General surgical principles

Question 1

What are halsted’s principles of surgery? (7)

Answer 1

• Gentle tissue handling
• Meticulous haemostasis:
• Preservation of blood supply:
• Strict asepsis:
• Minimal tension:
• Accurate tissue apposition:
• Obliteration of dead space:

Question 2

3 different ways to hold a scalpel and when to use each grip?

Answer 2

1. pencil grip - fingers alone move blade - small incisions
2. Fingertip grip - whole arm moves blade - >3cm long
3. palm grip - rarely used - v forceful

Question 3

2 different ways of cutting with scalpel

Answer 3

1.press cutting - pencil grip - pressure in direction of motion
2.slide cutting - pressure at 90* - other tissue tenses laterally

Question 4

3 ways of cutting with scissors

Answer 4

1.scissor cutting
2.push cutting
3. blunt dissection

Question 5

electrosurgical instruments (difference and use)

Answer 5

monopolar - cut and coagulate
bipolar - coagulate only
more traumatic so only used on anaesthetised patients

Question 6

what is the use of retractors?

Answer 6

expose surgical field and move tissues

Question 7

electrosurgery precautions (5)

Answer 7

• Do not use electrosurgery in the presence of volatile/flammable gases or liquids
• The ground plate for monopolar systems must be in complete contact with the animal to avoid burns at the plate contact points.
• Do not wrap the power lead in a coil around towel clips.
• Keep the electrodes clean so they function properly.
• Keep power settings as low as possible

Question 8

different types of suction heads and uses?

Answer 8

-Frazier-ferguson - fine work during dissection
-Yankauer - removing large volumes from body cavities
-Poole - multiple holes = doesn’t block easily

Question 9

What are the complications of improper tissue handling?

Answer 9

ischaemia
necrosis
dead space formation
wound contamination
increased pain

Question 10

what are the good qualities of a suture material (5)

Answer 10

easy to handle
high tensile strength
good knot security
no reaction
persist as long as needed

Question 11

different types of sutures

Answer 11

monofilament
multifilament
absorbable
non-absorbable
synthetic
natural

Question 12

3 different suture patterns

Answer 12

1.appositional - wound edges in direct contact
2.inverting - turns inwards
3.Everting - turns outwards

Question 13

What is used for tissue adhesives

Answer 13

Cyanoacrylates (only for skin)

Question 14

What are non-absorbable suture materials?

Answer 14

Nylon

Question 15

What are absorbable suture material?

Answer 15

Vicryl
Monocryl
PDS

Question 16

What are commonly used suture patterns for subcutaneous tissue?

Answer 16

Simple continuous
Continuous horizontal mattress pattern