Principles of Operative Technique Flashcards Preview

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Flashcards in Principles of Operative Technique Deck (17):
1

What are Halsted's principles of surgery?

Asepsis
Gentle tissue handling
Accurate haemostasis
Preservation of vascularity
Careful approximation of tissues
Obliteration of dead space
No tension on tissues

2

What are the different incision methods?

Scalpel
Diathermy
Laser

3

What is the correct way to use a scalpel?

Hold with a pencil grip and make a single bold incision of the correct length and depth

4

When are scissors used?

For cutting tissues below the skin, blunt dissection or undermining tissue. They allow very controlled cutting

5

What is the advantage of using diathermy?

It can be very quick and has good haemostasis.

6

What can be done to aid haemostasis?

Pressure
Packing
Wound closure
Haemostats
Diathermy
Ligatures
Topical agents
Tourniquet
Vascular clips and staples

7

How does one choose a haemostatic process?

That which is least traumatic, will leave the least foreign material and necrotic tissue and is quickest. It may also depend on the tissue or vessel.

8

What is important to remember when ligaturing a BV?

Leave 4-5mm between ligature and clamp as the clamp changes the shape of the BV which may cause the ligature to come loose if placed too close to the haemostats.

9

What are the different types of ligature?

BV:
Simple encircling
Double
Halsted's transfixing
Modified transfixing
TISSUE:
Cruciate
Simple interupted
Mattress
Stick ties

10

What ligatures are there for vasuclar pedicles?

Triple clamp tecqnique
Modified millers know
Transfixing
Divide the pedicle

11

How should swabs be used correctly?

Count in and out
Use pressure
Blot don't wipe
Use single swabs
Open the swab out

12

Why is monopolar diathermy more dangerous than bipolar?

With monopolar, if the patient is not earthed correctly then this will cause burning to the patient.

13

What topical haemostatic agents are there and when should they be used?

Vasocontriction e.g. ice, adrenaline
Promote clotting e.g. fibrin, collagen etc.
Phsical barrier e.g. bone wax/tissue glue

14

How long can a tourniquet be used for?

20 mins - then need to remove to prevent permanent tissue damage

15

How can operative tissue trauma be reduced?

-Handle gently - fine sharp intruments, stay sutures, surgeons fingers
-Gentle retraction - hand held rather than self retaining
- Tissue moistness
-Suction rather than swab usage

16

Be sure to revise instruments a lot!

n/a

17

When should lavage be used?

When there is widespread contamination - it should not be used if there is only a bit as it will spread the contamination around the cavity