Sef lucrari dr.

Tamas

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Surgical fundamental skills

Iind year, medicine

We need to know:

- anatomy

- phisiology

- microbiology

goal:practical activity in clinic (oncalls)

 Surgical fundamental skills

1. Preparing the surgeon for surgery

 Surgical fundamental skills

positioning
2. Preparing the patient for surgery

monitoring
Isolating the operatory field

decontamination
Surgical fundamental skills
preparing for the intradermal test

3.Local anesthesia

subcutaneous injection
testing the patients reaction intradermal injection

testing the quality of local anesthesy

Surgical fundamental skills
4. Organising the table with sterile instruments
Surgical fundamental skills

5. Surgical knots- Ethicon plate

Surgical fundamental skills
discontinuous(separate stiches)
VI.Skin suture

simple continuous

intradermal

continuous suture entrapment

Surgical fundamental skills

VII. bandages and dressings

Surgical fundamental skills

medical specialties

SURGICAL SPECIALTIES
Surgical fundamental skills

SURGERY
medical field that treats diseases
by cutting and opening

SURGERY(as proceeding) any technique/

proceeding on a patient, performed in a hospital , by a
surgical team.
 preparing the surgical field for the
management of a superficial wound

SURGICAL WOUND

WHAT IS A WOUND ?
absence of skin/mucosa
cut

wound

surgical wound

burn
 preparing the surgical field for the
management of a superficial wound

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SUPERFICIAL WOUND

TOPOGRAFIC ANATOMY LAYERS

Superficial

Middle

Deep
 preparing the surgical field for the
management of a superficial wound

superficial
skin,

celular tissue ,

superficial fascia.

testing the cutaneous fold

preparing the surgical field for the management of
a superficial wound

middle
deep fascia

muscle

blood vessel

nerve
 preparing the surgical field for the
management of a superficial wound

Deep

bones

deep vessels and nerves

 preparing the surgical field for the
management of a superficial wound

ANATOMY: the separation between the superficial and deep tissues

DEEP FASCIA
 preparing the surgical field for the
management of a superficial wound

DECONTAMINATION ?

BACTERIA

CONTAMINATION/ INFECTION

DESINFECTION
STERILIZATION
 preparing the surgical field for the
management of a superficial wound

CONTAMINATION
direct contact with an infection source
INFECTION:
the entrance and developement of some pathogenic
agents ,in a living body, (parasites,bacteria or
viruses ) and the tissuess reactions to this
agression, meaning the inflamation

tumor
rubor
calor
dolor
functio laesa
DESINFECTION
procedure with temporary result ,wich
exterminates/annihilates
the bacteria and viruses
- works in inert environments , using physical and
chemical means
 STERILISATION:
complete elimination/annihilation of any kind of micro-organism , including
the bacterial spores
active and efficient on
the inert objects
 preparing the surgical field for the surgical
management of a superficial wound

operation room the place where the surgical act develops

structure
Filter

Circuits:sterile materials, unsterile materials, medical staff,

patient

Rules for maintaining sterility

Protocoles for the activity

 preparing the surgical field for the
management of a superficial wound

operation room the place where the surgical

act develops

structure

Filter
 Operation room - Filter
before surgery

special place for scrubbing

special scrubbing rules

 Operation room

coating sterile surgical gawn

2

6
coating sterile surgical gloves
 Circuits: sterile materials,unsterile
materials,medical staff, patient
Rules for maintaining the sterility
 Protocols for the activity

positioning
II. Preparing the patient for surgery

monitoring
Isolating the operatory field

decontamination
surgical field
region or segment to be operated
+cleaning +decontamination

+isolating
 preparing the surgical field for the
management of a superficial wound

sterile handling of the materials and surgical instruments

+sterile protection equipment

+sterile forceps for handling the materials
+circuits for surgical room
 preparing the surgical field for the surgical
management of a superficial wound

preparing the surgeon for surgery

+equipament(costume for the
surgical room,masc,bonnet)
+surgical scrubbing(special
solutions,technique,timing)
+sterile surgical gawn
+sterile gloves
 preparing the surgical field for the surgical
management of a superficial wound

preparing the patient for surgery

outside the operation room
+informed consent
+cleaning(shower,eliminating the
hair)
+special equipament (single use)
 preparing the surgical field for the surgical
management of a superficial wound
left lateral position

preparing the patient for surgery

inside the operating room
+correct positioning on the surgical table

positioning on the orthopedic table

gynecological positioning
inside the surgical room

+superficial venous acces (cannula) +monitor(blood

pressure,heart rate,O2
peripheric
level)

+testing the patients reaction to local anesthesia

 preparing the surgical field for the
management of a superficial wound

preparing the surgical field

+ the correct use of a hemostatic band(tourniquet)= reduce the
bleeding ,better view

1. protection
gause 2. placing the band proximal to
the surgical field
 preparing the surgical field for the
management of a superficial wound

preparing the surgical field

+ correct use of the hemostatic band = reduce the bleeding

3. flexion of the fingers 4. elastic band application

from distal to proximal
 preparing the surgical field for the
management of a superficial wound

preparing the surgical field

+ correct use of the hemostatic band = reduce the bleeding

6. check the pulse

5. inflate the band

absence of pulse
using the elastic band
skin color
reduces the blood volume
from distal segment of the limb temperature
 preparing the surgical field for the
management of a superficial wound

preparation
+decontamination (solutions,limits,technique)
+limits( sterile drapes- unique or multiple use,
technique)
 preparation of a surgical field for the
surgical management of a superficial
wound

preparing the table with sterile instruments

+draping the table with sterile materials
+correct ,sterile handling and manipulating for the
instruments
+correct position of the instruments on the surgical
table
+preparing the materials for local anesthesia
+sterile draping of the surgical table
+handling and manipulating the
sterile instruments
+sterile handling of the surgical
instruments
+correct position of the instruments on
the table
 +correct position of the instruments on
the table
incision soft tissue manipulation disection

scissors
scalpel

surgical forceps

suture
surgical haemosthasis

haemosthasis forceps needle-holder

+preparing and testing the solutions
for local anesthesia
 Thank
you!!!