Ops Details Part I Flashcards by Abdelrahman Unknown

What are the types of suture materials?

Natural
Synthetic
Absorbable
Non-absorbable
Monofilament
Multifilament

Each type has specific characteristics and uses in surgical procedures.

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What is the ideal suture material characterized by?

Safe (sterile, non-allergenic)
Easy to handle
Induces minimal tissue reaction
Not predisposed to bacterial growth
High tensile strength
Secure knotting
Resistant to shrinking in tissues
Absorbed completely

These qualities are essential for effective wound closure and healing.

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Fill in the blank: Absorbable sutures are used to hold wound edges in approximation temporarily, until they can withstand _______.

normal stress

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What are the characteristics of plain gut sutures?

Loses tensile strength quickly (half-life 5-7 days)
Produces marked tissue reactivity

Plain gut sutures are natural absorbable sutures.

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What is the half-life of chromic gut sutures?

10-14 days

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What are the types of non-absorbable sutures used for?

Exterior skin closure
Permanent encapsulation within the body cavity
Prosthesis attachment
Patients with a history of reaction to absorbable sutures

Non-absorbable sutures remain in place for an extended period.

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True or False: Monofilament sutures have more pliability than multifilament sutures.

False

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What is a purse string suture used for?

To close circular wounds such as hernia or appendiceal stump

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What are the recommended suture removal times for different body areas?

Face: 3-4 days
Scalp: 5 days
Trunk: 7 days
Arm or leg: 7-10 days
Foot: 10-14 days

Timely removal is important to prevent complications.

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What are surgical drains classified by?

Communication with atmosphere (closed or open)
Structure of drain (flat sheet, corrugated sheet, tube, sump)
Material (rubber, latex, plastics, siliconized)
Pliability (soft, rigid)
Flow (passive or active)
Site drained (pelvic, subhepatic, subcutaneous)

Each classification helps determine the appropriate drain for specific surgical needs.

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What is the rule for abscess drainage incisions?

Incision must be at the most dependent site
Adequate incision length
Parallel to major vessels and nerves
Along skin crease if possible

Proper incision technique is essential for effective drainage.

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What is delayed primary closure?

Approximation of wound margin delayed for several days to prevent infection

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What is the purpose of wound closure tapes?

Useful for flat, dry, nonmobile surfaces where wounds fit together with no tension

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What type of wounds are tissue adhesives not useful for?

Wounds near the eye
Mucous membranes or mucosal surfaces
Wet wounds or exposed to body fluids
Areas with dense hair
Wounds under significant tension

These conditions can complicate healing and adhesion.

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What key factors are considered in the classification of surgical incisions?

Vertical (midline, paramedian)
Transverse (Kocher’s subcostal, McBurney’s)
Oblique (muscle cutting)
Abdominothoracic

The type of incision can affect recovery and surgical outcomes.

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What are the steps involved in the technique of abscess drainage?

Incision at the most dependent site
Open cavity and expose loculi
Pack cavity with gauze
Leave drain in place for 48-72 hours

Proper technique is crucial for effective drainage and preventing recurrence.

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What are the indications for Hilton’s Method?

Used where important structures like vessels or nerves are liable to be injured

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What is the function of a Penrose drain?

Flat drain dependent on gravity and capillary action

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What is healing by secondary intention?

Open wound margins spontaneously approximate by biologic contraction

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What is the incision type used in the breast?

Radial incision, circumareolar, or at sub-mammary fold

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How should incisions be made in the axilla?

Vertical to gap when the arm is abducted

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What is the incision direction in the cubital fossa?

Transverse in the cubital crease

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What is the incision direction in the gluteal region?

Downwards, lateral & forwards along fibres of gluteus maximus

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What is the incision direction in the popliteal fossa?

Transverse in the popliteal crease

What is the incision method for draining a pulpe space abscess?

A lateral straight incision under local ring anaesthesia

What position should a patient be in for breast abscess drainage?

