaped part,
and a thin, plastic tube that connects the mouthpiece
to the compressor.12/23/2018 WHSA@Nirmal raj 32

33. 8.Medical and surgical gloves
• Until late in the 19th century most surgeons used to
operate with their bare hands. A few doctor tried
cotton or silk gloves but they proved impractical
and impossible to sterilize today, sterile disposable
gloves are in common use by medical personnel
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34. 9.Urinary catheter
• A urinary catheter is any tube system placed in the
body to drain and collect urine from the bladder.
• Urinary catheter are sometimes recommended as a
way to manage urinary incontinence and urinary
retention in both men and women.
• Catheters come in a large variety of sizes,
materials (Latex, Silicone, and Teflon) and types
(Foley catheter, Straight catheter, Coude tip
catheter). It is recommended to use the smallest size
of catheter, if possible
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35. Foley's catheter
• A Foley catheter is a soft plastic or rubber tube that
is inserted into the bladder to drain the urine.
• Complications of catheter use may include urinary
tract or kidney infections, blood in the urine
(hematuria).after many years of catheter use,
bladder cancer may also develop.
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36. Suprapubic catheter
• A supra-pubic catheter is an indwelling catheter that
is placed directly into the bladder through the
abdomen.
• The catheter is inserted above the pubic bone.
• The insertion site (opening on the abdomen) and the
tube must be cleansed daily with soap and water and
covered with dry gauze
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37. Long-term (indwelling) urethral catheters
• A catheter that is left in place for a period may be
attached to a drainage bag to collect the urine.
• There are 2 types of drainage bags. One type is a leg
bag, which is a smaller drainage to the leg. A leg
bag is usually worn during the day since it fits
discreetly under pants or skirts, and is easily
emptied into the toilet.
• The other type of drainage bag is a larger drainage
device (down drain) that may be used during the
night. This device usually hung on the bed or placed
on the floor.
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38. • The drainage bag must always stay lower than the
bladder to prevent a back flow of urine up into the
bladder.
• The drainage device should be emptied at least
every 8 hours, or when the device is full.
• Care must be taken to keep the outlet valve from
becoming infected.
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39. Thanks for your attention…
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