intro to surgery

Question 1

analgesics

Answer 1

pain relief

Question 2

antiseptic

Answer 2

slows or stops growth of microorganisms on external surfaces of the body, helps prevent infection

Question 3

Anaesthetics

Answer 3

produce complete or partial loss of feeling
(local or general or regional)

Question 4

Halsted’s principles

Answer 4

1) strict asepsis
2) gentle tissue handling
3) preservation of blood supply
4) adequate hemostasis
5) elimination of dead space
6) minimize tissue tension
7) accurate tissue closure
8) debridement of dead tissue

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Question 5

strict asepsis

Answer 5

defined as the absence of pathogenic microbes in living tissue

accomplished by
- aseptic prep of the patients skin
- sterilization of instruments, gloves, gowns, drapes etc
- prep of the surgery team for aseptic surgery
- careful draping of the patient

Question 6

aseptic technique

Answer 6

defined as practice which prevents cross contamination in surgery

Question 7

prep of the patients skin

Answer 7

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1) chlorohexidine surgical scrub; cleanser and antibacterial
2) alcohol; antiseptic kills bacteria on skin
3) alcohol/ chlorohexidine solution; final prep

Question 8

sterilization of instruments

Answer 8

• steam under pressure (autoclaving)
• dry heat
• gas sterilization
• radiation
• chemical sterilization

Question 9

surgical scrub; 2 commonly used surgical scrub agents

Answer 9

chlorhexidine and povidine-iodine (betadine)

chlorhexidine; wider bacteriocidal effect, longer persistent residual action

Question 10

surgical hand scrub aim

Answer 10

to remove as many micro-organisms as possible from hands, nails and arms by mechanical washing and antiseptic contact time (5-8 mins)

Question 11

draping the patient order

Answer 11

1st between patient and surgeon
2nd and 3rd head and tail
4th far side

Question 12

gentle tissue handling

Answer 12

handling live tissue as gently as possible during surgery

Question 13

rough handling or crushing of tissues will lead to

Answer 13

swelling, inflammation and post-operative pain and discomfort for the animal

Question 14

correct use of instruments

Answer 14

• helps minimize trauma
• blunt dissection
• appropriate forceps type

Question 15

moistened laporotomy sponges

Answer 15

to maintain tissue hydration

Question 16

methods for gentle tissue handling

Answer 16

assistant fingers
doyen bowel clamps
stay sutures in hollow organs

Question 17

preservation of blood supply

Answer 17

preserve blood supply where possible to help w healing, done by careful dissection

Question 18

for preservation of blood supply must be aware

Answer 18

of surgical anatomy and ensure ligated vessels are not supplying viable tissue

Question 19

adequate hemostasis, hemostasis vital because….

Answer 19

• uncontrolled hemorrhage life threatening
• blood ideal medium for bacterial contamination
• blood clots stop the co-aptation of wound edges
• fluid and dead space in the wound area interferes w healing
• blood obscures the surgical field

Question 20

how is hemostasis achieved by

Answer 20

• ligation
• electrocautery
• Haemostatic forceps
• pressure

Question 21

elimination of dead space

Answer 21

• dead space allows the accumulation of fluid and air to disrupt the close approx of tissues and delay its healing

Question 22

elimination of dead space leads to decrease risk of

Answer 22

seroma or hematoma formation

Question 23

how to prevent dead space

Answer 23

• good tissue apposition
• pressure bandage
• use of sutures to close dead space
• active and passive drains

Question 24

minimize tissue tension: excessive tension is

Answer 24

unnecessary and sometimes detrimental

Question 25

how much tension to use

Answer 25

• can’t be too tight; crushing and pressure necrosis could result
• loose enough to allow for postop swelling
• but not too loose; could cause leakage or dehiscence

Question 26

accurate tissue closure; purpose of wound closure is to

Answer 26

bring the edges together to allow for healing

Question 27

careful approx of tissues is achieved by

Answer 27

appropriate suturing techniques

Question 28

tissue that cannot be salvaged must be

Answer 28

removed to allow wound healing to take place

Question 28

debridement of dead tissue; necrotic tissue is

Answer 28

dead or devitalized

Question 29

layer debridement

Answer 29

• debride progressively from surface of wound to deeper tissues
• allows conservation of healthy tissue

Question 30

en bloc debridement

Answer 30

• complete excision of wound leaving healthy tissue
• wound closure can occur

Question 31

gastric dilation and volvulus

Answer 31

GDV; emergency surgery, twisted stomach