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Questions and Answers
What is one systemic effect that can occur during intraoperative procedures?
What is one systemic effect that can occur during intraoperative procedures?
- Tissue devitalisation
- Blood pressure changes (correct)
- Increased dead space
- Reduced visualisation
What is the typical blood volume loss threshold for dogs before they show symptoms of shock?
What is the typical blood volume loss threshold for dogs before they show symptoms of shock?
- 100-120 mL/kg BW
- 20-30 mL/kg BW
- 40-60 mL/kg BW
- 70-90 mL/kg BW (correct)
Which of Halsted's Principles is crucial in preventing bleeding during a surgical procedure?
Which of Halsted's Principles is crucial in preventing bleeding during a surgical procedure?
- Preservation of blood supply (correct)
- Uncontrolled suction techniques
- Aggressive tissue manipulation
- Immediate closure of incisions
What is a temporary method used for controlling bleeding during surgery?
What is a temporary method used for controlling bleeding during surgery?
What should be checked at the end of a surgical procedure to ensure that bleeding does not recur?
What should be checked at the end of a surgical procedure to ensure that bleeding does not recur?
Which of the following is NOT one of the 5R's of surgery?
Which of the following is NOT one of the 5R's of surgery?
What does the suffix '-ectomy' refer to in surgical terminology?
What does the suffix '-ectomy' refer to in surgical terminology?
Which diagnostic element is primarily concerned with understanding the patient's physical condition before surgery?
Which diagnostic element is primarily concerned with understanding the patient's physical condition before surgery?
Which of the following factors is NOT considered in the decision-making process for surgery?
Which of the following factors is NOT considered in the decision-making process for surgery?
Which principle emphasizes the importance of careful handling of tissue during surgery?
Which principle emphasizes the importance of careful handling of tissue during surgery?
What is an important consideration regarding the extent of aftercare in surgical decision-making?
What is an important consideration regarding the extent of aftercare in surgical decision-making?
In surgical terminology, what does the suffix '-ostomy' indicate?
In surgical terminology, what does the suffix '-ostomy' indicate?
Which of the following best describes 'reconnaissance' in the context of surgery?
Which of the following best describes 'reconnaissance' in the context of surgery?
What should be considered when using forceps to grasp tissue?
What should be considered when using forceps to grasp tissue?
What is a potential trauma risk when using thumb forceps?
What is a potential trauma risk when using thumb forceps?
Which of the following is a characteristic of basic exposure retractors?
Which of the following is a characteristic of basic exposure retractors?
What should be avoided to prevent trauma when using suction devices?
What should be avoided to prevent trauma when using suction devices?
What is the primary goal of dissection in tissue handling?
What is the primary goal of dissection in tissue handling?
What is the primary objective of angiogenesis during the healing process?
What is the primary objective of angiogenesis during the healing process?
During which time frame does fibroplasia peak?
During which time frame does fibroplasia peak?
Which cells are considered the key troops in the process of contraction?
Which cells are considered the key troops in the process of contraction?
What is the primary mission objective of epithelialization?
What is the primary mission objective of epithelialization?
What role do macrophages play in the healing process?
What role do macrophages play in the healing process?
What is the time frame for angiogenesis to occur after the injury?
What is the time frame for angiogenesis to occur after the injury?
Which process involves the cleanup of degenerating neutrophils?
Which process involves the cleanup of degenerating neutrophils?
During which phase does the creation of a microvascular network occur?
During which phase does the creation of a microvascular network occur?
What is a gossypiboma?
What is a gossypiboma?
Which condition is associated with the failure of proper wound healing?
Which condition is associated with the failure of proper wound healing?
What should be done to ensure accurate specimen collection for testing?
What should be done to ensure accurate specimen collection for testing?
What is the primary reason for empirical antimicrobial therapy?
What is the primary reason for empirical antimicrobial therapy?
Which is NOT a clinical factor to consider in managing surgical site infections (SSIs)?
Which is NOT a clinical factor to consider in managing surgical site infections (SSIs)?