Supine with the arm abducted on an arm board

What is the procedure for incising a breast abscess?

Incise the abscess, take a swab of pus for culture and sensitivity

What should be done after breaking down loculi in a breast abscess?

Send part of the cyst wall to histology

What is the purpose of packing the cavity after abscess drainage?

To promote healing and prevent re-accumulation of fluid

When should a tube drain be considered in breast abscess treatment?

In large abscesses that are not in the dependent part of the breast

What should be done if there is surrounding cellulitis or skin damage after an abscess drainage?

Leave the wound open with a small pack in situ

What is the position for drainage of a perianal abscess?

Lithotomy

What type of incision is made over a perianal abscess?

Cruciate incision

What should be used for postoperative care of a perianal abscess?

Loose packing and dressing or warm sitz baths

What are the postoperative complications of perianal abscess drainage?

Development of fistula-in-ano, bleeding/haematoma

What position is recommended for drainage of a parotid abscess?

Supine with head up and neck extended

What is the incision type for a parotid abscess?

Vertical incision of skin and superficial fascia

What is Hilton's Method used for?

To open the cavity of the abscess while avoiding injury to facial nerve branches

What is Ludwig’s angina?

Infection involving sublingual, submental, and submandibular spaces, often of dental origin

What are the signs of Ludwig's angina?

Pain, drooling, dysphagia, submandibular swelling, trismus

What is the management for Ludwig's angina?

Airway management, early aggressive antibiotics, surgical intervention

What is the procedure for ingrowing toenail surgery?

Wedge excision of nail and tissue around, complete removal of germinal matrix

What postoperative advice should be given after ingrown toenail surgery?

Elevate the leg for 1 day, remove dressing and sutures after 12 days

What is the indication for excision biopsy of a breast lump?

When fine needle aspiration or Truecut biopsy has failed to exclude malignancy

What should be confirmed before a breast lump procedure?

The side and site of the breast lump

What incision types can be used for breast lump surgery?

Circumareolar or radial incision

What should be ensured during the incision for breast surgery?

Complete haemostasis with diathermy

What is emphasized during the dissection of benign breast lesions?

Stay close to the lesion itself, avoiding unnecessary excision of healthy tissue

What is the preferred method for closing the wound after excision?

Use Vicryl for subcutaneous tissues and subcuticular Monocryl or Prolene for skin

What should be done with specimens during excision?

Send for histopathology

What should be used to hold and stabilize very mobile breast lumps during dissection?

Allis forceps ## Footnote Allis forceps are specialized surgical instruments used to grasp and hold tissues securely.

What instruments can be used to dissect breast tissue?

Scalpel, scissors, diathermy ## Footnote Diathermy is a surgical technique that uses high-frequency electrical currents to cut tissue and coagulate blood vessels.

What is the aim during the haemostasis phase in breast surgery?

Complete haemostasis ## Footnote Haemostasis refers to the process of stopping bleeding, essential for surgical procedures.

What should be inspected in all quadrants of the biopsy before closure begins?

All quadrants for haemostasis ## Footnote Ensuring haemostasis in all quadrants minimizes the risk of postoperative bleeding.

What should be done if there is a large cavity or dead space during closure?

Bring out a small suction drain ## Footnote A suction drain helps to remove fluids that may accumulate in the cavity post-surgery.

What type of suture should be used to close breast tissue and subcutaneous tissues?

Vicryl on a cutting needle ## Footnote Vicryl is a type of absorbable suture material commonly used in soft tissue closure.

What suture material is recommended for skin closure?

Subcuticular Monocryl or Prolene ## Footnote Monocryl is an absorbable suture, while Prolene is a non-absorbable suture material.

What should be infiltrated into the wounds at the end of closure?

Local anaesthetic ## Footnote Local anaesthetic helps to minimize pain in the postoperative period.

How should the wounds be dressed after closure?

With an adhesive waterproof dressing ## Footnote This type of dressing allows for bathing in the early postoperative period without wetting the wound.