Haemostasis + Asepsis

Question 1

How to achieve haemostasis (clot)

Answer 1

• arrest haemorrhage
• pressure - apply moist tissue for 5 mins
• use smallest possible haemostats
  tip clamping = 90 to tissue
  jaw clamping = 90 to vessel
• radiofrequency instruments = mono/bipolar

Question 2

vessel sealing devices (3)

Answer 2

1.electrothermal bipolar vessel sealers
2.harmonic scalpels
3.ligatures

Question 3

Surgical asepsis - all wounds become infected - need to minimise this
Whats the 4 categories of asepsis

Answer 3

1.Clean
2.Clean-contaminated
3.Contaminated
4.Dirty

Question 4

factor that may increase risk of infection (6)

Answer 4

1.clipping site - increases bacterial growth = only do so immediately before surgery
2.Anaesthesia and surgery time - risk doubles every hour of surgery
3.Propopfol use - supports bacterial growth
4.endocrinopathies - immunosuppression
5.number of people in operating rooms
6. Sex - males at higher risk

Question 5

Host factors that may increase risk of infection?(6)

Answer 5

1.trauma
2.foreign materials
3.ischaemia
4.poor nutrition
5.chemotherapy
6.systemic disease - uraemia

Question 6

Endogenous sources of contamination (3)

Answer 6

1.skin
2.respiratory tract
3.gastrointestinal tract

Question 7

Exogenous sources of contamination (4)

Answer 7

1.room air
2.surgical team
3.instruments
4.drapes

Question 8

ways of preventing infection

Answer 8

1.prepare patient +surgical team
2.Sterilise equipment
3.Disinfect theatre
4.Don’t clip or prepare patient in theatre
5.lavage with isotonic saline at end of procedure to reduce bacterial count