Surgery Final Flashcards
what are 3 questions to ask when you get an oncology case
1) what is it
2) where is it
3) how bad is it
what are two reasons to give prophylactic antibiotics
> 2h
entry into a hollow viscus (dirty surgery)
when would you give antibiotics prior to surgery if you want them to be in the blood for when you cut
30 minutes prior
why are biological indicators more accurate than chemical indicators
indicates there was appropriate temperature and time to kill the organisms present in the biological indicator
what are 3 important characteristics for choosing suture material
strength, suture size, monofilament vs multifilament, absorbable vs non-absorbable
what areas of the gown are not sterile
back, 2 inches above the elbows, neck, shoulders, below the armpits, anything below the level of the surgical field, cuffs
describe flash sterilization
unwrapped instruments placed in an open tray with towel lining bottom; 132 C for 4 min minimum; requires prevacuum autoclave
describe steam sterilization
uses a gravity displacement autoclave (like a pressure cooker); controlled temperature, pressure and time; minimum 121 C for 30 minutes; arrange instruments vertically and do not overfill
describe ethylene oxide sterilization
kills all microorganisms using gas (chemical sterilization); many illegal in Canada and the US; requires long aeration times; cannot use on some material such as plastic and rubber
describe plasma sterilization
uses vapour phase hydrogen peroxide; no aeration or toxic residues; expensive and cannot sterilize all materials with this method (ex. gauze, plastics)
describe cold sterilization
used for instruments for “dirty” surgeries; soaking instruments in chemicals such as glutaraldehyde; must rinse thoroughly before using
describe radiation sterilization
uses gamma radiation; commonly in manufacturing settings due to cost and regulations
describe primary fracture healing
occurs when there is absolute fracture stabilty (<2% strain and <0.01mm gap)
Steps:
1) initial fibrin matrix with angiogenesis
2) lamellar bone fills gap within days-weeks; initially laid down perpendicular and eventually is reorganized
describe secondary fracture healing
occurs when there is good fracture stability; sequential production of granulation tissue, fibrous tissue, fibrocartilage, bone; faster than primary bone healing
Steps:
1) inflammation
2) intramembranous ossification
3) soft callus (chondrogenesis)
4) hard callus (endochondral ossification)
5) bone remodelling
what type of fracture can you use a pin-cerclage for?
simple long oblique (>2x width of bone) or spiral fractures
what are the 3 bandage layers
contact, padding, compression
what type of splint can immobilize the humerus
Spica
what is a Velpau sling
immobilizes the elbow
What is the Ehmer sling
immobilizes a hindlimb
what are the wound classifications
clean, clean-contaminated, contaminated, dirty
what are the 3 complications of bone healing
malalignment, non-alignment, delayed alignment
what are the 5 forces acting on the bone and what type of fracture would they create
SIMPLE
- tension (transverse fracture)
- compression (oblique fracture)
- shearing (transverse fracture)
COMPLEX
- torsion (spiral fracture)
- bending (Y-shaped fracture)
how do you describe a fracture (6)
- bone involved
- location within the bone
- fracture complexity (simple, comminuted, segmental)
- fracture configuration (spiral, wedge, oblique, transverse)
- fracture characteristic (open, closed)
- displacement
what are the types of biopsies
incision and excisionaln
