Incision & Drainage: Viva Guide

• Comprehensive guide for viva preparation covering indications, steps, complications, and mnemonics for common surgical procedures.

Incision & Drainage

• Mnemonic for Indications: "P.U.S. W.A.S. H.O.T."
• Paronychia is an indication.
• Ulcerated Abscess is an indication.
• Sebaceous Cyst Infection is an indication.
• Wound Infection is an indication.
• Abscess (Breast, Pilonidal, Perianal) is an indication.
• Soft Tissue Cellulitis with Fluctuation is an indication.
• Hematoma with Infection is an indication.
• Osteomyelitis Drainage is an indication.
• Thigh, Ischiorectal, Ludwig’s Angina are indications.
• Mnemonic for Steps: "S.T.A.B. & D.R.A.I.N."
• Supine position & Antiseptic Cleaning are the first steps.
• Take incision at most prominent part.
• Abscess contents must be drained.
• Break all loculi.
• Drain pus for Culture & Sensitivity.
• Rinse cavity with Antiseptic.
• Assess for fresh blood ooze (indicates completion).
• Insert Drain if required.
• Secondary Healing or Closure is the next step.
• Mnemonic for Complications: "R.I.S.K.S."
• Recurrence of Abscess can occur.
• Incomplete Drainage can occur.
• Sinus Formation can occur.
• Hemorrhage (if near vessels) can occur.
• Septicemia can occur.

Herniotomy

• Mnemonic for Indications: "C.A.R.T."
• Children (Pediatric Hernia) is an indication.
• Asymptomatic Hernia is an indication.
• Recurrent Hernia (small) is an indication.
• Tension-Free Repair is an indication.
• Mnemonic for Steps: "I.N.G.U.I.N.A.L. H.E.R.N.I.A."
• Incision in Inguinal Region is the first step.
• Navigate through subcutaneous tissue.
• Gain access to Inguinal Canal.
• Uncover Hernial Sac.
• Inspect Sac & Reduce Contents.
• Neck of Sac Ligated & Excised.
• Approximate Layers.
• Layer-wise Closure.
• Mnemonic for Complications: "W.H.I.R.L."
• Wound Infection can occur.
• Hematoma can occur.
• Testicular Ischemia (due to cord damage) can occur.
• Recurrence can occur.
• Lymphatic Leak can occur.

Hydrocele Surgery (Jaboulay’s)

• Mnemonic for Indications: "S.W.E.L.L."
• Symptomatic Hydrocele is an indication.
• Weakening of Scrotum is an indication.
• Enlarging Hydrocele is an indication.
• Large Hydrocele is an indication.
• Lymphatic Obstruction is an indication.
• Mnemonic for Steps: "H.Y.D.R.O.C.E.L.E."
• Hold Scrotum & Antiseptic Cleaning are the first steps.
• Y-shaped Vertical Incision.
• Dissect Layers of Scrotum.
• Reach Tunica Vaginalis.
• Open Tunica & Drain Fluid.
• Cut & Evert Tunica (Jaboulay’s).
• Ensure Hemostasis.
• Layer-wise Closure.
• Examine for Recurrence Prevention.
• Mnemonic for Complications: "B.I.G. D.R.I.P."
• Bleeding can occur.
• Infection can occur.
• Granuloma can occur.
• Damage to Testis can occur.
• Recurrence can occur.
• Infertility can occur.
• Pyocele can occur.

Thyroidectomy

• Mnemonic for Indications: "G.O.I.T.E.R."
• Graves’ Disease is an indication.
• Obstructive Goiter is an indication.
• Indeterminate Thyroid Nodule is an indication.
• Thyroid Cancer is an indication.
• Enlarged Goiter is an indication.
• Refractory Thyroiditis is an indication.
• Mnemonic for Steps: "T.H.Y.R.O.I.D."
• Tilt Head 15° & Position Supine.
• Horizontal Incision must be made in Neck.
• Yank Strap Muscles Apart.
• Retract Thyroid & Ligate Veins.
• Obtain Control of Superior & Inferior Thyroid Arteries.
• Identify Recurrent Laryngeal Nerve & Parathyroids.
• Dissect & Remove Thyroid.
• Mnemonic for Complications: "P.A.L.S."
• Parathyroid Damage (Hypocalcemia) can occur.
• Airway Obstruction can occur.
• Laryngeal Nerve Injury can occur.
• Scar Formation can occur.

Appendicectomy

• Mnemonic for Indications: "R.A.P.I.D."
• Right Lower Quadrant Pain is an indication.
• Acute Appendicitis is an indication.
• Perforation Risk is an indication.
• Infection Prevention is an indication.
• Diagnostic Uncertainty is an indication.
• Mnemonic for Steps: "A.P.P.E.N.D.I.X."
• Apply Antiseptic & Drape.
• Position Patient Supine.
• Perform McBurney’s Incision.
• Expose & Enter Peritoneum.
• Navigate to Cecum & Identify Appendix.
• Divide Mesoappendix & Ligate Vessels.
• Isolate & Tie Base of Appendix.
• eXcise Appendix & Close Layers.
• Mnemonic for Complications: "I.C.E. P.A.C.K."
• Infection can occur.
• Cecal Injury can occur.
• Enteric Fistula can occur.
• Paralytic Ileus can occur.
• Adhesions can occur.
• Chronic Pain can occur.
• Kicking Peritonitis can occur.

A comprehensive guide for viva preparation covering indications, steps, and complications for incision and drainage procedures. Includes useful mnemonics to aid in recall. Covers key aspects such as site preparation, incision technique, and post-operative care.