Principles of Operative Surgery Flashcards
ectomy
removal of an organ
orraphy
repair of tissues
ostomy
artificial communication between hollow viscous and the skin
otomy
cutting open
plasty
reconstruction
pexy
relocation
how should hair be removed alongside surgery?
only if necessary as infection increases
how to use skin prep/ operative drapes
0.5% chlorhexidine
or 10% povidone iodine with 70% alcohol
disposable, double thickness linen sheets
define…
oscopy
examination of hollow viscus
what are the 3 tissue layers
epidermis
dermis
hypodermis
difference between sharp and blunt dissection
sharp dissection: using scissors, scalpel etc
blunt dissection: cleaving soft tissues apart, eg using mosqiito forceps
what is diathermy
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.
types of diathermy, describe each and potential problems
- 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
3 main categories of suture and types of each
- absorbable: dexon (polygycolic acid), vicryl (polyglactin)
- slowly absorbed: PDS (polydioxanone)
- non-absorbable: silk, nylon, polypropylene
why is silk not often used for sutures
irritant
4 common skin closure techniques and when they’re used
- 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
3 ways of approximating skin edges
- 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
excision technique for excision of cyst
- incision beyond end of lesion
- plane of dissection around cyst by blunt dissection
- cyst removed intact with overlying skin
5 reasons to dress wounds
- maintain wound in warm moist state
- absorb bleeding/tissue fluid
- protect delicate healing tissue
- apply pressure to prevent haematoma
- conceal wounds from view
4 types of skin flaps
- random pattern flaps
- axial flaps (connected to blood vessels)
- myocutaneous flaps
- free flaps (move skin and blood vessels to new site)
5 things done in surgery involving infected tissues
- thorough cleaning of all foreign materials
- excision of non-viable tissues
- loose open packing
- inspection of wound under anaesthesia
- delayed primary closure
on what areas are skin grafts successful
well-vascularised non-infected tissue
where skin grafts often fail
- avascular wounds eg bone without periosteum, tendons with peritoneon, denuded cartilage
- heavy contamination with micro-organisms (infection)
- blood clot (but can survive on plasma)
what is a random pattern flap
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
principle of axial flaps
skin supplied by specific blood vessel and its accompanying venae comitans
principle of myocutaneous flaps
skin over muscle will survive if the pedicle to the muscle is not divided
when are microvascular free flaps used
autotransplant
tissue must survive on single pedicled blood supply with an artery and draining vein
