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69 Cards in this Set
- Front
- Back
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What 3 hurdles must modern surgery overcome? What is the "4th hurdle"?
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1. Bleeding (hemostasis)
2. Infection (asepsis) 3. Pain (analgesia/anesthesia) 4. Minimization of surgical procedure |
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Who must provide consent before beginning a veterinary surgical procedure? What is this consent called?
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Vet consent + owner consent = informed consent
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What does ACVS stand for?
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American College of Veterinary Surgeons
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What are physical sterilizing agents discussed in class? Chemical?
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Physical (dry heat, pressurized steam, gamma radiation)
Chemical (Ethylene Oxide, Glutaraldehyde) |
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What concentration of chlorhexidine or iodine should be used in wound care? On serosa?
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Wound (<0.05% chlorhex; <1% iodine)
NEVER used on serosa! |
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What are the three types of autoclaves? Which can be used to "flash" instruments?
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Gravity displacement
Steam pulsing Prevacuum autoclaves (fastest; can use for flashing) |
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What is the safe autoclave standard for temp/time?
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13min @ 120C
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What must be kept in mind when using cold sterilization?
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Gluteraldehyde-soaked instruments must be flushed well with sterile saline!
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T or F:
The surgeon and surgical tools are the primary sources of infection in a surgical procedure. |
False!
It is contamination from the patient! |
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How far from the projected surgical incision site should be clipped?
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at least 10cm
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When is the rough scrub considered complete?
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When the EtOH scrub comes off CLEAN!
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What is the recommended contact time used for detergent in the sterile scrub?
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5min
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How much skin around the incision site should be exposed when draping?
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2 - 5 cm
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How many microbes/minute do people shed?
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1K to 10K microbes/minute
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What microbes are harbored in human hair?
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S. aureus, E. coli, Strept.
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Use of masks can reduce microbe levels by what level?
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NO REDUCTION IN BACTERIAL COUNT!! Does decrease aerosol contamination
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What are Halstead's Principles of proper surgical technique (there are 7)?
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Gentle tissue handling
Preservation of vascular supply Removal of necrotic tissue Accurate hemostasis Anatomic tissue approximation w/o tension Obliteration of dead space Strict aeseptic technique |
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What measures can be used to increase the shelf life of autoclaved instruments?
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Double wrapping
Heat sealing Plastic cover |
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What is the total blood volume for adult small animals? For young animals?
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Adults - 8% BW (70-80ml/kg)
Young - 10% |
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Why is it important to count sponges?
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Don't wanna leave any behind!
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What size vessels are ligation candidates? What suture material sizes are good for ligation?
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Vessels > 1 or 2mm
Use 0, 2/0, or 3/0 suture |
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T or F:
A Penrose Drain should never drain via the drain lumen. |
True! Penrose drains drain via the outside circumference
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What are indications for drain use?
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Eliminate dead space
Evacuate existing fluids Evacuate anticipated fluid/gas collections |
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Choose passive or active drain...
...uses natural pressure gradients. |
passive
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Choose passive or active drain...
...often has a one-way valve (or condom) affixed to one end. |
passive
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Choose passive or active drain...
...uses negative pressure. |
active
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Choose passive or active drain...
...reduces chance of infection. |
active
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Choose passive or active drain...
...more difficult to maintain. |
active
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Choose passive or active drain...
...often used in deep areas or cavities. |
active
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When should most drains be removed?
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2-5 days
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Which of the following are useful in maintaining drain patency?
a) preiodic retrograde flushing b) initial flushing with heparin c) special antibiotic or heparinized coatings |
b) initial flushing with heparin
c) special antibiotic or heparinized coatings RETROGRADE FLUSHING IS CONTRAINDICATED |
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What pressure should be used in lavaging wounds?
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10-15psi (use 19ga needle w/35cc syringe)
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Which solution should be used in wound lavage?
a) hypotonic b) isotonic c) hypertonic |
b) isotonic
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Choose electrocautery, monopolar, or bipolar electrosurgery...
...direct heat coagulates proteins causing hemostasis. |
Elecrocautery
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Choose electrocautery, monopolar, or bipolar electrosurgery...
...uses a grounding plate |
monopolar electrosurgery
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Choose electrocautery, monopolar, or bipolar electrosurgery...
