Pre And Post Op Flashcards
Function of doxapram
Increase respiratory rate
Function of myofibroblast
Wound contraction
Caution for what type of vessels during adrenaline and diarrhea use
End arteries
Caution during redo open inguinal hernia
Testicular vessel
What is holiday Segar formula used for
Fluid requirement of chocolate
100+50+20 ml/kg for 1st day
Add 10 for subsequent days for next 7 days
Feeding of patients with cvs accident
Percutaneous gastrostomy or
Feeding jejunostomy if with esophagectomy
Previous use of lidocaine for heart
Antiarrhythmic
Drug for
1.Neuropathic pain
2.Trigeminal neutral
3.Diabetic neuropathy
For
1. Amitriptyline, pregabalin
2. Carbamazepine
3. Duloxetine
When best to start oral feeding
Within 24 hours
Harmonic scalpel
The harmonic scalpel uses high-frequency ultrasound energy to cut tissue and seal blood vessels. The scalpel’s surface vibrates at 55,500 Hz, which creates friction and stress in the tissue’s molecules. This friction generates heat, which denatures the tissue’s proteins. The denatured proteins then seal blood vessels and coapt tissue. The scalpel’s design also helps to couple the ultrasonic energy with the tissue. For example, the hook blade’s large outer radius and flat blade sides allow for coagulation and coaptation without cutting or boring into soft tissues. The scalpel also has a ball coagulator that can be used to coagulate surfaces.
The harmonic scalpel’s high-frequency vibration minimizes the amount of energy that’s transferred to the surrounding tissue, which can help to limit collateral damage. The scalpel was developed in the early 1990s as an alternative to other methods of controlling blood vessels. It’s typically made up of a hand-held ultrasonic transducer, generator, hand switch, foot pedal, and the scalpel itself.
Suture Tor for vascular anatomists
Non absorbable monofilament round tip
Use of bogota bag
Visualize visceral condition and viability before anastomosis
#A Bogota bag is a sterile plastic bag used to temporarily close abdominal wounds after surgery. It’s often used when primary closure isn’t possible or other techniques aren’t available. The bag is typically a 3-liter genitourinary irrigation bag that’s sewn to the skin or fascia of the anterior abdominal wall. The bag allows the peritoneal viscera to expand, which prevents increased intra-abdominal pressure. It also provides a window for inspecting the contents of the abdomen.
Disadvantage of should sutures
Polyfilament (prone to infection)
Non absorbable
Though cheap
Suture for scrotal skin of children
The main difference between the two sutures is the rate of absorption: Vicryl Rapide® is irradiated and hence is absorbed much more quickly than Vicryl®. Vicryl® has 75% of its original breaking strength at 14 days and 50% at 21 days. In contrast, Vicryl Rapide® has 50% at 5 days and almost none at 14 days.
Rapide absorbable 5-0 vicryl
Round body needle using sites
Palm
Sole
Tendon
Because cutting body will make 3 cutting wounds at the point of insertion
Anastomosis of intestine stapler vs hand sewn
The left colon is more dirty so the hand sewn is better to prevent leakage
Small intestine stapler can be use
Jenkins rule for suture
*Suture length 4 times the incision length
*1cm away from incision edge
*1cm away from facial plane
*1cm away from each other
Needle must not penetrate the facial plane
Use of silk suture
To fix train tube
But causes ugly scar
Suture for abdomen wall mass closure
PDS
Red sign of wound dehiscence
Seroma coming out
Factors increase risk of abdominal wound dehiscence and management
Mx
Malnutrition
Jaundice
Vitamin deficiencies
Major wound contamination like fecal peritonitis
Poor blood supply
Poor surgical technique(not following Jenkins rule)
Site of wound(more in descending colon)
Analgesic
IV Fluid
Broad antibiotics
Cover wound with saline impregnated gauze
Correct underlying cause
Arrange to return to OT
May need application of bogota bag and/or vacuum dressing
After anastomosis early feeding and early mobilization use important
Factors increase risk of abdominal wound dehiscence and management
Mx
Malnutrition
Jaundice
Vitamin deficiencies
Major wound contamination like fecal peritonitis
Poor surgical technique(not following Jenkins rule)
Analgesic
IV Fluid
Broad antibiotics
Cover wound with saline impregnated gauze
Correct underlying cause
Arrange to return to OT
May need application of bogota bag and/or vacuum dressing
After anastomosis early feeding and early mobilization use important
What type of stoma is done in colorectal anastomosis
Loop ileostomy
Not loop colostomy
Type of sure in children’s scrotal skin
Absorbable as far as possible because removal of suture will be challenge
Suture for fixing suction tube
Prolene
What type of drain we must put near viscera
Non suction drain
Sites for suction drain
After mastectomy
After orthopedic surgery
Material of T tube and time of removal
latex tube
10 days after making sure there is no stone passing through and the track is patent
What is Penrose drain
Rubber tube drain mostly used in plastic surgery to prevent hematoma formation below the flap . Removed after 1-2 days
How you reduce post operative intra abdominal wound infection after appendicectomy
Prophylactic antibiotic
