Surgical Technique Flashcards
What is the target intra-abdominal pressure when inflating the abdomen for laparoscopic surgery?
12 - 15 mmHg
What would you a silk suture for?
Skin closure
What are the uses of PDS?
- Visceral anastomosis
- Dermal closure
- Mass closure of abdominal wall
Absorbable. Up to 3 months
When are prolene sutures used?
- Vascular anastomosis
- Tendon repair
Permanent sutures
How long does vicryl take to be absorbed?
up to 6 months
When should the use of a monopoly be avoided if possible?
In patients with pacemakers
What are the functions of bipolar and monopolar in surgery?
Bipolar: only coagulation
Monopolar: cutting and coagulation
What are the advantages of bipolar?
- safe to vital structures
- no chance of burn
- can be used with pacemakers, digits, scrotum, penis
Current stays between prongs of bipolar to minimises burn to surrounding structures
How is most re-usable surgical equipment sterilised?
Autoclaving - use of hot steam
How are scopes sterilised?
Use Glutaraldehyde solution
What is primary wound closure?
Clean wound (e.g. incision), closed by suturing methods and heals by primary intention
What is vacuum assisted closure and what are its disadvantages?
Negative pressure used to facilitate wound closure and helps to remove exudate
Disadvantages:
- Cost
- Risk of formula formation if used incorrectly on sites such as bowel
What is grafted during a split thickness graft?
Superficial dermis is removed by dermatome (commonly from thigh)
If an elderly patient trips over and sustains a large pretibial laceration with no bone exposed, what is the most appropriate approach to wound management?
Split thickness skin graft
Pretibial lacerations do not heal well and heal poorly under simple closure
How would you biopsy an unknown skin lesion?
Excisional biopsy with 2mm margin
+/- intra-operative frozen section to decide if a greater margin should be made
