principles of surgery

Question 1

Incisions principles

Answer 1

a) Sharp disposable blade

b) Firm continuous stroke

c) The surgeon should hold the blade
perpendicular to tissue surface

d) Avoid cutting vital structures

e) incisions in the oral cavity should be properly placed. It is more desirable to incise through attached gingiva and over healthy bone

Question 2

Prevention of flap necrosis

Answer 2

1- The base of the flap(away from the teeth ) should be wider than the apex (tip, teeth region)

2- The length of the flap preferably to be not more than twice the width

3- when possible, an axial blood supply should be included in the base of the flap. Ex greater palatine artery

4- The base of flaps should not be excessively twisted, stretched, or grasped

Question 3

Prevention of flap dehiscence (separation)

Answer 3

1- Re-approximate the edges of flap margins over healthy bone
2- Avoid tension of the flap

Question 4

Prevention of flap tearing

Answer 4

1- Wide flaps
2- Adequate vertical incisions

Question 5

When bone is cut

Answer 5

copious amounts of irrigation, to decrease the amount of bone
damage from heat

Question 6

(Prevention of excessive blood loss during surgery)
Why is it important?

Answer 6

• Decrease blood loss
• Improve visibility during surgery
• Prevent hematoma formation
• Prevent wound infection

Question 7

(Prevention of excessive blood loss during surgery) how ?

Answer 7

• Assist natural hemostatic mechanisms: pressure >
stasis >coagulation
• Thermal coagulation e.g. electrocautery
• Pressure dressing
• Suturing and ligation
• Vasoconstrictive substances e.g. epinephrine

Question 8

Dead Space Management

Answer 8

Dead space in a wound fills with blood, creating a Hematoma with a high infection potential.

Question 9

Decontamination and Debridment

Answer 9

Decontamination:
Use of Irrigation (e.g., Saline )

Debridment: careful removal from injured tissue of necrotic, foreign, and severely ischemic

Question 10

Edema Control

Answer 10

the more loose connective tissue that is contained in the injured region ( Attached gingiva < floor of the mouth)

Question 11

The dentist can control the amount of
postsurgical edema by:

Answer 11

• Atraumatic surgical technique
• Cold packs
• keeping the head elevated above the rest of the body
• Short-term, high-dose systemic corticosteroids