38 Questions
What is the primary function of semiocclusive dressing?
Allowing water vapor and gases to permeate
Which type of suture material is prone to minimal tissue reaction and minimal infection?
Monofilamentous
What is the primary mechanism of vacuum-assisted closure?
Applying negative pressure to the wound
What is the primary function of the skin's barrier against infection?
Preventing infection
What is the purpose of occlusive dressing?
Supporting wound healing
What is the primary method of calculating burn surface area?
Employing the rule of nine
What type of burn is caused by ignition of clothes?
Flame burn
What is the primary function of the sweat glands in the skin?
Regulating body temperature
What is the primary goal of the primary survey in managing multiple-injury patients?
To identify and treat life-threatening conditions
What type of trauma is characterized by stab or penetrating objects?
Penetrating trauma with low velocity
What is the indication for admission to hospital in burn patients?
Full thickness burn and associated injury
What is the purpose of using saline or tap water in burn management?
To limit the depth of tissue destruction
What is the correct sequence of management priorities in multiple-injury patients?
Airway, breathing, circulation, and disability
What is the ideal cream for local wound care in burn patients?
Water-soluble base with antibacterial effect
What is the characteristic of high-velocity penetrating trauma?
Causes shock waves that may injure structures far from the main missile tract
What is the primary concern in managing kypertrophic scar and keloid?
Cosmetic appearance
What is the primary objective of the initial step in stopping hemorrhage?
To control bleeding
What is the purpose of positioning in controlling hemorrhage?
To elevate the limb and control venous bleeding
In what type of cases is the use of a tourniquet justified?
In cases where limb amputation is necessary
What is the primary objective of restoring blood volume?
To restore blood volume to stable levels
What is the purpose of decontamination?
To remove visible contaminants
What is the purpose of disinfection?
To reduce the number of viable microorganisms
What is the mode of disinfection used for surgical instruments?
Chemicals such as glutaraldehyde
What is the purpose of monitoring in hemorrhage management?
To monitor the patient's response to resuscitation
What is the primary cause of asphyxia in inhalation injury?
Laryngeal edema
What is the main purpose of local wound care in early burn complications?
To prevent infection and septicemia
What is the common consequence of neglected dehydration in burn patients?
Renal failure
What is the primary purpose of washing with saline prior to use?
To prevent the agent from being toxic to human tissues
What is the primary reason for skin grafting in burn patients?
To promote healing in full-thickness burns
What is the common complication of burn injuries that can lead to death?
Infection and septicemia
What is the primary difference between disinfection and sterilization?
Disinfection destroys all microorganisms except spores, while sterilization destroys all microorganisms including spores
What is the primary purpose of administering H blockers or proton pump inhibitors in burn patients?
To prevent gastric ulceration and bleeding
What is the primary mode of sterilization using steam under pressure?
Autoclaving
What is the common complication of deep circumferential wounds?
Constricting eschar
What is the primary purpose of using chemical agents such as glutaraldehyde?
To sterilize delicate equipment
What is the primary precaution when operating on a patient with HCV or HIV infection?
All of the above
What is the late complication of burns that can occur over a joint?
Contracture
What is the primary purpose of using gamma rays in sterilization?
To sterilize delicate materials and catheters
Study Notes
Sutures
- Absorbable sutures: absorbed by the human body, used in deep tissues (e.g., Vicryl, catgut)
- Non-absorbable sutures: remain and maintain tensile strength, used in skin closure or when tensile strength is required (e.g., silk, polypropylene, stainless steel)
- Monofilamentous sutures: produce minimal tissue reaction and infection (e.g., polypropylene, Monocryl)
- Multifilamentous sutures: higher incidence of tissue reaction and infection (e.g., Silk, Vicryl)
Wound Dressing
- Aim of dressing: support wound healing, minimize wound contamination, and drain wound discharge if present
- Types of dressing:
- Occlusive dressing: conventional gauze and adhesive plaster
- Semiocclusive dressing: permeable to water vapor and gases, impermeable to bacteria
- Dressing with osmotic agents: helps absorb wound discharge (e.g., Debrisan, honey)
- Vacuum-assisted closure: applies negative pressure to remove tissue exudate and aid tissue growth
Burns
- Functions of the skin:
- Barrier against infection
- Prevents excess water evaporation
- Provides sweat glands for regulating body temperature
- Aids in vitamin D synthesis
- Rule of nine: calculates burn extent
- Aetiology of burns:
- Scald (boiling water)
- Flame burns (ignition of clothes)
- Electrical burn
- Chemical burn
- Inhalation or respiratory burns
- Degrees of burns:
- 1st degree: epidermis damaged only (e.g., sunburn); rapid healing
- 2nd degree: epidermis and part of dermis destroyed; healing within weeks without scarring
- 3rd degree: complete destruction of epidermis and dermis; slow healing with scarring and possible skin grafting
- Complications of burns:
- General complications: inhalation injury, neurogenic shock, hypovolemic shock, renal failure, gastric ulceration, multi-organ failure
- Local complications:
- Early: infection, constricting eschar, suffocation, compartmental syndrome
- Late: contracture, hypertrophic scar, malignant transformation
- Management of burns:
- First aid: ensure patent airway, administer strong analgesics, use saline or tap water to limit tissue destruction
- Admission to hospital indicated for: burnt area > 10% in adults, full-thickness burn, inhalation burn, associated injury, electric or chemical burn
- Local wound care: water-soluble creams with bactericidal effect (e.g., silver sulphadiazine)
Multiple-Injury Patient
- Mechanisms of injury:
- Penetrating trauma (low-velocity, high-velocity)
- Blunt trauma (multiple direct blows, fall from height, road traffic accident)
- Organized trauma care:
- Establish management priorities
- Primary survey: A (airway and cervical spine control), B (breathing), C (stop hemorrhage), D (definitive treatment)
- Resuscitation: restore blood volume, optimize oxygen delivery, monitoring
Decontamination and Antiseptics
- Decontamination: process of removing microorganisms
- Methods: cleaning, disinfection, sterilization
- Cleaning: removal of visible contaminants (e.g., hand wash, instrument wash)
- Disinfection: reduction of viable microorganisms to an acceptable level
- Antiseptics: disinfectants safe for application to epithelial surfaces (e.g., povidone-iodine, chlorhexidine, alcohols, hexachlorophene)
- Sterilization: destruction of all microorganisms (including spores, viruses, and mycobacteria)
- Modes of sterilization: autoclaving, chemical agents (e.g., ethylene oxide gas, glutaraldehyde), physical agents (e.g., gamma rays)
This quiz covers the classification of sutures based on their absorbability and other properties. It includes examples of different types of sutures and their characteristics.
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