Minor Surgery ll Flashcards
What is electrosurgery
dont use around ______
sterile electrode w + current destroys tissue and coagulates BV
ETOH, flammable materials, metal implants, jewelry
Electrocautery
indirect electrical current, no blood loss
Hyfrecation
direct, high freq current flows through tissue to generate heat. quick effective w minimal blood loss and great precision
Tissue biopsy: Excisional
type of blade, angle, shape, and parallel to _______
3-1 elliptical w 30 degree angle corners using # 15 blade - parallel to Langer’s Lines
Scalpes # 11
pucture abscess, incisions, stabbign
15
blunt dissection, excision, trimming
10
like 15 for thick skin
3
disposable, sterile, attached to reusable handle
Types of forceps: tooth vs toothless
toothless crushes skin, foreign body removal
Scissors: iris vs metzenbaum
irisi - fine dissection, dont cut sutures
metz - blunt dissection
needle holder vs hemostat
hemostat - holding clamping
Remove sutures after how long for:
face/neck
arm/hands
trunk/legs/feet/scalp
3-5 d
7-10 d
7-14
Conventional cutting
cosemtic procedures
Reverse Cutting
MC for what we do
Tapered
peirces and spreads wo cutting- bowel, muscle, fascia
blunt
dissect friable tissue instead of cutting - LR, KD, SP, cervix
keep wounds/dressing dry for how long?
redress every ____
24-48 hrs and limit movement
2-3 d
remove sutures w ___ scissors or #___ blade with knots pulled _____
iris, 11, across
Hematoma may lead to complicationss______
lasts how long?
infx, dehiscence
24-72 hrs
Lidocain/xylocaine
max child
max adult
10 cc of 1% soln contains 100 mg
max child: 3.3-4.5 mg/kg, not to exceed 75-110 mg total
max adult: 4.5 mg/kd, not to exceed 30 ccs of 1% (300mg)
Bupivicaine/marcaine
max adult
max adult: 4 mg/kg of 0.25%, not to exceed 200 mg
Histofreeze
shelf life
inhalation causes
3 yr
CNS depression, chronic exposure hepatotoxic
NO
Shelf life
prolonged exposure
store indefinitely
prologed exposure: infertility, abortion
MC tissue destruction method
Liquid Nitrogen
LIquid Nitrogen - how to what happens never use when may cause CI
2-3 min freezing zone around lesion for 10-30 sec
- blister forms within few hrs, scab 1 wk, healing 2-3 wks
- never use straight from dewar bottle (HPV)
- depigmentatio
- CI malign, raynauds, sensitive skin
Hyfrecation
bipolar vs unipolar
requires pad to complete circuit
no second electrode needed
2% glutaraldehyde takes how long to disinfect and to sterilize.
has low or high tissue toxicity
10 min, 10 hrs
low
sterilize boiling how long?
30 min
Dry heat sterilization
160c/320 f for 1 hr
Autoclave sterilization
15 psi @ 121 C for 15 min
