Marius and Stine doc Flashcards
(103 cards)
periods of surgery and milestones
1) primeival times until 1846
only removed injured parts
2) 1846 - 1960s
discovered narcosis
removal and reconstruction of injured parts
Milestones
- initiation and application of asepsis and antisepsis, discovery of blood groups
development of intensive therapy
3) 1960s - today
the development of instruments,
natural science research,
and technical development allowing huge modern advances in surgical approaches and interventions
In 1962 the first kidney transplant occured in Szeged
In 1967 the first heart transplant occured in South Africa.
When was Ether day and who did what
Dr William Morton
Anesthetized a patient with Ethyl Ether
October 16 1846
When and whom invented chlorinated lime hand washing? His findings
Ignaz Semmelweis 1847
It could drastically reduce the rates of peurpural fever after giving birth.
Who invented antiseptic theory
Joseph Lister
He used phenol to clean surgical tools.
1867
Who introduced the antiseptic theory in hungarian surgery
Ignaz Semmelweis
Name 4 surgical instruments refer to doctors in the development of surgery
Kocher clamp
Lumnitzer clamp
Pean clamp
Hegar needle holder
What does NOTES mean?
Natural Orifice Transluminal Endoscopic Surgery
Synonyms for NOTES technique
Endoscopic
Transgastric
Transvaginal
Transcolonic
Transvesical
List bloodless and bloody procedures
Endoscopy
Laparoscopy
Reducing a broken bone
Organ transplantation
C-section
Appendectomy
Definition of surgical intervention
Any diagnostic or therapeutic procedure, when we disrupt the body integrity or reconstruct tissues is a surgical intervention.
Specifically, a procedure performed on a living body with instruments for the repair of damage or restoration of health, especially on involving incision, excision, or suturing.
What do the septic and aseptic operating theatres stand for
In septic operating rooms infected body parts are operated.
In aseptic operating rooms, the operation is not on an infected body part, and the danger of bacterial infection does not usually exist
They can share a common corridor
How shall the staff and patient enter the operating room?
Before entering the room the staff should change clothes in the locker room and put on the surgical cap and face mask, then enter.
The patients are brought in after passing through a separate locker room.
Describe the structure of the operating room.
50-70 m2 without windows
lighted
walls covered with light colored tiles
Artifical ventilation and air conditioning
Must be separate from the wards and ICU, but should be close to the ICU.
Operating room complex consists of Locker rooms Scrub in area Preparing rooms Operating theatres
No gaps in the walls or floor, and easily cleaned
Automatic doors
Central and portable vacuum system
Pipes for gases
Main layout:
Operating lamp, Operating table, Sonnenburgs table, Supplementary instrument stand, Kick bucket, Suction apparatus
Diathermy
Microwave oven
Anesthesia machine and anesthesia instruments
Waste bin
List 8 equipments/instruments in the operating room
Operating lamp, Operating table, Sonnenburgs table, Supplementary instrument stand, Kick bucket, Suction apparatus Diathermy Microwave oven Anesthesia machine and anesthesia instruments Portable X ray Waste bin
Explain the rules of behaviour in the operating room!
Only those whose presence is necessary should be in the Operating room
Activity causing increased air flow should be avoided (laughter, talking, movements)
Entry into the OR is allowed only in operating room outfit and shoes worn exclusively in the OR, a complete change of clothes is required for all staff and patients coming into the OR.
Leaving the OR in a surgical outfit is forbidden
Door of the OR must remain closed
Movement into the OR out of the holding area/locker room is only allowed in a cap and mask that covers the hair, mouth, and nose.
Describe the general rules of the aseptic operating room!
Only sterile instruments can be used for a sterile operation
Sterile personnel can only handle sterile equipment, and sterile equipment can only be handled by sterile personnel
Sterile instruments only stay sterile if handled by a sterile person
Instruments located below the waist are no longer sterile
If a sterile instrument contacts one of doubtful sterility, it is no longer sterile
Edges of boxes and pots are not sterile
A surgical area can never be considered sterile, however the applications of aseptic rules are mandatory
Explain the definition of asepsis!
All of the procedures, actions designed to keep microorganisms away from patient’s body and the surgical wound. The purpose of asepsis is to prevent contamination.
In a wider sense, the asepsis means such an ideal state when the instruments, the skin, and the surgical territory do not contain microorganisms.
Explain the definition of antisepsis!
Includes all those procedures and techniques designed to eliminate microbial contamination present on objects and skin by means of sterilization and disinfection. The purpose of antisepsis is to eliminate or remove contamination that is present.
Because skin surfaces and so the operating field and the surgeon’s hands can not be considered sterile, in these
cases we can not talk about the superficial sterilization. In a wider sense, antisepsis includes all those prophylactic procedures designed to ensure surgical asepsis.
How to prevent the evolution of postoperative wound infections
before the surgery?
Careful scrubbing and preparation of the operation site.
Only wearing sterile clothes in the OR
Knowledge and control of risk factors, normalizing serum glucose for diabetic patients.
Perioperative antibiotic prophylaxis in septic or high risk patients.
How to prevent the evolution of postoperative wound infections
during the surgery?
- Appropriate surgical techniques must be applied
- Change of gloves and rescrub if necessary.
- Normal body temperature must be maintained. Narcosis may worsen the thermoregulation.
Hypothermia and general anesthesia both induce vasodilatation, and thus the core temperature
will decrease. - The oxygen tension must be maintained at a proper level.
How to prevent the evolution of postoperative wound infections
after the surgery?
- Wound infection generally evolves shortly (within 2 hours) after contamination.
Hand washing
and
the use of sterile gloves while handling wound
dressings and changing bandages during the postoperative period.
What is the definition of sterilization!
The removal of viable microorganisms (including latent and resting forms such asspores) which can be achieved by different physical and chemical means and methods.
Important methods that are used frequently: autoclaves, gas sterilization by ethylene oxide, cold sterilization, irradiation plasma sterilization
What is the definition of disinfection!
The reduction of the number of viable microorganisms by destroying or inactivating them.
Generally used methods: low-temperature steam, chemical disinfectants phenols, chloride derivatives, alcohols, quaternary ammonium compounds Iodine solutions
Explain the steps of the two-phase surgical hand scrub!
Mechanical cleansing followed by rubbing with disinfectant
Mechanical cleansing:
Wash hands and forearms thoroughly with soap and warm water.
No time limit on this phase, just until we are satisfied.
Wash the soap off completely, there can be no foam on your hands in phase 2.
Use paper towels to dry the hands and forearms completely
Disinfecting phase Rubdisinfectant hand scrub 5 times for one minute each time. 1st time: all the way to the elbow 2nd: 2/3 of forearm 3rd: 1/2 4th: 1/3 5th: only the hands and wrists.