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TMS Basics > Surgeries Causes & Indications > Flashcards

Surgeries Causes & Indications Flashcards

1
Q

What are the known causes of chronic non healing wounds?

A

Diabetes, Alcoholic, Rheumatoid Arthritis, Obesity, Autoimmune Disorder, Venous Stasis

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2
Q

What are the known complications of surgeries for chronic non healing wounds?

A

Wound Dehiscence, surgical site infection, chronic venous stasis

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3
Q

What is an example of a chronic non healing wound?

A

Ulcers ex: Diabetes, Venous Stasis or Pressure

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4
Q

How does a patient develop an ulcer?

A

Due to poor circulation and neuropathy for patients with diabetes/venous stasis, cuts in the feet or blisters turn into ulcers, becoming infected and do not heal.

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5
Q

What are the known causes of tram flaps?

A

TRAM flap causes include:

a) mastectomy
b) history radiation to the chest wall
c) failure previous breast reconstruction
d) excess lower abdominal tissue (patient request abdominoplasty)
e) No recipient vessels for a free flap reconstruction because of previous chest or axillary surgery or severe scarring from radiation therapy

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6
Q

What are the known complications of surgeries for tram flaps or open flaps?

A

Hernias, Tissue Necrosis, Infection, lack of blood supply, scar tissue formation, hyperalgesia

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7
Q

What is a Tram Flap?

A

TRAM stands for transverse rectus abdominis, a muscle in your lower abdomen between your waist and your pubic bone. A flap of this skin, fat, and all or part of the underlying rectus abdominus (“6-pack”) muscle are used to reconstruct the breast in a TRAM flap procedure.

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8
Q

What is an Open Flap?

A

Flap surgery is a technique in plastic and reconstructive surgery where any type of tissue is lifted from a donor site and moved to a recipient site with an intact blood supply.

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9
Q

What is the difference between a graft and a flap?

A

A graft does not have an intact blood supply and therefore relies on growth of new blood vessels. A flap is done to fill a defect such as a wound resulting from injury or surgery when the remaining tissue is unable to support a graft, or to rebuild more complex anatomic structures.

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10
Q

What are known open flap causes?

A

Infection, Trauma, Tissue Necrosis, etc

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11
Q

What are known causes for abdominalplasty?

A

sagging skin after pregnancy, excess abdominal fat, separation or weaning of the abdominal muscles, increased concentration of abdominal fat

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12
Q

What are known complications of Abdominalplasty surgery?

A

Wound complications: infection, dehiscence, seroma and/or hematoma, marginal necrosis)

Complications after surgery: deep vein thrombosis, pulmonary embolism, ileus, nerve damage, death

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13
Q

What are known causes of mastectomy?

A

Breast Cancer

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14
Q

What are known complications of a mastectomy?

A

Seroma, Hematoma, lack of blood supply, increased risk of infection, scar tissue formation, hyperalgesia

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15
Q

What are known causes of an irradiated wound?

A

Radiation after Cancer

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16
Q

What are known surgical complications of an irradiated wound?

A

Lack of blood supply, infection, tissue necrosis, seroma, hematoma, scar tissue formation

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17
Q

What are known complications of an open abdominal wound?

A

Dehiscence, Infection

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18
Q

What are known causes of an open abdominal wound?

A

peritonitis, ruptured abdominal aortic aneurism, acute pancreatitis, organ surgery, trauma, and after laparotomy when a wound cannot be close without tension because of visceral swelling.

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19
Q

What are known surgical complications of an open abdominal wound?

A

Wound Dehiscence, Infection, seroma, hematoma, nerve injury

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20
Q

What are known causes of necrotizing fasciitis?

A

Infection, most likely from group A streptococcal bacteria “flesh eating bacteria”

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21
Q

What are known surgical complications for necrotizing fasciitis?

A

Death, Skin loss, Scarring, Toxic Shock Syndrome

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22
Q

What are known causes for an exposed tendon of bone?

A

Trauma (crush injuries, fractures), pressure or diabetic ulcers, infected surgical wounds

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23
Q

What are known surgical complications for treating an exposed tendon or bone?

A

lack of blood supply, adhesions, scare tissue formation, loss of tendon viability, osteonecrosis.

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24
Q

What are known causes for a fasciotomy?

