Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FA2 Principles of Surgery > Lecture 13 9/27/24 > Flashcards

Lecture 13 9/27/24 Flashcards

1
Q

What is a clean operative wound?

A

non-traumatic, non-inflamed operative round in which the resp., GI, oropharyngeal, genital, and urinary tracts are not entered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which procedures fall into the clean category?

A

-exploratory laparotomy
-elective neuter
-total hip replacement
-fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a clean-contaminated operative wound?

A

operative wound in which the resp., GI, oropharyngeal, genital, and/or urinary tract is entered in a controlled condition without unusual contamination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which procedures fall into the clean-contaminated category?

A

-enterotomy
-live fetus c-section
-laryngotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a contaminated operative wound?

A

procedure in which GI contents or infected urine is spilled, or a major break in aseptic technique occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which procedure is an example of the contaminated category?

A

cystotomy with presence of infected urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a dirty operative wound?

A

procedure in which a viscus is perforated, or presence of purulent discharge or fecal contamination occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which procedures fall into the dirty category?

A

-excision of abscesses
-peritonitis
-bullae osteotomy for otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What should be done when contamination occurs during a surgical procedure?

A

-begin by using moisturized gauze sponges to remove gross contamination
-perform lavage
-remove lavage fluid and remaining contaminants with poole suction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the bacteria count required for infection to occur?

A

10^5 bacteria per gram of tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the risk of surgical site infection with each operative wound classification?

A

clean: 2 to 4.8%
clean-contaminated: 3.5 to 5%
contaminated: 4.6 to 12%
dirty: 6.7 to 18.1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the characteristics of a superficial incisional surgical site infection?

A

-occurs within 30 days of surgery
-infection of the skin or subcutaneous tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the criteria for a superficial incisional surgical site infection?

A

-pain/tenderness, redness, heat, and/or localized swelling
-positive culture from aseptically obtained fluid from the wound
-purulent discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the characteristics of a deep incisional surgical site infection?

A

-occurs within 30 days of surgery if no implant used
-occurs within 1 year of surgery if implant is present and infection relates to operation
-infection of the fascia or muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the criteria for a deep incisional surgical site infection?

A

-localized pain/tenderness, redness, heat, and/or localized swelling
-fever
-purulent discharge
-deep abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the characteristics of an organ/space surgical site infection?

A

-occurs within 30 days of surgery if no implant used
-occurs within 1 year of surgery if implant is present and infection relates to operation
-infection of any part of the anatomy other than the incision that was manipulated during the procedure

17
Q

What are the criteria for an organ/space surgical site infection?

A

-localized pain/tenderness, redness, heat, and/or swelling
-fever
-fluid accumulation
-purulent discharge

18
Q

What are the characteristics of deep and superficial SSI diagnosis?

A

-must distinguish between normal inflammatory reaction vs bacterial infection
-normal inflammation should resolve in 48 hours
-assess swelling, redness, and tenderness/pain
-assess serosanguineous and/or purulent discharge

19
Q

What are the systemic signs for all types of SSI?

A

-fever
-leukocytosis
-neutrophilia +/- left shift
-septic arthritis
-osteomyelitis
-peritonitis

20
Q

What are the patient-related factors for surgical wound infection?

A

-age
-body condition score/nutritional status
-co-morbidities
-altered immune system
-concurrent infection in a remote body system

21
Q

How can the incidence of SSI be limited?

A

-adequate preparation of the patient
-adequate preparation of the surgical team
-obedience to the Halsted principles of surgery
-judicious use of antimicrobials

22
Q

What are the Halsted principles?

A

-strict aseptic technique during prep. and surgery
-meticulous hemostasis
-obliteration of dead space
-minimize tissue trauma; careful handling
-preservation of blood supply
-avoid undue tension on tissue
-accurate tissue apposition

23
Q

What are the four main sources of bacteria in surgical site infections?

A

-environment/operating room
-surgeons
-instruments (only one that can truly be sterile)
-patients

24
Q

How can surgeons reduce the bacteria that they introduce to their patients?

A

-adequate scrubbing techniques
-appropriate use of cap, mask, and gloves
-appropriate gowning techniques/use

25
Q

How can bacterial contamination from surgical instruments be reduced?

A

-ensure everything used in surgery is sterile
-follow the shelf life recommendations that go along with the product wrapping/packaging
-use sterilization indicators

26
Q

Which steps can be taken to ensure patients do not infect their own wounds?

A

-large/wide clipped area
-adequate draping

27
Q

Which foreign materials can be present in surgical sites?

A

temporary:
-surgical drains
-absorbable suture material
permanent:
-non-absorbable suture material
-abdominal mesh
-orthopedic implants

28
Q

What are the intrinsic risk factors for SSI?

A

-duration of surgery and anesthesia
-type of surgery/cleanliness classification
-presence of foreign material in the surgical site

29
Q

When are antimicrobials used in surgery?

A

-surgeries are high risk (not clean)
-consequence of infection would jeopardize animal’s life
-estimated surgical time is longer than 90 minutes
-prosthesis implantation is used

30
Q

When should pre-op antibiotics be administered?

A

-30 minutes to 1 hours before procedure if going IV
-1 to 2 hours before if going IM

31
Q

Which bacteria are most likely to cause surgical infection?

A

ortho: Staphylococcus spp.
GI: E. coli, polymicrobials, anaerobes
cats: Pasteurella

32
Q

What are the potential side effects of antimicrobials used for surgical site infections?

A

-nephrotoxic
-liver deficiency
-pregnancy complications/metabolism by fetus

33
Q

What are the characteristics of prophylactic antimicrobials?

A

-delivered 30 minutes to 1 hour before surgical incision
-ideally delivered IV
-may be repeated every 1.5 to 2 hours depending on procedure length
-discontinued immediately after closure or within 24 hours

34
Q

What are the characteristics of therapeutic antimicrobials?

A

-started after diagnosing SSI
-ideally started immediately after obtaining sample for cytology and culture
-therapy begins empirical
-ideally given IV or PO in SA, IV/IM/PO in LA
-initial treatment for 3-4 days, then reassess patient
-duration of treatment varies with site of infection

35
Q

What is a nosocomial infection?

A

infection contracted during the hospitalization; absent at the time of admission

36
Q

What are the treatment steps for surgical wound infections?

A

-bacterial culture to identify pathogen and sensitivity
-drainage and debridement of wound
-cover wound with sterile bandage
-judicious use of antibiotics

37
Q

What are the types of peritonitis?

A

-following a surgery
–aseptic
–septic
-presence of free abdominal fluid

38
Q

What are the characteristics of medical management of peritonitis?

A

-stabilize the patient
-patient typically in shock
-hypoproteinemia, hypotension, hypoglycemia, and electrolyte imbalance common
-IV crystalloids +/- plasma transfusion/colloids given
-empirical, broad spectrum antimicrobials used

39
Q

What are the characteristics of surgical management for peritonitis?

A

-exploratory laparotomy
-copious lavage
-active or open abdominal drainage

FA2 Principles of Surgery (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions