Principles of Operative Surgery Flashcards

1
Q

ectomy

A

removal of an organ

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2
Q

orraphy

A

repair of tissues

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3
Q

ostomy

A

artificial communication between hollow viscous and the skin

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4
Q

otomy

A

cutting open

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5
Q

plasty

A

reconstruction

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6
Q

pexy

A

relocation

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7
Q

how should hair be removed alongside surgery?

A

only if necessary as infection increases

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8
Q

how to use skin prep/ operative drapes

A

0.5% chlorhexidine
or 10% povidone iodine with 70% alcohol
disposable, double thickness linen sheets

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9
Q

define…

oscopy

A

examination of hollow viscus

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10
Q

what are the 3 tissue layers

A

epidermis
dermis
hypodermis

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11
Q

difference between sharp and blunt dissection

A

sharp dissection: using scissors, scalpel etc

blunt dissection: cleaving soft tissues apart, eg using mosqiito forceps

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12
Q

what is diathermy

A

a medical and surgical technique involving the production of heat in a part of the body by high-frequency electric currents, to stimulate the circulation, relieve pain, destroy unhealthy tissue, or cause bleeding vessels to clot.

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13
Q

types of diathermy, describe each and potential problems

A
  • monopolar (coagulation or cutting): charge in to patient and out through remote plate. BUT stimulates other muscles, nerves in pt at the same time
  • bipolar: charge moves from 1 side of forceps to the other. much more common
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14
Q

3 main categories of suture and types of each

A
  • absorbable: dexon (polygycolic acid), vicryl (polyglactin)
  • slowly absorbed: PDS (polydioxanone)
  • non-absorbable: silk, nylon, polypropylene
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15
Q

why is silk not often used for sutures

A

irritant

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16
Q

4 common skin closure techniques and when they’re used

A
  • simple uninterrupted: fine sutures on face
  • vertical mattress sutures: large wounds, but leave scar
  • skin staples
  • subcuticular: most commonly used, look the best. secured at each end with a knot or bead
17
Q

3 ways of approximating skin edges

A
  • subcutaneous layer of absorbable suture
  • undercutting of skin margins widely to apposition of edges of defect
  • excision of wound end to eliminate dog ear when one side of wound is longer than the other
18
Q

excision technique for excision of cyst

A
  • incision beyond end of lesion
  • plane of dissection around cyst by blunt dissection
  • cyst removed intact with overlying skin
19
Q

5 reasons to dress wounds

A
  • maintain wound in warm moist state
  • absorb bleeding/tissue fluid
  • protect delicate healing tissue
  • apply pressure to prevent haematoma
  • conceal wounds from view
20
Q

4 types of skin flaps

A
  • random pattern flaps
  • axial flaps (connected to blood vessels)
  • myocutaneous flaps
  • free flaps (move skin and blood vessels to new site)
21
Q

5 things done in surgery involving infected tissues

A
  • thorough cleaning of all foreign materials
  • excision of non-viable tissues
  • loose open packing
  • inspection of wound under anaesthesia
  • delayed primary closure
22
Q

on what areas are skin grafts successful

A

well-vascularised non-infected tissue

23
Q

where skin grafts often fail

A
  • avascular wounds eg bone without periosteum, tendons with peritoneon, denuded cartilage
  • heavy contamination with micro-organisms (infection)
  • blood clot (but can survive on plasma)
24
Q

what is a random pattern flap

A

no specific blood vessel in the pedicle being nourished via dermal plexus
2:1 ratio of length to width of base
can be used to cover local defect eg by rotation, advancement, transposition

25
Q

principle of axial flaps

A

skin supplied by specific blood vessel and its accompanying venae comitans

26
Q

principle of myocutaneous flaps

A

skin over muscle will survive if the pedicle to the muscle is not divided

27
Q

when are microvascular free flaps used

A

autotransplant

tissue must survive on single pedicled blood supply with an artery and draining vein