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Capstone 2 > Surgery > Flashcards

Surgery Flashcards

1
Q

pros and cons of monofilament

A

smooth passage through tissue

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2
Q

pros and cons of multifilament

A

stronger than mono, but has drag/damages tissue

absorbs faster than absorbable monos

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3
Q

pros and cons of absorbable suture and name some

A

loses tensile strength faster than non-absorb

e.g. maxon, PDS - absorb in 6 mo

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4
Q

pros and cons of rapidly absorbable suture and name some

A

rapid - good for oral tissue
monocryl, biosyn - absorb in 3 mo
vicryl rapide - 6 wks

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5
Q

pros and cons of non-absorbable suture

A

stronger, eventually loses some tensile strength but not degraded

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6
Q

Brands/types of synthetic absorbable monofilament

A

Maxon (polyglyconate), PDS (PDX, polydioxanone)

Biosyn (Glycomer 631), Monocryl (Poliglecparone 25)

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7
Q

Brands/types of synthetic absorbable multifilament

A

Polysorb, Dexon, Vicryl (polyglactin 910), Vicryl rapide,

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8
Q

Brands/types of synthetic non-absorbable monofilament

A

Nylon (=Polyamide) Novafil, Dermalon, Ethilon, Monosof, Prolene, gore-tex, surgilene, surgipro

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9
Q

Appropriate suture size for visceral closure in small animals

A

5-0 to 3-0

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10
Q

when would you use a taper suture needle (circular body)

A

minimal effort needed to enter tissue b/c make smallest holes

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11
Q

when would you use a cutting needle (triangle body)

A

thick tissue (e.g. fascia, skin, intradermal)

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12
Q

characteristics of simple interrupted

A

appositional

not tension relieving

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13
Q

characteristics of cruciate

A

appositional

tension relieving

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14
Q

characteristics of vertical mattress

A

everting

tension relieving

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15
Q

characteristics of cushings

A

minimally inverting

not tension relieving

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16
Q

suture plan for SQ closure

A

4-0 to 3-0 (usually 3-0) absorbable suture (e.g. biosyn)
taper needle
continuous appositional pattern - simple continuous or continuous horizontal mattress

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17
Q

suture plan for skin closure

A

4-0 to 3-0 (usually 3-0) non-absorbable suture (e.g. nylon)
cutting needle
ford interlocking pattern (modified simple continuous, less likely to fail, good apposition/tissue stability)

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18
Q

suture plan for gastrotomy closure

A

5-0 to 3-0 (usually 3-0) absorbable suture (e.g. biosyn/monocryl, PDS)
taper needle
double layer continuous inverting pattern: cushing/connell/simple continuous then a lembert (partial thickness)

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19
Q

antimicrobial plan for a clean-contaminated sx

A

prophylactic antimicrobials indicated

post-op therapeutic depends on case - “just in case” is not an indication

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20
Q

Between Maxon, PDS, Biosyn, and Monocryl, which are from the same company and which behave like eachother

A

Maxon, biosyn are from Medtronics
PDS, Monocryl are from Ethicon
Maxon and PDS are similar, Monocryl and biosyn are similar

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21
Q

what is the use of topical antiseptics and wound cleaning?

A

Don’t use in the wound - impairs healing by killing recovery cells –> more necrotic tissue to harbor bacteria
Use on intact skin around wound only

22
Q

best antiseptics to use with wound cleaning? Which to avoid?

A 
acetic acid (vinegar) or surfactant-based cleaners
avoid iodine, chlorohex, hydrogen peroxide
23
Q

Color scheme for wound assessment

A

Black (or exposed bone) - necrotic
yellow (or grey, green, etc) - fibrinous
red - granulation
pink - epithelium

24
Q

What wound colors mean debridement is necessary?

A

Black or yellow - fibrinous or necrotic means infection is present

25
Q

what dressing should you use for a necrotic, heavily exudative wound?

A

Must debride

saline, hypertonic saline, kerlix aMD (antimicrobial woven gauze) or honey

26
Q

what dressing should you use for a dry wound?

A

Must re-moisturize

gel dressing

27
Q

what dressing should you use for a wound with granulation tissue?

A 
Must get wound contraction, granulation tissue enhancement
calcium alginate (curasorb)
28
Q

what dressing should you use for a wound with epithelialization

A

semi-occlusive foam dressings - COPA, hydrasorb

29
Q

what dressing should you use for an exposed bone wound?

A

calcium alginate - stimulates soft tissue coverage

30
Q

CSU’s general preferred suture material for bowel closure

A

Biosyn (good initial strength, then absorbed quickly

31
Q

CSU’s general preferred suture material for urinary bladder or uterus closure?

A

Monocryl - high starting strength & at 50% of strength loss, bladder has regained 50% of it’s strength

32
Q

What is the concern with using an inverting suture pattern in the gut? everting?

A 
inverting = stricture - if must use, cushing is preferred pattern b/c doesn't penetrate lumen
everting = leakage, adhesions, don't use
33
Q

What suture pattern is preferred in the gut?

A

Appositional pattern preferred - simple continuous (or modified gambee - invert mucosa, oppose serosa)

34
Q

What is the holding layer for the ventral midline abdominal approach?

A

linea alba

35
Q

What is the holding layer for the paramedian abdominal approach?

A

external rectus sheath

36
Q

What is the holding layer for the paralumbar/flank abdominal approach?

A

external abdominal oblique fascia

37
Q

Where is the incision placed for a foreign body enterotomy?

A

aboral to the foreign body b/c healthier tissue

38
Q

How do you initially stabilize an injury distal to stifle or elbow?

A

robert jones bandage +/- splint

leave for NO MORE than 1-3 days

39
Q

How do you initially stabilize an injury proximal to stifle or elbow

A

crate rest

40
Q

Why do you avoid coaptation in tiny dog breeds?

A

poor blood supply to distal radius/ulna = slow healing, re-fx common

41
Q

what can occur if part of the ovary is left behind during an ovariectomy?

A

pyometra d/t ovarian remnant syndrome

42
Q

benefits of neutering a female dog

A

decreased risk for mammary neoplasia (MGT) if before 2.5 yo

no risk of pyometra

43
Q

cons of neutering a female dog

A

increased risk for cancers, obesity

early spay may cause incontinence, delayed closure of long bone growth plates, possible ortho issues

44
Q

arthroscopy vs. arthrotomy

A

arthroscopy - scope

arthrotomy - same, but larger incision - for larger fragments or fracture, sepsis

45
Q

3 common complications to fracture repairs in EQ

A

implant failure
infection
support limb laminitis - put foot support on non-injured foot

46
Q

What is the most common EQ fracture

A

ulna/olecranon - characteristic dropped elbow appearance

47
Q

Name some commonalities with tendon injuries

A

flexor tendons > extensors
SDFT > DDFT (b/c SDF is more external, smaller, less vascular)
forelimb > hind

48
Q

If you see mild hyperextension of the fetlock, you can expect ___ to be transected

A

SDF

49
Q

If you see moderate hyperextension of the fetlock, you can expect ___ to be transected

A

SDF & DDF

50
Q

If you see no fetlock support, you can expect ___ to be transected

A

SDF, DDF, suspensory ligament

Capstone 2 (6 decks)

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