Medical terms

Question 1

Biosecurity

Answer 1

A set of measures to prevent introduction and spread of
infectious diseases.

Question 2

Asepsis

Answer 2

Absence of microorganisms that cause disease.

Question 3

Aseptic technique

Answer 3

Method to prevent contamination by microorganisms.

Question 4

Antisepsis

Answer 4

Exclusion, destruction, or inhibition of growth or multiplication of microorganisms from body tissues and fluids.

Question 5

Antiseptics

Answer 5

Chemical compounds inhibiting the growth of microorganisms without necessarily killing them.

Question 6

Sterile

Answer 6

Free of living organisms.

Question 7

To sterilize

Answer 7

To make an object sterile (destroying bacteria, viruses, fungi,
protozoa).

Question 8

Sterile technique

Answer 8

Method by which contamination with microorganisms is prevented to maintain sterility throughout the surgical procedure.

• Sterile personnel gowned & gloved
• Sterile personnel touch only sterile items/areas
• Sterile drapes are used to create a sterile field
• Use only sterile items within a sterile field
• All sterile items should be opened, dispensed and transferred by methods that maintain sterility
• The field should be monitored constantly and the surgical staff should be able to recognise when they have broken technique and act accordingly

Question 9

Disinfection

Answer 9

Chemical or mechanical destruction of pathogens.

Question 10

Decontamination

Answer 10

Cleaning and disinfecting or sterilizing processes carried
out to make contaminated items safe to handle.

Question 11

Infection

Answer 11

• Invasion and multiplication of microorganisms (e.g. bacteria, viruses, parasites) that are not normally present at the site
• Potentially devastating and challenging complication of surgery
• In hospital settings, transmission of microorganisms is most
  commonly contact-related
• All possible measures should be taken to reduce the risk of iatrogenic infection

Question 12

Draping

Answer 12

• Creating & maintaining sterile field around the operative site with
  nonabsorbant towels
• Performed by a gowned and gloved team member when antiseptics have dried
• One at a time
• Drapes should not be flipped or shaken
• Once placed, should not be readjusted
• After the animal and nearby nonsterile surfaces have been covered with sterile drapes, the instrument tray can be arranged, and surgery can begin

Question 13

Hemorrhage

Answer 13

Hemorrhage (bleeding):
An abnormal escape of blood from an artery, a vein, an arteriole, a venule or a capillary network

• Caused by traumatic injury/medical condition
• External/internal
• Primary hemorrhage occurs soon after an injury
• Secondary hemorrhage follows an injury after a considerable lapse of
  time
• Arterial/ venous/ capillary/ parenchymatous

Question 14

Surgical site infection (SSI)

Answer 14

Infections that directly result from surgical procedures.

• Incisional (actual site of incision)
  
  • Superficial (skin and sc tissue)
  • Deep (deep soft tissue layers
    [muscle, fascia])
• Organ/space (infection of an anatomic part that was manipulated)
• Infection occurs within 30 days of the surgical procedure or within 1
  year if associated with surgical implant

Clinical signs:
-redness
-swelling
-heat
-serous discharge
-wound dehiscence (avautuminen)
-fever, weakness, anorexia

Question 15

Implants

Answer 15

Foreign substances used to support, rebuild or mimic function of
an anatomic structure.

Question 16

Biofilm

Answer 16

Colony of microorganisms, within a matrix of extracellular polymeric substance that they produce (biofilm microorganisms usually
resistant to AB).

Question 17

Prophylactic (ennaltaehkäisevä) use of antibiotics

Answer 17

• Significant risk of infection
• Infection would be catastrofic
• Must be present at the site during the time of potential contamination
• Not a substitute for proper aseptic technique
• Rational selection of AB
• Effective against at least 80% of probable pathogens
• Cefazolin (cefuroxime)
  
  • No adverse effects on platelet
    aggregation, bleeding time,
    platelet size or count,
    prothrombin or activated partial
    thromboplastin time
• Given 30 – 60 min i.v. before incision and discontinued within 24 h (ideally at the end of the procedure)

Question 18

Therapeutic use of antibiotics

Answer 18

• Ideally based on culture and susceptibility results
• Delay might be problematic
• Based on clinical judgement, knowledge of the antibiotic’s mechanism of action, microbiologic factors

Indicated in patients with:
* Overwhelming systemic infection
* When infection is present at the
surgical site or in a body cavity
* With any contaminated or dirty
surgical procedure

• Ideal drug is the least toxic, kills bacteria at the site of infection and
  does not negatively influence the host immune system
• Generally instituted/started before surgery and continued 2-3 days after
  apparent resolution of infection

Question 19

Wound

Answer 19

Injury to the body that results in disruption of the continuity
of the body structure.

Question 20

Dead space and drainage

Answer 20

Dead space:
Resulting from suturing of large wounds promotes fluid
accumulation, which is a good medium for growth of bacteria

Drainage:
Necessary at times (moderate contamination or a large dead space)

Passive drains (Penrose drain)
1. Easier to insert, cost less
2. Draining under gravity
3. Risk of ascending infection

Active drains
1. Creation of vacuum that removes fluid by suction
2. Can be placed anywhere on the body
3. Containers need to be emptied regularly
- Removal as soon as possible

Question 21

Debridement

Answer 21

The removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue.

In case of debris or necrotic tissue, anaesthesia often required.

Objective to convert the open contaminated wound into a surgically clean wound.

Question 22

Nosocomial infections

Answer 22

Caused by environmentally resistant bacteria during hospitalization/surgery.

Risk factors:
* Overuse of antibiotics
* Indwelling (sisäinen) catheters
* Diagnostic procedures
* Advanced age
* Chronic debilitating disease

Prevention – control of the hospital
environment, rational AB use

Question 23

Flail chest

Answer 23

At least two continuous ribs fractured, each at two locations. It results in a portion of the thoracic wall that will move in a paradoxical motion during inspiration and expiration.

Flail chest refers to a freely movable segment of the thoracic wall secondary to fractures of consecutive ribs.

In most cases of flail chest, each affected rib is fractured at multiple sites.