Basic surgical procedures: incisions, wound suturing, suture materials, curettage, draining, swabbing, puncture

Question 1

Incision

Answer 1

Cut or wound in skin or mucosa by a sharp instrument (surgical blade, cautery, laser) to expose underlying structures for surgical access

Question 2

Incision is placed

Answer 2

• Sound bone
• Away from surgical area to ensure prevention of wound dehiscence

-Parallel to structures without causing damage to vital structures

Question 3

Extraoral incisions should be

Answer 3

• Planed along “Langer lines” of normal skin tension or creases
• Minimal scar formation will be seen

Question 4

Intraoral incision should

Answer 4

-Be planned to prevent scar contraction or fibrosis(prevent normal functioning of soft tissues)

Question 5

Type of blade for planning an incision

Answer 5

• Sharp appropriately sized
• Ensures clean single stroked incision without much tissue damage

Question 6

Finger use during incision

Answer 6

Skin and mucosa being incised stabilised with finger(guides passage of blade)

Question 7

Type of stroke used during incision

Answer 7

• Firm continuous stroke
• Multiple strokes cause tissue damage and bleeding

Question 8

Angulation of incision

Answer 8

• No sharp angles
• Change in direction achieved by gradual curve(sharp angles =>extensive scaring)

Question 9

Incision in gingiva

Answer 9

• Desirable through attached gingiva and over healthy bone
• Suture line should have adequate bone support

Question 10

When making an incision near teeth for extraction

Answer 10

-Should be made in gingival sulcus

Question 11

Indirect incisions are used to access

Answer 11

• Soft palate
• Tongue
• Cheeks
• Lips
• Floor of mouth

Question 12

Contraindications for placement of incision lines

Answer 12

• Over canine prominence(soft tissue defect will be created due to bony fenestration)
• Vertical incision in mental nerve region
• On palate near greater palatine vessels
• Through incisive papillae
• Over freni
• Vertical incisions on lingual side of mandibular arch

Question 13

Types of incisions

Answer 13

• Horizontal
• Vertical
• Semilunar(curved, elliptical)

Question 14

Function of Flap design

Answer 14

-Intraoral surgical flaps

• Gain access to area of operation
• Move tissues from one place to another
• Reduces pain, swelling and morbidity associated with damage

Question 15

Types of flaps

Answer 15

• Trapezoidal Flap
• Triangular Flap
• Envelope flap
• Semilunar flap

Y-shaped flap

• X-shaped flat
• Pedicle flap
• Pedicle bridge flap

Question 16

Methods of closing wounds

Answer 16

• Suturing
• Stapling
• Tissue adhesives

Question 17

Method of wound closing that leaves the most acceptable scarring

Answer 17

Suturing

Question 18

Types of sutures

Answer 18

1. Resorbable(surgical gut, vicryl polydiaxonone, collagen) or Non resorbable(Linen, surgical silk, surgical cotton, surgical steelm nylon, polypropilen)
2. Monofilament or Multifilament

Question 19

Tamponing

Answer 19

• Filling wounds and cavities with sterile materials
• Arrests bleeding
• Iodine gauze or silicone
• Can be left for 2-5 days

Question 20

Drainage

Answer 20

• Removing fluids from pathological cavities
• Silk, rubber and plastic tubes

Question 21

Puncture

Answer 21

• Piercing tissue with sharp tool
• Diagnostic→ purulent processes/cysts/tumours
• Aspiration→ pathological fluids
• Introduction of drugs