Surgical Techniques

Question 1

Skin loss less than 1cm square

Answer 1

No need for a flap, graft or anything only primary dressing

Question 2

Split thickness graft advantage

Answer 2

Can put holes to increase surface area but bad cosmesis so not recommended on face
No wound contraction

Question 3

Flap vs graft

Answer 3

Flap has blood supplying vessels in it so needs vessels anastomosis
Graft doesn’t. So it revascularizes itself from receiver bed

Question 4

What type of grafy to use in 3dr degree burn

Answer 4

Split thickness to cover a large surface area

Question 5

What is prefabricated flap

Answer 5

Flap prefabrication involves the introduction of a new blood supply by means of a vascular pedicle transfer into a volume of tissue. After a period of neovascularization, this volume of tissue may be transferred, based only on its implanted vascular pedicle.

Question 6

Clean wound skin list less than 1cm and more than 1cm

Answer 6

Undermining is a suturing technique that involves using sterile scissors to separate the skin from the underlying connective tissue around a wound. This technique can help reduce tension on the wound, which can lead to faster healing and less chance of scarring. However, undermining can also have negative effects, such as cutting nerves and blood vessels, which can slow healing and cause temporary anesthesia.

Less-do primary closure
More-do undermining procedure

Here are some things to consider when undermining a wound:
Amount of undermining
The amount of undermining should be based on the wound site and skin laxity, and should allow the wound to close with minimal tension. A general rule of thumb is to undermine to the same radius as the wound’s maximum width.
Depth of undermining
The depth of undermining will vary depending on the site of the wound:
Scalp: Undermine in the avascular space below the galea to avoid cutting hair follicles
Face: Undermine in the upper subcutaneous fat
Torso: Undermine at any level of fat
Hands: Undermine just below the dermis

Question 7

Antidote of prilicaine used in bier’s block

Answer 7

Bier’s block, also known as intravenous regional anesthesia (IVRA), is a safe and effective technique that uses a local anesthetic and a tourniquet to provide anesthesia and analgesia for short-term extremity surgeries. The procedure involves:

Methylene blue or intra lipid

1.Placing a peripheral intravenous (PIV) catheter in the arm, hand, or leg
2.Injecting a large volume of dilute local anesthetic into the extremity
3.Inflating the proximal cuff of the tourniquet 50-100 mm Hg above systolic blood pressure
4.Removing the Esmarch bandage
Injecting 30-50 mL of local anesthetic over 1-2 minutes
5.The tourniquet prevents the local anesthetic from spreading systemically, isolating it in the target area. The procedure has a reported success rate of 96–100%.
Some modifications to the technique over the years include: Lower doses of local anesthetic, Longer-acting local anesthetics, and Additives to the block solution.
Some adjuncts have been used to improve sensorimotor blockade, reduce tourniquet pain, and improve post-operative pain scores. Ketorolac has the best evidence for providing postoperative pain relief.
Before performing the procedure, clinicians should document limb neurovascular observations. They should also be able to provide resuscitation if local anesthetic poisoning occurs, and may benefit from supervision if they do not have prior experience with the procedure.
Some absolute contraindications to the procedure include:
Open wounds, sores, or active soft tissue infections in the extremity
Hypersensitivity/allergy to local anesthetics
Poor baseline limb perfusion in the extremity
Active deep vein thrombosis or thrombophlebitis
Poorly controlled hypertension
Contraindications to tourniquet use

Question 8

Toxic features of lidocaine

Answer 8

Cardiac arrhythmia
Metallic taste
Mouth numbness

Question 9

Relation of bipolar diathermy with alcohol based disinfectant

Answer 9

May cause fire

Question 10

Contraindication of electrocautery

Answer 10

Pacemaker of heart
Definition of heart
Pregnancy
Reproductive organs
Neurological dysfunction(Cognitive impairment, epilepsy,Impaired sensation of skin)
Phlebitis

Front of neck

Question 11

Electrocautery type in hand and penis

Answer 11

Bipolar with Colorado needle too prevent ischaemia

Question 12

Absorbable vs nonabsorbable

Answer 12

Skin,vessels,nerves nonabsorbable
Under skin absorbable cause no interruptions during their regeneration