Surgical Principles 2 Flashcards
do not cut blood vessels that have __
names, especially short names
surgical hemorrhage can be __, ___ or __
iatrogenic, genetic, or acquired
what causes delayed hemorrhage?
- primarily due to incomplete treatment of primary hemorrhage
- happens ~24 hours or more post op
- poor ligation technique
- intra-op hypotension
- dysphoric recovery
minor hemorrhage may hit __ while major may hit __
you, the wall
controlling hemorrhage by direct pressure
- use finger first in combination with a sponge
- 30 seconds for platelet aggregation
- 2-3 minutes for fibrin clot
- blot don’t wipe
controlling hemorrhage by hemostats
- crush tissue at point of application damaging the vessel wall and activating the clotting cascade
- small vessel = definitive, large = temporary
- use smallest curved forceps
hemostats in combinationg with ligatures are used for __
large vascular pedicles or larger single vessels
- perpendicular to vessel
- concave surface toward line of transection
- tips up
- grasp with jaw for increased security
ligatures should use the __ suture of adequate __ which is commonly __ or __
smallest, strength, 2-0, 3-0
t/f: extra throws do not increase knot security
T
small vessels can use __ ligatures while larger vessels should be __ ligated with __ plus __
circumferential, double, circumferential plus transfixing
3 clamp technique
- used for larger vessels or vascular pedicles
- gain control of vessel before transecting
- provides crushed area for more secure ligation
- tips up if using curved hemostats
cautery should be used on __ vessels only
small
make sure that the __ plate is working before using monopolar electrocautery or __ may occur
grounding, burns
hemostatic materials/gelfoam
- gelatin based hemostatic sponge
- purified porcine skin gelatin
- properties not completely understood, but appears to be physical
- small amounts completely absorbed in 4-6 weeks
4x4 fully saturated = __
5ml