What is a common symptom of inflammation that can indicate an infection?
What is a common symptom of inflammation that can indicate an infection?
Which key factor is critical in the assessment of postoperative patients?
Which key factor is critical in the assessment of postoperative patients?
What does antimicrobial-impregnated material aim to achieve?
What does antimicrobial-impregnated material aim to achieve?
Which factor does NOT impact closure considerations of a wound?
Which factor does NOT impact closure considerations of a wound?
Which management step is essential for the intervention of surgical site complications?
Which management step is essential for the intervention of surgical site complications?
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Study Notes
Reasons for Surgery (5R's)
- Repair: To fix damaged tissues or structures.
- Remove: To excise diseased or unwanted tissues.
- Reconstruct: To restore the normal structure and function.
- Reconnaissance: To diagnose through exploratory surgery.
- Revise: To correct or improve an existing surgical procedure.
Surgical Terminology
- -otomy: To open a part of the body.
- -ectomy: To remove a specific organ or tissue.
- -ostomy: To create an opening in the body.
- -plasty: To form or reshape a body part.
- -pexy: To attach or affix an organ.
- -rrhaphy: To suture tissue together.
- -centesis: To perforate or tap into a body cavity.
- -oscopy: To visually examine an area using an endoscope.
Diagnostic Approach
- Signalment: Collecting details about the patient including age, breed, and personality.
- History: Assessing medical background and the duration of the illness.
- Physical Exam: Conducting a thorough physical assessment of the patient.
- Diagnostic Testing: Utilizing CBC, biochemistry, urinalysis, imaging, or treatment trials for diagnosis.
Decision-Making in Surgery
- Consider alternatives: medical treatment or monitoring if surgery is not the best option.
- Evaluate surgery based on patient factors, client understanding, and surgical considerations:
- Patient: Signalment, health history, and physical condition.
- Client: Understanding of outcomes, costs, and aftercare.
- Surgical: Timing, technique, staff, and facilities available.
Halsted's Principles for Surgery
- Gentle Handling of Tissue: Minimize tissue trauma during surgery.
- Meticulous Hemostasis: Control bleeding effectively.
- Preservation of Blood Supply: Avoid unnecessary vessel damage.
Managing Surgical Bleeding
- Characterization: Assess location (internal vs external), rate (sudden vs chronic), and volume of bleeding.
- Blood Volume Tolerance:
- Dogs can tolerate 70-90 mL/kg BW (8%).
- Cats can tolerate 40-60 mL/kg BW (5%).
Intraoperative Monitoring and Management
- Monitor bleeding with suction, swabs, and anaesthetic monitoring.
- Apply techniques to achieve hemostasis:
- Digital pressure, clamps, tourniquets, ligation, and electrocautery.
- Post-surgery, ensure proper return of tissues to their original state.
Proliferation Phase in Healing
- Angiogenesis: Formation of new blood vessels (days 4-6).
- Fibroplasia: Migration of fibroblasts and formation of new tissue (peaks days 7-14).
- Contraction: Reducing the size of the wound.
- Epithelialization: Resurfacing the wound, initiated within hours.
Trauma and Tissue Handling
- Forceps: Should be used to minimize trauma during dissection.
- Retractors: Provide proper exposure without excessive pressure or time.
- Suction: Utilize carefully to avoid damaging tissue.
Surgical Complications
- Gossypiboma: Retained surgical sponge or gauze.
- Infection Requirements: A source, mode of transmission, and susceptible host must be present.
Managing Surgical Site Infections (SSI)
- Prompt identification and assessment of SSI deep tissues.
- Sample collection for culture before starting antibiotics.
- Choose appropriate antimicrobial therapy based on culture results.
Postoperative Care
- Wound assessment: Monitor for infection and dehiscence.
- Patient assessment: Evaluate comfort, function, and physiological parameters.
Intervention Strategies
- Assess complications post-surgery and determine corrective measures as necessary.
- Aim for continual improvement in the patient’s condition post-surgery.
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