Tech in Surgery Prep / Unit 20 TSC 499 review, 2 to 3 minutes
The Wrong Suture Opened
The idea
A worked example, constructed for this course, shows how a misread suture size is caught and what happens next.
In practice
During a hernia repair, the surgeon asks for a suture in a particular size for the repair. The circulating nurse, busy with another request, pulls a package of the same material from the shelf and holds it out. Sam, the scrub person, reads the package before it is opened and sees that its size is three, not three-zero: a much heavier suture than requested. Sam says the size aloud and points out the difference. The circulating nurse checks and agrees, returns the unopened package to the shelf, and opens the correct one. Sam reads that package too, the material, the size with its zeros, and the needle, and says it aloud as it is passed. Later that week, the circulating nurse mentions the near miss at a staff meeting, and the department reorganizes the suture shelf so that sizes of the same material are separated by a divider.
Where people slip
Reading the package before it is opened made this a near miss instead of a wasted suture or the wrong suture in the patient. The two directions of the size scale make such errors easy, which is why every package is read in full, every time, by both people involved. The scrub person is the last check before a suture reaches the surgeon's hand, and the first person who can see the package and the request side by side. Saying the size aloud as it is passed gives the surgeon one more chance to catch a mismatch, at almost no cost in time.
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