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15 Cards in this Set

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  • Back
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
Minimal tissue reaction, not antigenic
Not toxic
Easy to handle
Good for wound healing
Materials :
Oxidized Cellulose
Tissue Adhesives
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)
Bowel Anastamosis (needle, surgical material, suturing technique)
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.
Steps of bowel anastamosis
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
Parenchymal organs (needle, surgical material, suturing technique)
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
Surgical classification of parenchymal organs capsule
Spleen : Very thin and sensitive; Kidney : Proper capsule, fatty capsule, Renal fascia (in-->out); Pancreas : Thin capsule
Conicotomy (indications, priorities, steps of the technique)
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)
Skin Incision(2 fingers under thyroid cartilage)
Cut cricothyroid membrane (keep hole open)
Closing of abdominal wall in 2 layers
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 :
Closing of abdominal wall in 3 layers
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 - ???
Brand names of bioplasts
Fibrin - Sevac, Gelatin - Gelaspon, Oxidized Cellulose - Surgicel, Collagen - Avitene, Collagen+Fibrin - Tachocomb
Tracheostomy (indications, types, steps of technique)
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
Pringle Maneuver
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
Baron's maneuver
Pressing the hepatoduodenal ligament for 10 minutes. Used to reduce blood flow ???
Midline laparotomy, which tissue do you cut into
Skin, subcutaneous fat tissue, linea alba, transversalis fascia and preperitoneal fat fascia, parietal peritoneum
Paramedian laparotomy, which tissues do you cut into
Skin, subcutaneous fat tissue, anterior rectus sheeh, rectus abdominis, posterior rectus sheet, transversalis fascia and preperitoneal fat tissue, parietal peritoneum