...heat is generated by tissue's resistance to electrical current. |
Monopolar and bipolar electrosurgery
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What are dangers of monopolar electrosurgery systems?
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Burns due to direct coupling of instruments or reduced grounding pad contact
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Choose electrocautery, monopolar, or bipolar electrosurgery...
...no grounding plate necessary. |
electrocautery and bipolar electrosurgery
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What are the 5 types of staple/ligature devices?
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Disposable skin stapler
Surgiclip/Ligaclip LDS (ligating & dividing stapler) TA (thoraco-abdominal stapler) GIA (gastro-intestinal-anastomotic stapler) |
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When should staples be removed?
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10-14d
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What type of staple/ligature device would be used in...
...gastric vessel ligations? |
LDS (ligating & dividing stapler)
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What type of staple/ligature device would be used in...
...small animal deep incisions? |
Surgiclip/Ligaclip
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What type of staple/ligature device would be used in...
...partial gastrecomies, partial splenectomies, or intestinal anastomoses? |
TA (thoraco-abdominal stapler)
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What type of staple/ligature device would be used in...
...side-to-side intestinal anastomoses? |
GIA (Gastro-intestinal-anastomotic stapler)
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In general...how far should sutures be placed from the wound edge? How far from each other?
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5mm from wound edge; 5mm from each other
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What are the 3 main types of suture patterns? What is the major characteristic of each?
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Simple - single pass on each side then tied
Mattress - 2 passes on each side, then tied Continuous - multiple passages, tied on each end |
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Choose interrupted or continuous suture...
...provides a better seal. |
continuous
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Choose interrupted or continuous suture...
...provides adjustable tension. |
interrupted
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Choose interrupted or continuous suture...
...loss of knot can be disasterous! |
continuous
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Which of the following are applications of the simple continuous suture pattern?
a) Subcutaneous b) Bowel c) Fascia d) Bladder e) Pleura |
All of em!
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What are applications for the cruxiate suture pattern?
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Skin closure
Bodywall closure |
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When are inverting suture patterns used? What are the major suture patterns for inversion?
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Intestinal surgery;
Lembert, Halsted, Cushing, Connell |
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Which appositional suture patterns are commonly used on skin? Which of these are ONLY used in skin?
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Simple interrupted
Simple continuous Cruxiate (only in skin) Interrupted or continuous Intradermal (only in skin) Ford interlocking (skin or diaphragm) |
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What are the 6 inverting suture patterns discussed in class? Which one is unique in penetrating the bowel lumen?
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Lembert
Halsted Connell (penetrates lumen) Pursestring Cushing Parker-Kerr |
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Which type of appositional suture is NOT used on skin?
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Gambee
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Choose Lembert, Halsted, Cushing, or Connell type suture pattern...
...is an appositional pattern. |
ALL OF THEM
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Choose Lembert, Halsted, Cushing, or Connell type suture pattern...
...a horizontal mattress in Lembert fashion. |
Halsted
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Choose Lembert, Halsted, Cushing, or Connell type suture pattern...
...can be a interrupted or continuous pattern. |
Lembert
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Choose Lembert, Halsted, Cushing, or Connell type suture pattern...
...provides less inversion than the Lembert. |
Cushing
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Which appositional suture pattern is used for stump closure?
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Purse-string
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What are the suture patterns used to close a large gap?
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Mattress (horizontal, vertical)
Near/far/far/near |
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What is the fate of absorbable sutures?
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breakdown, phagocytosis, metabolism, excretion
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Choose monofilament or multifilament suture...
...less prone to wicking and infection. |
monofilament
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Choose monofilament or multifilament suture...
...has more tissue drag. |
Braided
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What are the three main types of absorbable synthetic monofilaments? What is the trade name for each?
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Polyglyconate (Maxon)
Polyglecaprone 25 (Monocryl) Polydioxanone (PDS) |
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What are the two main types of absorbable synthetic multifilaments? What is the trade name for each?
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Polyglycolic acid (Dexon)
Polyglactin 910 (Vicryl) |
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Choose Maxon, Monocryl, or PDS...
...takes 28-56 days to lose 50% of tensile strength. |
PDS
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Choose Maxon, Monocryl, or PDS...
...takes 7 days to lose 50% of tensile strength. |
Monocryl
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Which suture material is highly reactive? What is the use for this material?
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Silk - good for opthamology, ligatures, and plastic surgery
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