Operating theatre practice Flashcards
Aims of the Operating Theatre
To provide an area that is
free from infectious
organisms
Operating Theatre Design Principles
End room
Sufficient size
Ease of movement without contamination
Easily Cleaned
One way movement of personnel
Separation between clean
and contaminated areas
Designated for specific
types of surgery
Patient Preparation Area
- Induce anaesthesia
- Preoperative preparation of
surgical site - Placement of intravenous
catheter - Catheterisation of bladder
Mobile overhead theatre lights bulb types
Halogen bulbs - prevent shadows
Theatre Ambient temperature
15-20 degrees
Operating Theatre Ventilation
Positive pressure ventilation
Changes in air ventilation hourly (operating theatre)
20 air changes per hour
Surgery classification ‘Clean surgery’
Does not enter any contaminated viscus
No break in sterile technique
Surgery classification Clean- contaminated
Enters the oropharynx, respiratory, alimentary or urogenital tracts.
No other source of contamination
Contaminated surgery
Major spill of contaminated material at surgery, or a
break in sterile technique, or entry into a viscus with a
high bacterial load e.g. colon
Infected surgery
Surgical site is known to be already infected
Dirty procedure
Removal of ulcerated mammary strip
Enema
Pyometra
Aural surgery
Abscesses, Old wounds
Removal of necrotic
tissue
Clean contaminated surgery
Bitch spay
Lung lobectomy
Gastrotomy
Tracheotomy
Clean
Neutering
Uncomplicated hernias
Tibial fracture fixation
Lipoma removal
Spinal surgery
Diathermy
Used for blood vessels coagulation
or cutting tissues
Two types of Diathermy
- Monopolar- needs earthing plate
- Bipolar
Tourniquets length of use
15min
What is an Esmarch bandage?
Drains the limb of blood first
Types of Suction Tip
Frazier-Used for fine delicate
suction
Yankauer- Bulb at the end
(reduce trauma/maximum visibility)
Poole- removed pooled blood
Charcoal adsorbers
should be weighed
every morning
Cryosurgery?
Kills living tissue by freezing them
* Liquid nitrogen
* N2O
Stainless Steel facts
Material of choice
Resistant
Strong
Stainless Steel
* Martensitic
* Austenitic
Martensitic
* ‘Cutlery Stainless Steel’
* High carbon steel with chromium
Austenitic
* ‘Marine Grade Steel’
* With chromium, nickel and molybdenum
Stainless steel can have
the following finishes
- Satin
- Mirror
- Ebony
Tungsten Carbide identification
Gold handles
Chromium-Plated Carbon Steel
highly polished surface
Titanium
Orthodpaedic plates/implants
Ophthalmic instruments (Less glare)
Vitallium
Mostly used in dentistry
Stainless steel bone plate should not be held in place with
Vitallium screws due to electrolytic and chemical reactions
Unused packs of instruments should be repacked
and re-sterilised after
12 weeks
Unused double packed instruments should be repacked and re-sterilised
6 months
Decontamination Cycle
Cleaning
Disinfection
Inspection
Lubrication
Packing
Sterilisation
Storage
Use
Types of forceps
Dressing
Tissue
Artery
Artery Forceps examples
- Spencer wells
- Kelly
- Rochester
- Cairns
- Halsted mosquito (smallest)
Tissue Forceps examples
- Allis
- Babcock
- Sponge holding
- Duval
Dissecting Forceps examples
- Standard
- Adsons
- Emmett
- Debakey
Rat-tooth Forceps examples
- Standard
- Treves
- Lane
Scissors
- Standard
- Treves
- Lane
Visceral Clamps
- Doyen
- Parker-Kerr
- Mayo-Robson
Towel Clips examples
- Cross action
- Jones cross action
- Backhaus
Blade holders Size 3 handle:
10, 11, 12, 15 blade
Blade holders Size 4 handle
20, 21, 22 blade
Beaver handle?
very small blade, ophthalmic work
Handheld Retractors examples
- Langenbeck
- Hohmann
- Volkmann
- Czerny
- Senn
Self-retaining Retractors examples
- Gelpi
- Wests
- Travers
- Gossett
- Balfour
Needle Holders
- Gillies
- Mayo Hegar
- McPhail
- Olsen Hegar
- Bruce Clarke
Speculums examples
- Eyelid
- Vaginal
Rongeurs are used for
For bone nibbling
procedures
Bone Curette are used for
Remove loose of degenerate tissue
and Cancellous bone (grafts)
Venables Plate holes
round
Sherman Plate
squiggly plate
Dynamic compression plate holes
oval shaped
Self-tapping Screws identification
Slotted heads
Two notches at the screw
tip
Pre-tapped Screws (AO type)
Hexagonal head
The A/O ASIF System
methods of fracture repair
Tensile Strength
Knot Security
Stiffness and Elongation
Memory
Chatter
Tissue Drag
Capillarity
Autoclaving is satisfactory for which suture materials
(no more than 3 x )
Nylon
Polypropylene
Polyester
Steam sterilisation should not be used on…?
absorbable suture materials
sterilisation method safe for all sutures
Ethylene Oxide
Natural absorbables are broken down by?
Phagocytosis
Synthetic absorbables are broken down by…?
hydrolysis
How many days can it take absorbable suture material to lose tensile strength
60 days
What does half life refer to?????
Tensile strength
Where is non Non-Absorbable
sutures usually used
skin
Metric - smallest to largest
0.2 - 8
USP smallest to largest
10/0 - 6
Catgut smallest to largest
8/0 - 4
atraumatic needles AKA
swagged
Round bodies needles are best for
Slide through body tissues, dilates
rather than cutting them
Cutting needles are best for
cuts rather than
dilate: skin and tough tissues
Taper-cutting needles are best for
Ideal for tough or calcified tissues:
Cardiac and vascular procedures
Reverse cutting needles are best for
skin
Suture Patterns Apposing
Sutures bring the tissues in
direct apposition
Suture Patterns Everting
Sutures turn wound edges
outwards
Suture Patterns Inverting
Sutures turn tissue inwards
