MG II – Seminarul 15

SURGERY (III)
Fundamentals of Medical-Surgical Nursing: A Systems Approach,
edited by A.M. Brady, C. McCabe, M. McCann,
Trinity College Dublin, Dublin, Ireland, 2014, pp. 105-123

The sterile field

The area around the operating table and the patient covered in sterile surgical drapes is
known as the sterile field. Only members of the scrub staff can enter this area. Maintaining the
sterile field is of paramount importance to prevent exposing the patient to a risk of infection. The
scrub and circulating nurses have to follow their duty of care and acknowledge if they break the
sterile field. For
example, circulating personnel who are not wearing sterile gowns and gloves could accidentally
touch
the sterile drapes and possibly cause contamination.
All members of the surgical scrub staff will undertake a surgical hand-scrub and put on
sterile gloves before they enter the sterile field and before preparation of the surgical instruments
and accessories.

drape - câmp operator, cearşaf chirurgical

to drape - a drapa, a înconjura cu cearşafuri câmpul operator, a pregăti câmpul operator
scrub staff - personalul de sală (personalul implicat în activitatea de anestezie şi operatorie)
contaminant - contaminant
air contaminant (syn.) air pollutant - aerocontaminant, poluant atmosferic
chemical contaminant - contaminant chimic
to contaminate (syn.) to infect - a contamina, a infecta
contaminated (syn.) infected - contaminat, infectat
contaminating - contaminant
contamination - contaminare
airborne contamination - contaminare pe calea aerului
cross contamination - contaminare încrucişată
risk of contamination - risc de contaminare

Surgical sutures
Each type of suture material is coded by a standard colour for easy identification. The
information on the front of each suture identifies the type and length of the suture material, the date
of manufacture, the expiry date, the type of needle and its sterility status.
Absorbable Non-absorbable
Natural or synthetic Resists the body’s attempt to dissolve it
Short-term wound support May be removed after the surface incision has healed
Decomposes; degrades as the wound heals Used for suturing fat, muscle and skin
Used on internal tissues
Also for subcutaneous suturing of skin

sutural - sutural
suture - sutură; sinfibroză propriu-zisă
absorbable surgical suture - sutură resorbabilă
nonabsorbable surgical suture - sutură neresorbabilă
absorbable - absorbabil, resorbabil
nonabsorbable - neabsorbabil, neresorbabil
support - suport; sprijin; întreţinere
 to decompose - a descompune, a (se) dizolva; a putrezi
to degrade - a (se) degrada, a descompune, a deteriora

Surgical needles
Surgical needles are identified by their shape and size. Surgical needles vary in size, shape
(straight, curved or J-shaped) and type so the doctor can choose the relevant needle and suture for
the surgical incision. As an alternative to suturing the skin, surgeons can use skin staples to close
the wound. These are applied using a skin closure unit that works in a similar way to a paper
stapler.

needle - ac
biopsy needle - ac de biopsie
needle biopsy (syn.) aspiration biopsy - biopsie cu ac, biopsie prin aspiraţie
blunt point needle - ac cu vârf bont
curved needle - ac curbat
disposable needle - ac de unică folosinţă
eye of the needle - ureche de ac
needle-holder (syn.) needle forceps - port-ac
injection needle - ac pentru injecţie
J-shaped needle - ac în forma literei J, ac tip schior
round point needle - ac cu cap rotund
straight needle - ac drept
suture needle - ac pentru sutură
needleless -fără ac
needle-shaped (syn.) acicular - în formă de ac, acicular, aciform
staple - capsă, bridă
medical staple - agrafă chirurgicală
to staple - a capsa
stapler - capsator
medical stapler - capsator medical

Surgical dressings
The surgical dressing acts as a physical barrier between the wound and any microorganisms
and sources of infection, and also protects the delicate healing tissue. There are many different
dressings, each of which has its own properties.
Passive – a traditional dressing that provides cover over the wound (gauze);
Interactive – a polymeric film that is mostly transparent, permeable to water vapor and oxygen,
and non-permeable to bacteria (hydrogels and foam dressings);
Bioactive – a dressing that delivers substances active in wound healing, such as hydrocolloids and
alginates, and collagens.