A

Compartment syndrome, Crush injuries, severe burns, obesity, injury or fracture resulting in blood leaking into the muscle, contusion/trauma

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25
Q

What are known surgical complications for a fasciotomy?

A

Adhesions, scar tissue formation, limb amputation, loss of mobility of the joint involved

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26
Q

What is a fasciotomy?

A

A surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle.

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27
Q

What are known causes a mass or abscess removal?

A

Benign or Cancerous Tumor, Cysts, Infection, Seroma/Hematoma after surgery

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28
Q

What are known surgical complications for a mass removal or abscess?

A

Seroma, Hematoma, Infection, Scar tissue formation

29
Q

What are known causes of a soft tissue void?

A

Ulcer, burn, soft tissue tumors, infection, surgery

30
Q

What are known surgical complications of a soft tissue void?

A

Surgery, Lack of blood supply, graft/flap failure, infection, seroma, hematoma

31
Q

What are known complications of scar tissue resection?

A

Scar widening, hypertrophy, infection, wound dehiscence, hyper pigmentation, keloid formation

32
Q

What are known causes of scar tissue resection?

A

Scar formation after surgery, keloid, adhesions, burns, infection

33
Q

Stages of the healing Cascade?

A

Injury, Hemostasis, Inflammation, Proliferation, Maturation

34
Q

What is the hemostasis phase and how long does it last?

A

Coagulation of blood to stop bleeding.

Lasts 5-10 minutes.

35
Q

What is the inflammatory phase and how long does it last?

A

Removal of devitalized tissue, prevent infection.
Early inflammatory phase lasts 24-48 hours.
Late inflammatory phase lasts 48-72 hours.

36
Q

What is the proliferative phase and how long does it last?

A

Fibroproliferative phase is the balance between scar formation and tissue regeneration. Focused on fibroblast migration, college synthesis, angiogenesis and epithelialization.

Begins at day 3-5.

37
Q

What is the maturation phase and how long does it last?

A

Remodeling phase where strength and structural integrity is maximized. Contraction and collagen remodeling occur.

Starts at 3 weeks lasts upwards of a 1 year.

38
Q

What is a PMA under government regulation?

A

Premarket approval is the FDA process of scientific and regulatory review to evaluate the safety and effectiveness of Class III medical devices

39
Q

What is Class III medical devices?

A

Class III devices are those that support or sustain human life, are of substantial importance in preventing impairment of human health, or which present a potential, unreasonable risk of illness or injury

40
Q

what is the CFR part 1271?

A

HCTP must be minimally manipulated for homologous use, the manufacturing doesn’t involve the combination of cells, no systemic effects, is not dependent on the metabolic activity of living cells is for autologous, allogenic or reproductive use?

41
Q

What does Homologous use mean?

A

the repair, reconstruction, replacement, or supplementation of recipients cells with a HCTP that performs the same basic functions in a donor.

42
Q

What is Off Label Promoting?

A

Off label promoting is when you promote a products for uses not approved by the Food and Drug Administration (FDA).

43
Q

What qualifying questions should you ask at every meeting with a doctor in order to information gather?

A

Time, Date, Location upcoming surgery

44
Q

What statement is made in order to close a surgeon?

A

Would you considering evaluating this product in an upcoming case?

45
Q

What does a rep do following an initial meeting?

A

Follow up same day

46
Q

What are the stages of the sales cycle )from prospecting to OR servicing)?

A
  1. Prospecting (collecting leads)
  2. Cold Calling
  3. Setting appointment with Dr.
  4. Qualifying (creating specific presentation tailored to Dr.)
  5. Product Demo
  6. Handling Objections
  7. Closing
  8. Follow up
  9. Get hospital urgent request form to Dr.
  10. Fill out Dr. Paperwork, send back to hospital
  11. Find out Time, Date, Location upcoming surgery
  12. Ship product to hospital
  13. Servicing product in surgery
47
Q

What are the stages of the sales cycle )from prospecting to OR servicing)?

A
  1. Prospecting (collecting leads)
  2. Cold Calling
  3. Setting appointment with Dr.
  4. Qualifying (creating specific presentation tailored to Dr.)
  5. Product Demo
  6. Handling Objections
  7. Closing
  8. Follow up
  9. Get hospital urgent request form to Dr.
  10. Fill out Dr. Paperwork, send back to hospital
  11. Find out Time, Date, Location upcoming surgery
  12. Ship product to hospital
  13. Servicing product in surgery
48
Q

What are the problems medical representatives need to properly identify and offer expert consultation to surgeons?

