Surgery Flashcards
define oscopy
examination of a hollow viscus
define ectomy
removal of an organ
define orraphy
repair of tissues
define ostomy
an artificial communication between a hollow viscus and the skin
define otomy
cutting open
define plasty
reconstruction
define pexy
relocation
what types of anaesthesia are available ?
local, regional, epidural and spinal, intravenous sedation, general
which factors make for good surgical practice ?
emotional neutrality, surgical team, informed consent and understanding, avoidance of errors, prophylactic measures, operation notes, postoperative course, surgical audit and education
how is the skin prepared and draped before an operation ?
0.5% chlorhexidine, double thickness lining sheets, disposable fabrics allow less penetration
why should alcohol not be used to prepare skin for an operation ?
alcohol burns
what factors should be considered when deciding where to place an incision ?
good access, orientation of skin tension lines, strength and healing potential of the tissues, anatomy of underlying structures, cosmetic considerations
what are the 3 tissue layers ?
epidermis, dermis, hypodermis
what are the 2 types of dissection ?
sharp
blunt - cleavage along natural tissue planes
what are the principles of haemostasis ?
clipping, ligation, under running, diathermy, tourniquet and exangination, pressure, hypotensive anaesthesia
what is diathermy ?
cutting with electricity
what is monopolar diathermy ?
charge begins at forcep and discharges out of the patient
what is bipolar diathermy ?
charge contained within the forcep and does not excite any part of the patient
which absorbable suture materials are available ?
dexon - polyglycolic acid
vicryl - polyglactin
slowly absorbed - PDS - polydioxanone
which non absorbable suture materials are available ?
silk (irritant), nylon, prolene
what is the purpose dressing a wound ?
maintain wound in a warm, moist state, absorb/contain superficial bleeding or inflammatory exudate, protect healing tissue, apply pressure to prevent haematoma, conceal wounds form view
how should infected tissues be treated during surgery ?
thorough cleaning, excision of non-viable tissue, loose open packing, inspection of wound under anaesthesia, delayed primary closure
how are good skin grafts achieved ?
applied to well vascularised non infected wounds,
require immobility but not pressure,
match texture and colour
what factors can cause a skin graft to be unsuccessful ?
avascular wounds e.g. bones without periosteum, tendons with peritenon, denuded cartilage,
hevy contamination with micro-organisms,
grafts can survive on plasma but not blood clots
what are the 4 types of skin flap ?
random pattern flaps,
axial flaps,
myocutaneous flaps,
free flaps
what are the features of random pattern flaps ?
no specific blood vessel,
2:1 ratio of length to width,
used to cover local defects
what is the principle of axial flaps ?
skin supplied by a specific blood vessel and its accompanying venae comitans
what is the principle of myocutaneous flaps ?
skin overlying a muscle will survive if the pedicle to the muscle is not divided
what is the purpose of microvascular free flaps ?
reconstruct complex wounds with complex tissue loss