dressing - pansament, bandaj; pansare, bandajare

passive dressing - pansament pasiv, cu funcţie doar de protecţie
gauze - tifon
interactive dressing - pansament interactiv, pansament superabsorbant, care creează o
barieră împotriva bacteriilor (cu hidrogel şi cu spumă poliuretanică)
film - peliculă, strat; film; folie
bioactive dressing - pansament bioactiv sub formă de tampoane spongioase liofilizate
sterile, adjuvant în procesele fiziologice de vindecare a plăgilor
hydrocolloid - hidrocoloid
alginate - alginat

Surgical drains
 Surgical drains are used by the surgeon to remove fluid (blood or serum) from the surgical
wound. The surgeon secures the drain tubing with surgical sutures. Dressings are placed around the
tubing to help prevent contamination from the wound dressing.

drain - dren
to drain - a drena; a evacua, a vida, a elimina lichidul dintr-o cavitate
to drain an abscess - a drena un abces
drainage - drenaj, drenare; vidare
incision and drainage - incizie şi drenaj
drainage tube - tub de drenaj
draining - drenare, vidare, secare
secure - sigur, în siguranţă; solid, tare, trainic
to secure - a asigura, a garanta; a lega; a prinde
tube - tub; trompă; sondă; structură anatomică cilindrică
tubing - tubaj; tub

Surgical instruments
The surgeon uses surgical instruments to dissect, resect or alter tissues during the surgical
procedure. They should only be used for their intended purpose.

Sponge-holding forceps ☛ To hold a swab used in prepping the patient

or swabbing a wound
Scalpel/blade ☛ To make an incision
Tissue forceps – with teeth at the end of the forceps ☛ To hold or grasp soft tissue
Artery forceps – curved or straight ☛ To clamp or dissect arteries or veins, and to
hold small swabs (pledgets)
Dissecting forceps ☛ To hold tissue when the surgeon is suturing
or dissecting it
• Non-toothed (internal tissues)
• Toothed (external tissues – skin or muscle)
Dissecting scissors – curved ☛ To dissect tissue
Scissors – curved or straight ☛ To cut tissue or sutures
Needle holder ☛ To hold and support the suture needle
Retractor ☛ To retract tissue
Towel clip & Tapes ☛ To hold surgical drapes in place
Suction ☛ To remove blood, debris or fluid

to dissect - a diseca, a secţiona, a rezeca; a analiza

dissecting - disecant
dissection - disecare, disecţie; rezecţie; obiect al disecţiei, piesă anatomică
to resect - a rezeca, a face o rezecţie; a exciza
resectable - rezecabil
resection (syn.) excision - rezecţie, excizie, extirpare a unui segment dintr-o structură sau
organ
forceps - forceps, pensă, cleşte
artery forceps - pensă arterială
curved forceps - pensă curbă
cutting forceps - pensă pentru tăiat
dissecting forceps - forceps de disecţie
dressing forceps - pensă pentru pansament
sponge holding forceps - pensă port tampon
tissue forceps - pensă anatomică
scalpel - bisturiu
 blade - lamă, lamelă
knife blade - lama bisturiului
clamp - clamp, clampă, clemă, pensă, agrafă
to clamp - a clampa, a lega, a încleşta
pledget - tampon mic, compresă mică
non-toothed - nedinţat
toothed (syn.) serrated (syn.) serrate - dinţat, zimţat, ca de fierăstrău
retractor - depărtător
clip - clamă, agrafă, clemă
debris - debriuri, rămăşite; eschile osoase

Recovery
Following surgery, all the patients are admitted to a recovery area – the post-anesthesia care
unit (PACU) – where they will be cared for in the immediate postoperative period. Practitioners
working in the PACU will deliver one-to-one patient care. They will receive a comprehensive
handover from the anesthesiologist that should include:
• the patient’s name;
• the operation or procedure that has been undertaken;
• the type of anesthetic delivered – spinal, epidural or general anesthetic;
• the intraoperative management in terms of airway management, observations (vital signs
recordings), positioning, warming devices, prophylaxis for deep vein thrombosis, and the
drugs and fluids administered;
• information relating to immediate postoperative care, for example surgical drains and
wound care;
• post-anesthesia instructions for PACU;
• postoperative instructions for the ward.
While obtaining the handover, the practitioner will be observing the patient’s airway and
recording their vital signs every 5 minutes for 20–30 minutes.

