3Rd Year Bst2

Front 1

Bioplasts

Back 1

Preparations made of natural material artificially implanted in the body.
They absorb completely and cause little or no damage to tissues.
Advantages :
Good hemostatic effect
Absorbable
Minimal tissue reaction, not antigenic
Not toxic
Easy to handle
Good for wound healing
Materials :
Fibrin
Gelatin
Oxidized Cellulose
Collagen
Collagen+Fibrin

Front 2

Tissue Adhesives

Back 2

Materials that make immediate and permanent connection between the wound edges.
Materials used can be :
GRF (Gelatine Resorcin Formaldehyde)
Cyanoacrylat (Histoacryl-blue)
Fibrin Sealant (Tissuco – Body temp., Beriplast – room temp)

Front 3

Bowel Anastamosis (needle, surgical material, suturing technique)

Back 3

Needle : Round body, serosal (atraumatic), 1/2 circular;
Surgical material : Monofilament or pseudofilament, size 3/0 or 4/0;
Suturing Technique : Lembert (seromuscular), Albert (all layers). Running sutures in adults, Interrupted sutures in children. Sutures should be free of tension, Depth of sutures and distance between them ~3mm.

Front 4

Steps of bowel anastamosis

Back 4

1. Scelitization : Clamping of the vasa recta
2. Use intestinal clamps 3cm from each side that is going to be sutured.
3. Make 2 sutures and then close the posterior wall of the intestine.
4. Anterior suture of the intestine.
5. Suture of the mesentery

Front 5

Parenchymal organs (needle, surgical material, suturing technique)

Back 5

Needle : Serosa needle or parenchymal needle (blunt tip);
Surgical material : Absorbable;
Suturing technique :
Simple interrupted suture, Mattress (horizontal or vertical) U,X,Z,8 Sutures, Pillot suture, Baron's maneuver, Pringle maneuver, Finger fracture technique, Cavitron ultrasonic surgical aspirator, laser

Front 6

Surgical classification of parenchymal organs capsule

Back 6

Spleen : Very thin and sensitive; Kidney : Proper capsule, fatty capsule, Renal fascia (in-->out); Pancreas : Thin capsule

Front 7

Conicotomy (indications, priorities, steps of the technique)

Back 7

Indications :
Upper airway obstruction (emergency). 1. Dyspnea, 2. Inspiratory Stridor, 3. Cyanosis, 4.Unconsciousness;
Priorities :
1. Mechanical cleaning,
2. Pharyngeal Airway (pipe)
3. Endotracheal tube
4. Needle Cricothyroidotomy;
Steps of technique :
Patient position (use pillow)
Orientation
Skin Incision(2 fingers under thyroid cartilage)
Cut cricothyroid membrane (keep hole open)

Front 8

Closing of abdominal wall in 2 layers

Back 8

Definition : closure of peritoneum and muscle together in one layer, and skin in second suture.
Needles :
Peritoneum - serosal needle
Muscle - cutting needle 1/2,5/8
Skin - cutting needle, 1/4, 3/8
Suturing material :
Peritoneum - mono/pesudofilament, absorbable
Muscle - nonabsorbable/absorbable, polyfilament
Skin - nonabsorbable, mono/polyfilament (pref. poly)
Suturing technique :
???

Front 9

Closing of abdominal wall in 3 layers

Back 9

Definition : closing each layer seperately (peritoneuum, muscle, skin)
Needles :
Skin - cutting needle, 1/4, 3/8
Muscle/peritoneum - serosal needle (??)
Suturing material :
Skin - mono/poly
Peritoneum/muscle - ???

Front 10

Brand names of bioplasts

Back 10

Fibrin - Sevac, Gelatin - Gelaspon, Oxidized Cellulose - Surgicel, Collagen - Avitene, Collagen+Fibrin - Tachocomb

Front 11

Tracheostomy (indications, types, steps of technique)

Back 11

Indications : elective only operation. Upper airway obstruction, Symptoms : dyspnea, inspiratory stridor, cyanosis, unconscious;
types: Tracheostomy superior (above thyroid gland isthmus), Tracheostomy inferior (below), Tracheostomy media (cut isthmus); Steps :
Patient position (pillow), Skin disinfection, Isolation&orientation, skin incision, divide muscle(steronyoid or sternothyroid), Cut pretracheal fascia, Cut between 2nd to 3rd or 3rd-4th C ring, check before inserting the Luer tube, insert Luer tube, Control, Wound closure, Fix tube

Front 12

Pringle Maneuver

Back 12

Used during hepatectomy to reduce blood loss. large hæmostat is used to clamp the lesser omentum interrupting the flow of blood through the Hepatic artery and the Portal vein

Front 13

Baron's maneuver

Back 13

Pressing the hepatoduodenal ligament for 10 minutes. Used to reduce blood flow ???

Front 14

Midline laparotomy, which tissue do you cut into

Back 14

Skin, subcutaneous fat tissue, linea alba, transversalis fascia and preperitoneal fat fascia, parietal peritoneum

Front 15

Paramedian laparotomy, which tissues do you cut into

Back 15

Skin, subcutaneous fat tissue, anterior rectus sheeh, rectus abdominis, posterior rectus sheet, transversalis fascia and preperitoneal fat tissue, parietal peritoneum