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Introduction to Surgery (Halsted’s Principles (Aseptic technique (Theatre,…
Introduction to Surgery
Terminology
Pathological suffixes
-lysis
-itis
-megaly
-rrhage
-rrhoea
-sclerosis
-stenosis
-algia
-dynia
-coele
-ectasia
-plegia
-ptosis
-ptysis
-malacia
Surgical suffixes
-centsis
-desis
-ectomy
-stasis
-stomy
-otomy
-plasty
-pexy
-rrhaphy
-plication
Halsted’s Principles
Aseptic technique
Theatre
Surgeon
Patient
Instrumentaion
Sharp anatomical dissection
Use existing tissue planes
Facilitates
realignment of tissue layers on closure
Obliteration of dead space
Obliteration of dead space
Purpose
Maximise healing
Minimise seroma and haematoma formation
Method
Reapposition of anatomic layers
Drains
Anatomic dissection
Gentle tissue handling
Maintain tissue hydration
Careful haemostasis
Minimise haematoma and contusion
Avoid tension
Re-apposition of anatomic layers
Tension-relieving techniques
Appropriate suture pattern
Tension causes dehiscence
Purpose
Reduced dehiscence
Rapid wound healing
Prevention of infection
Surgical wound classification
Clean
Non-traumatic
Elective
No inflammation
Resp, urogenital, GI tract not entered
Clean-contaminated
Minor break in asepsis
Resp, urogenital, GI tracts entered
controlled conditions
Implants
Contaminated
Fresh traumatic wound
Spillage from GI tract
Major break in asepsis
Infected urogenital/ biliary tract entered
Dirty
perforated viscus/ faecal contamination
traumatic wound
devitalised tissue
purulent discharge
Foreign body
Prophylactic antibiotics
risk of infection is high
subsequent infection
catastrophic effects
orthopaedic implants
i/v 20 minutes before first cut