Principles of Operative Surgery Flashcards
Name 5 types of anaesthesia?
Local Regional Epidural / spinal Intravenous General
Why is hair removed pre- operatively?
Vision, only remove if necessary as infection increases
What is used for skin preparation?
0.5% chlorhexidine
10% povidine iodine in 70% alcohol
What does choice of incision achieve?
Good access Orientation of skin tension lines Strength and healing potential of tissues Anatomy of underlying structures Cosmetic considerations
What are the 3 tissue layers?
Epidermis, Dermis, Hypodermis
Name 3 suture materials and give examples of each?
Absorbable : Dexon - polygycolic acid, Vicryl - polyglactin
Slowly absorbed : PDS - polydioxanone
Non absorbable : Silk, nylon, prolene - polypropylene
Name 4 common skin closure techniques?
Simple interrupted
Vertical mattress (large wound, tend to scar)
Skin staples
Subcuticular
Name 3 types of reconstructive surgery for malignant disease?
Primary closure
Skin grafts
Skin flaps
When is a skin graft the best type of reconstructive surgery?
On well vascularised skin, non infected wounds, best with skin matching texture and colour
What are the 4 types of skin flap for reconstructive surgery and describe them?
Random pattern flaps - no specific blood vessel
Axial flap - skin supplied by specific blood vessel and it accompanying venae comitans
Myocutaneous flaps - skin overlying muscle, will survive if the pedicle to the muscle is not divided
Free flaps - an autotransplant. The tissue must survive on a singe pedicled blood supply with an artery and draining vein
Where is it best to get tissue from for oral and pharyngeal mucosal flaps?
Radial
Where is it best to get tissue from for total mandible and skin / mucosa reconstruction?
Fibula
Where is it best to get tissue from for hemi mandible / maxilla mucosa/skin?
DCIA (deep circumflex iliac artery)
