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Minor Surgery I Final > Final > Flashcards

Final Flashcards

1
Q

Expected complications of surgery

A 
Inflammation
Edema
Stretching
Dehiscence
Increased risk of infxn
Scarring
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2
Q

Keloid scar

A

Develops outside of normal incision site

More common when incisions are made across Langer’s lines

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3
Q

Hypertrophic scar

A

Stays within incision site but grows bigger within the site

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4
Q

Abscess scalpel type

A

11

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5
Q

Shave biopsy scalpel type

A

10 or a derma blade

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6
Q

What is the tension at a wound 10-14 days after a closure?

A

5-6% of strength

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7
Q

What is the tension at a wound 1 month after closure?

A

30-40% of strength

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8
Q

When do you use 1/100,000 epi?

A

Typical procedures

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9
Q

When do you use 1/10,000 epi?

A

Anaphylaxis IV

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10
Q

When do you use 1/1000 epi?

A

IM

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11
Q

How much epi do you inject?

A

0.3 cc

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12
Q

Why do we perform corner stitches?

A

Decreases the chance of compromising circulation

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13
Q

What is in biopsy containers to preserve the sample?

A

10% formalin

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14
Q

Use horizontal and vertical mattress sutures when..

A

elliptical removal with a lot of tension

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15
Q

Why do we use langers lines?

A
  • reduces scarring
  • reduces tension
  • improves healing time
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16
Q

Delayed closure time frame

A

4 days or 96 hours if there are no signs of infxn

17
Q

Laner’s lines

A

correspond to natural orientation of collagen fibers in the dermis and parallel to the orientation of the underlying muscle fibers

18
Q

Three phases of healing

A
  1. inflammatory: immediate-2-5 days. bleeding stops. inflammation.
  2. proliferative: 5 days-3 weeks. granulation. contraction. epithelialization.
  3. maturation: 3 weeks-2 years. collagen forms which increases tensile strength to wounds.
19
Q

Four groups of wounds

A
  1. clean
  2. clean-contaminated
  3. contaminated
  4. dirty and infected
20
Q

Primary (first) intention

A
  • Start with a clean wound
  • Close promptly
  • produce minimal edema
  • have no local infxn
  • have no serious discharge
  • heal in a minimum of time
  • heal w/ good skin edge approximation and eversion
  • heal with minimal scar formation
21
Q

2 scenarios of secondary intention

A
  1. wound hails to heal via primary intention due to excessive tissue trauma and/or loss, imprecise approximation of tissues
  2. wound is left open on purpose (a “paper cut”, abrasion or draining and abscess). Wound allowed to heal w/o closure, heals from inner layers towards the surface (“granulation from below”)
22
Q

Pros of secondary intention

A

simple

relatively low risk of infxn

23
Q

Cons of secondary intention

A
  • may take a long time to heal

- tends to cause larger scars

24
Q

What size sutures for hand wounds?

A

4-0 or 5-0

25
Q

Third intention (delayed primary closure)

A
  1. debride wound of non-vital tissues
  2. leave wound open
  3. pack wound w/ a sterile dressing
  4. cover with a supporting bandage: REPEAT DAILY
  5. healing “open” wound gradually gains sufficient resistance to infxn and granulation tissue covers the raw edges
  6. when health granulation tissue develops, usu in 4-6 days, draw the granulated surfaces together
  7. carefully approximate skin edges and underlying tissues w/ sutures as accurately as possible
26
Q

Tx of choice for most abcesses

A

Incision and drainage

27
Q

Excision

A

any removal of tissue by cutting the entire lesion out/off

28
Q

Wound care overview

A
  1. assess for wound contamination and tissue damage
  2. check flexion/extension of all joints against resistance for underlying nerve and tendon damage
  3. R/O fractures
  4. In relatively “clean” wounds: first inject anesthesia with a 25-27 g needle from inside of wound outward just under the skin
  5. In “contaminated” wounds clean skin first
  6. then inject anesthesia in fan like pattern through skin surface around laceration
  7. REMEMBER: no anesthetics w/ epinephrine in areas of limited blood supply
  8. clean and debride as nedded
  9. culture if risk of inxn
  10. carefully close wound & bandage appropriately: apply minor surgery tincture, antibiotic or vaseline
29
Q

Suture removal time: face

A

3-5 days

30
Q

Suture removal time: scalp

A

5-7 days

31
Q

Suture removal time: extremity (low tension)

A

6-10 days

32
Q

Suture removal time: extremity (high tension)

A

10-14 days

33
Q

Suture removal time: abdomen

A

6-12 days

34
Q

Suture removal time: chest and back

A

6-12 days

35
Q

Complications of wound healing

A
  1. ecchymoses
  2. hematomas
  3. seromas
  4. infxn
  5. wound dehiscence
  6. bad scarring
  7. loss of function

Minor Surgery I Final (1 decks)

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