Surgery Flashcards
Indications for use of prophylactic antibiotic use (8)
1) Implants
2) Prolonged surgery
3) Trauma surgery
4) Revisional surgery
5) Immunocompromised patient
6) Extensive dissection
7) intra-operative contamination
8) endocarditis
Most commonly used antibiotics (3)
Ancef
Clindamycin (if PCN allergy)
Vancomycin (MRSA worry)
Indications for chest Xray (4)
40 years of age, smoker, any history of cardiac disease, any history of pulmonary disease
Indications for ordering an ECG (2)
> 40 years of age, any history of cardiac disease
Most common time post op for myocardial infarction
Day 3
How long should elective surgery be delayed following an MI or CABG
6 months
What should be obtained prior to surgery on a patient with Rheumatoid
cervical spine x-ray
When should aspirin be d/c prior to surgery
7 days due to irreversible binding to platelets
When should NSAIDs be d/c prior to surgery
3 days due to reversible binding to platelys
When should heparin be d/c prior to surgery
8 hours
When to d/c coumadin prior to surgery
3-4 days
What should INR be for elective surgeries
<1.4
Order of wound graft closure (4)
1) direct closure
2) graft
3) local flap
4) distant flap
Stages of skin graft healing (4)
1) Plasmatic
2) Inosculation of blood vessels
3) Re-organization
4) re-innervation
AO principles
1) anatomic reduction
2) rigid internal fixation
3) preservation of blood supply
4) early ROM
What are steps necessary for inserting a fully threaded screw (6)
1) overdrill near cortex
2) underdrill through far cortex
3) countersink
4) measure
5) tap
6) screw
Amount of screw to pass the far cortex
1.5 threads
Purpose of tapping
to create a path for the screw threads
Why countersink screw
Prevents stress risers and soft tissue irritation .
Provides even compression from screw head
Describe a mini fragment screw
Screw sizes of: 1.5, 2.0, 2.7
All fully threaded cortical screws
What are the differences between cortical and cancellous screws
Cortical has smaller pitch
Cortical has smaller rake angle
Cortical has smaller difference between thread diameter and core diameter
Describe a Malleolar screw
For fixation of medial malleolus, partially threaded, same thread profile and pitch as cortical screw, trephedine self cutting tipping
What screw has a fluted tip
self-tapping
Overdrill, underdrill and countersink for 1.5 mini fragment(fully threaded)
overdrill- 1.5
Underdrill- 1.1
Countersink 1.5