to recover - a se însănătoşi, a se vindeca

to recover consciousness - a-şi recăpăta cunoştinţa
to recover from - a se însănătoşi după/în urma
recovered - restabilit, însănătoşit
recovery - recuperare, vindecare, însănătoşire
full recovery - restabilire completă
recovery period (syn.) recovery time - perioadă de recuperare
post-anesthesia care unit (PACU) (syn.) post-anesthesia recovery (PAR) - cameră de
supraveghere post anestezică (CSPA)
handover - transfer, predare
to manage - a administra, a conduce; a gestiona
management - administraţie, conducere; gestiune
case management - gestionarea cazului
hospital management - conducerea spitalului
pain management - gestionarea durerii

Pain management is often addressed and planned prior to surgery so that pain is managed
proactively rather than reactively once the patient is out of the theater. However, patients do not
always respond to pain in the same way, so pain management regimens are dependent on using
effective communication skills to elicit information on how much pain patients are suffering and
what type of pain it is. It is important to obtain a detailed handover to establish whether the patient
has had an analgesic in theater and if so what type, for example an opiate, non-steroidal anti-
inflammatory drug or paracetamol.
Not all pain experienced in recovery can be attributed to surgery; other factors contributing
to pain - headaches, bladder distension, pain from positioning, etc. - may need to be considered. It
is important to assess the nature and cause of any pain, and a number of tools have been devised to
establish the severity of the pain, including visual and verbal pain scales. As with any drugs that are
administered to a patient, there are a number of issues to consider, including what analgesic drugs
are available, the pharmacology of these drugs, their indications and contraindications, and also
their interactions.

to elicit - a reuşi să obţină un răspuns, a provoca (o reacţie); a smulge, a extrage

non-steroidal anti-inflammatory drug (NSAID) - antiinflamator nesteroidian (AINS)
to distend - a întinde, a (se) dilata; a (se) umfla, a balona
distended - întins, dilatat; umflat, balonat
distension - distensie, întindere; umflare, balonare
abdominal distension - distensie abdominală; balonare abdominală
bladder distension (syn.) full bladder - glob vezical
distent - dilatat; întins
to devise - a inventa, a născoci, a imagina
scale - scală, scară gradată, gradare; solz; crustă
visual analogue scale (VAS) - scala vizuală analogică (SVA)
verbal numeric scale (VNS) - scala numerică verbală (SNV)

Patients who have been administered opioids will need to be closely monitored for a longer
period of time in recovery as opioids can have a number of adverse effects, including respiratory
depression and nausea and vomiting.
Any drugs administered in the recovery area should be documented in the patient's recovery
care plan. Details required include the drug administered, the dose of the drug, the route by which it
was delivered and the time at which it was delivered. This record will then be signed by the person
who administered the drug. Specific criteria from PACU are often utilised in recovery and should
be met prior to the patient returning to the ward. These criteria are variable and are adapted for
individual recovery areas, often depending on the types of patient and the surgical procedures
undertaken. They offer guidance on the minimum safe requirements for vital signs, including:
- conscious level;
- oxygen saturation levels and respiratory rate;
- blood pressure;
- heart rate;
- temperature;
- pain and PONV scores;
- urine output in catheterized patients.

nausea - greaţă, senzaţie de vomă

postoperative nausea - greaţă postoperatorie
nauseant - emetizant, care provoacă greaţă
to nauseate - a simţi greaţă, a-i fi greaţă
nauseous - greţos, care provoacă greaţă
to vomit - a vomita, a avea vărsături, a voma, a vărsa
vomiting (syn.) emesis - vomitare, emesis, vărsătură
PONV (postoperative nausea and vomiting) score - scor de greaţă şi vărsături
postoperatorii