A
  1. How to help granulate tissue faster,
  2. Promote angiogenesis (decreasing lack of blood supply to graft)
  3. Prevent post surgical infection
  4. Prevent seroma, hematoma, dehiscence
  5. Improve Flap/Graft take
49
Q

What are the 3 pillars of Aristotle’s Art of Persuasion?

A

Ethos
Pathos
Lagos

50
Q

What is Ethos?

A

Appeal to Moral Character

51
Q

What is Pathos?

A

Emotional appeal through story telling

52
Q

What is Logos?

A

Appeal to logical reasoning

53
Q

What is the first step to handling objections as identified in the book Digging Deeper?

A

Ask If/Then questions to determine the true objection

54
Q

If you place a phone call to a medical facility and are unable to reach the contact in order to gather information, what do you do?

A

Immediately send an email and/or swing by the office same day.

55
Q

What are the necessary information required by the TM to obtain in order to execute properly when information gathering?

A

Time, Date, Location

56
Q

What is the call pattern for follow up?

A

Follow up every 3 days via Call/Email/Text

57
Q

Before entering the operating room, what information is required by the rep to obtain in order to properly advise the surgeon and facilitate a consultive sale?

A
  1. Identify name of procedure
  2. Research causes and associated complications
  3. Prepare tailored pitch for product by writing it down ahead of time
  4. Recite pitch and bring it with you into OR
  5. Consider potential objections
  6. Write objections down and how to over come them (ie. price)
58
Q

Daily protocol includes lead resulting and continuous reporting in order to manage accounts and adhere to the 3 day call pattern, allowing a TM to move the account through the sales Cycle. What is an example of proper lead resulting?

A

10/11 called scheduled to follow up on case status, left voicemail, sent email. Will stop by today.

59
Q

What does a TM need to do in order to prepare for a meeting?

A
  1. Research and review clinical data
  2. Optimize time/create agenda list information necessary to gather
  3. Tailor pitch
  4. Bring necessary material for presentation including highlighted studies
  5. Anticipate objections
  6. Strategize how to overcome objections
60
Q

In the Challenger Sale, what are the 6 steps to commercial selling?

A
  1. Warmer
  2. Reframe
  3. Rationale Drawing
  4. Emotional Impact
  5. New Way
  6. Your Solution
61
Q

What is the first step in the challenger sale and describe it.

A

Warmer. Building credibility by acknowledging the customers challenges.

“Lead Hypothesis of Customer Needs”

62
Q

What is the second step in the challenger sale and describe it.

A

Reframe. Have client acknowledge challenges and connect these challenges to bigger problem.

“Define the customers needs, don’t respond to them”

63
Q

What is the third step in the challenger sale and describe it.

A

Rational Drawing. Where you explain why the reframe is worth the customers time through data.

64
Q

What is the fourth step in the challenger sale and describe it.

A

Emotional Impact. After rational drawing using data, now tell a story. One they can connect with that addresses issues the customer experiences every day. Tell a narrative how when these were addressed x, y, z, negative outcomes happened.

65
Q

What is the fifth step in the challenger sale and describe it.

A

New Way. Customer acknowledges challenges and potential negative outcomes and buys into the need for a solution or need to ACT differently. (This is not the solution phase, but acknowledging a solution is necessary)

66
Q

What is the sixth step in the challenger sale and describe it.

A

Your Solution. Deliver your unique solution, what is is, how it is different and how it will help.

67
Q

When starting a sales pitch, what is more important to lead with: Customer Needs or your unique data/differences?

A

Customer Needs. By addressing the customers needs/challenges, telling a story they can connect with and understand that these challenges are real and that a solution must be done, then you can provide your unique solution to there problem.

68
Q

In the Challenger Sale, describe what the author means by choreography?

A

Building a purposes teaching pitch that addresses the customers problems, telling a story that they can relate to, agree that there needs to be a solution and then presenting a solution. HOWEVER, this choreography begins by making your solution UNIQUE and then addressing the reframe, this will open someones eyes to problems they may not have known they had and allow you to lead them through the other steps to your unique solution.

TMS Basics (3 decks)

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