Chapter 41: Assisting with Minor Surgery
How large is the border all around the open wrapper on a sterile field considered contaminated?
1-inch
Maturation Phase of Healing
21 days to 2 years - Tissue cells strengthen and tighten the wound closure and form a scar
What is the suture removal time for facial sutures?
24-48 hours
Inflammatory Phase of Healing
3 days - Blood clot forms to stop bleeding and plug the opening of a wound
Proliferating Phase of Healing
3-21 days - Fibrin threads extend across the opening of a wound and pull edges together; cells multiply to repair the wound
Head and neck sutures remain in place for how long?
3-5 days
What is the suture removal time for head and neck sutures?
3-5 days
What is the suture removal time for abdominal sutures?
5-7 days
What is the suture removal time for weight-bearing joints and large bones sutures?
7-10 days
Surgical Asepsis
A complete absence of microorganisms and spores
What do regional, spinal, epidural, or saddle block anesthesia target?
A group of nerved
Medical Asepsis
A reduction in the number of microorganisms
Endocervical Curettage (ECC)
A scraping of endocervical cells from inside the cervical canal
What are the four types of wound classifications?
Abrasion, incision, laceration, and puncture
Colposcopy
An examination of the vagina and cervix performed using a colposcope
A sterile item can only touch what?
Another sterile item
Hemostats
Applied to blood vessels to hold vessels until they can be sutured
Sanguineous Drainage
Bloody drainage
Serous Drainage
Clear, watery drainage
Elective Surgery
Considered medically necessary but can be performed when patient wishes
Endometrial Biopsy (EMB)
Consists of using a curette or suction tool to remove uterine tissue for testing
What are the general classifications of instruments used in minor surgery?
Cutting, dissecting, grasping, clamping, dilating, probing, visualizing, or suturing
What is the most frequent growth removal procedure in the medical office?
Cyst removal
What does general anesthesia do?
Depresses the central nervous system (CNS) to cause unconsciousness
Electrodesiccation
Destroys tissue by creating a spark gap when the probe is inserted into unwanted tissue
Electrofulguration
Destroys tissue with a spark emitted from the tip of a probe positioned a short distance away from the unwanted tissue
Electrocoagulation
Destroys tissues and controls bleeding by coagulation
Outpatient Surgery
Does not require an overnight stay in a hospital
Bandages hold what in place?
Dressing
What are the categories of surgeries?
Elective, emergency, optional, outpatient, and urgent
What are the five types of currents used in electrosurgery?
Electrocoagulation, electrodesiccation, electrofulguration, electrosection, and electrocautery
Cyst
Enclose fluid-filled sac
What is often added to the anesthesia when operating on the face and head?
Epinephrine
Why do instruments require special care and attention?
Even slight damage to an instrument can result in a malfunction at a critical time during surgery
What are the two grasping and clamping instruments?
Forceps and ratchet closure or clasp
Bandages may be what material?
Gauze, fabric, or elasticized
Tissue Forceps
Have teeth and are used to grasp tissue
How is general anesthesia administered?
IV and inhalation
Wound complications include what?
Infection, hemorrhage, bleeding, dehiscence, and evisceration
Wounds go through what three phases before healing?
Inflammatory phase, proliferating phase, and maturation phase
This type of wound has edges that are torn in an irregular shape and can cause profuse bleeding and scarring.
Laceration
Laser is an acronym for what?
Light Amplification by Stimulated Emission of Radiation
What position should the patient be in for a colposcopy?
Lithotomy position
What position should the patient be in for an endometrial biopsy?
Lithotomy position
Optional Surgery
May not be medically necessary, but the patient wishes to have it performed
What are the types of scissors?
Metzenbaum, operating, dissecting, and bandage
____________ anesthesia is specifically injected into a nerve adjacent to the operative site. This type of anesthesia is used for surgery on hands, fingers and toes.
Nerve blocks
What does topical and local infiltration anesthesia target?
Nerve endings
Where are absorbable sutures used?
On internal organs
Where are nonabsorbable sutures used?
On skin surfaces
Which of the following is never considered outpatient surgery? a. Elective b. Urgent c. Optional d. Organ transplant e. Tonsillectomy
Organ transplant
What does nerve block anesthesia target?
Pain transmission along a single nerve
If you were to assist in suturing an eyelid, which gauge of silk would you choose?
Polyester
Which of the following is an anesthetic? a. Ethyl chloride b. Procaine (Novacaine) c. Tetracaine d.Chloroprocaine e. Epinephrine
Procaine (Novacaine)
What does local anesthesia do?
Provides a loss of sensation in a particular area of the body without overall loss of consciousness
A _____________ is used to remove tissue for examination and biopsy to detect cancerous cells
Punch
Purulent
Pus
Incision and drainage (I&D) is perform to do what?
Relieve the buildup of purulent material as a result of infection
Debridement
Removal of dead tissue around wound edges using sterile technique
Emergency Surgery
Required immediately to save a life
What is the most common dissecting instrument?
Scissors
What are the probing and dilating instruments?
Scope, speculum, probe, retractor, trocar, punch
What are the types of wound drainage?
Serous, sanguineous, serosanguineous, purulent
What is the most expensive suture material?
Silk suture
What are the two cutting instruments?
Small curved scalpels or knives
__________ are used to grasp foreign bodies.
Splinter forceps
What three shapes are suture needles available in?
Straight, curved, and swaged
Incision
Surgical cuts into tissue
Dressing
The application of a sterile covering over a surgical site or wound using surgical asepsis
Electrosurgery
The application of high-frequency electrical currents
Invasive Procedure
The body is entered
Vasectomy
The tying and cutting of the vas deferens
What happens to absorbable sutures?
They are digested by tissue enzymes and absorbed by the body tissues
Purulent Drainage
Thick puslike drainage that is green yellow or brown
Sersanguineous drainage
Thin watery drainage tinged with blood
What are the types of forceps?
Tissue, thumb, splinter, needle holder, hemostats, sponge, and towel clamps
Urgent Surgery
To be performed as soon as possible but is not an immediate or acute emergency
A curved suture needles allows the surgeon to do what?
To go in and out of tissue when there is not enough room to maneuver a straight needle
What are the types of local anesthesia?
Topical and local infiltration, nerve block, and regional, spinal, epidural, or saddle block
Thumb Forceps
Two-pronged with serrated tips to hold tissue
Speculum
Unlighted instrument with moveable parts that when inserted into a cavity can be spread apart for ease of visualization and tissue sample removal
Sponge Forceps
Used for holding sponges during surgery
Probe
Used to explore wounds and cavities usually with a curved, blunt point to facilitate insertion
Splinter Forceps
Used to grasp foreign bodies
Needle Holder Forceps
Used to grasp needles during suturing
Retractor
Used to hold back the edge of a surgical incision
Towel Clamps
Used to hold together the edges of sterile drapes
Punch
Used to remove tissue for examination and biopsy
Trocar
Used to withdraw fluids from cavities
Electrosection
Uses electric current to incise and excise the tissue
Electrocautery
Uses high-frequency, alternating electric current to destroy, cut, or remove tissue
Scope
Usually lighted, it is inserted into a body cavity or vessel to visualize internal structures
When is a straight suture needle used?
When the needle is pushed and pulled through the tissue without the use of a needle holder
Which of the following is not used to categorize instruments? a. Cutting b. Probing c. Grasping d. Clamp e. Cover
e. Cover