CHP 25 Minor Office Surgery

ABRAISION

(Scrape) Outer layers of skin are scraped or rubbed off

SKIN TAGS

(acrochordon)Small, painless, benign growths

Post operative instructions for toenail removal ?

1) Elevate the foot for 24 hours following procedure 2) Keep the area clean and dry 3) Cleanse toenail daily with warm water and gently dry the area. 4) Apply antibiotic ointment daily until the wound has completely healed. 5) Wear loose-fitting shoes for two weeks after the procedure 5) Avoid strenuous exercise for two weeks after the procedure 6) Contact the medical office if any signs of infection occur, which includes increasing pain, redness, swelling, and drainage from the toe.

How do you pour sterile solution?

1) read the label of the solution to ensure that you have the correct one. 2) check expiration date 3) check again to make sure its the right solution 4) place palm of your hand over the label, remove the cap by only touching the outside, and place the cap on a flat surface with the open end up 5) rinse the lip of the bottle if it been used by pouring a small amount of solution into a separate container. 6) Do not allow the neck of the bottle to come in contact with the sterile container, and careful not to splash solution

List three functions of a bandage.

1. apply pressure to control bleeding. 2. protect wound from contamination. 3. hold a dressing in place.

LIST TWO ADVANTAGES FOR USING A TUBULAR BANDAGE

1. easy to apply. 2. adheres more securely to the body part.

List three advantages of of adhesive skin closures

1. eliminate the need for sutures & local anesthetic. 2. easy to apply and remove. 3. lower incidence of wound infection

List two resons for performing a colposcopy.

1. examine vagina&cervix to detect areas of abnormal tissue 2. prevent cervical cancer.

MA RESPONSIBILITIES DURING A MINOR SURGICAL PROCEDURE

1. explain the patient prep required for the procedure & for obtaining the patient's signature on a written consent form for treatment. 2. preparing the patient's treatment form. 3. preparing the patient. 4. preparing surgery tray. 5. administering postop care. 6. cleaning the treatment room

LIST 4 EXAMPLES OF BODY PARTS TO WHICH A TUBULAR BANDAGE CAN BE APPLIED

1. fingers. 2. toes. 3. arms. 4. legs

LIST 2 USES OF THE FIGURE-EIGHT BANDAGE TURN?

1. holds dressing in place. 2. to support/immobilize an injured joint.

List 4 guidelines to follow when applying a bandage.

1. observe the principles of medical asepsis. 2. ensure skin is clean & dry 3. ensure joints/prominent parts of bones are padded to prevent bandage from rubbing. 4. if bandage roll is dropped during procedure, discard it & get a new one.

What are characteristics of melanoma?

1. one half of mole is different from other half. 2. edges of mole are notched/blurred. 3. color varies 4. diameter is larger than 1/4 inch 5. mole is painful, tender, itches, bleeds, oozes, or scaly appearance

CHARACTERISTICS OF A MINOR SURGICAL PROCEDURE?

1. performed in an ambulatory healthcare facility. 2. can be performed in a short period of time. 3. require a local, topical, or no anesthetic. 4. can be performed safely with minimal discomfort. 5. doesn't pose a serious risk to the patient.

List three causes of an ingrown toenail.

1. trauma. 2. improper nail trimming. 3. infection

5 GUIDELINES IN CARING FOR INSTRAMENTS

1.handle instruments carefully. 2. don't pile instruments in a heap3. rinse blood & body secretions off ASAP. 4.use instruments for their intended use. 5. sanitize/sterilize instruments with proper technique.

WHEN DO YOU REMOVE SUTURES FROM FACE AND NECK?

3 to 5 days

most frequent used sterile dressing

4 x 4

Sutures inserted into the arms and legs usually remove after?

7 to 14 days

WHEN DO YOU REMOVE SUTURES FROM CHEST-ARMS-LEGS?

7 to 14 days

HOW LONG DO ABSORBABLE SUTURES LAST?

7 to 21 days after incersion

What is an abscess?

An abscess is a collection of pus in a cavity surrounded by inflamed tissue

FURNICLE

BOIL=Localized staphylococcal infection that originates deep within a hair follicle.

WHAT TYPE OF ANTISEPTIC IS USED FOR OPERATIVE AREAS?

Betadine

WOUND

Break in continuity of an external or internal surface caused by physical means

INCISION

Clean, smooth cut caused by a sharp instrument.

What occurs during the inflammatory phrase in the healing process?

Fibrin network forms

SUTURES REMOVAL

Good blood supply - Sutures removed in 3 to 5 days; Chest, arms, legs, hands and feet - Sutures removed in 7 to 14 days.

phase 2 of wound healing

Granulation phase

phase 1 of wound healing

Inflammatory phase

TYPE OF MINOR OFFICE SURGERY PREFORMED IN MEDICAL OFFICE

Insertion of sutures, sebaceous cyst removal,incision and drainage of infections, mole removal, needle biopsy and cervical biopsy, in grown toenail removal.

Colposcopy is frequently performed for?

Its performed after abnormal Pap test results and to evaluate a vaginal or cervical lesion observed during pelvic examination

Advantage of using surgical skin staples?

Its the fastest method of closure of long skin incisions.

Laser Mole surgery is used to remove?

Its used to remove all small or flat moles that are brown or black in color

Characteristics of sebaceous cyst?

Its usually a white and yellow in appearance and varies in size from less than 1/4 inch (0.6) in diameter to nearly 2 inches (5 cm) in diameter. Its in a dome shape with a smooth surface filled with a thick, fatty-white, cheese material that had a foul odor.

When not in use, an instrument with a ratchet should be stored how?

Keep instruments with a ratchet in an open position.

COLPOSCOPE

Lighted instrument with a magnifying lens

ROLLER BANDAGE

Long strip of soft material wound on itself to form a roll.

Phase 3 of wound healing

Maturation phase

INGROWN TOENAIL

Occurs when toenail grows deeply into nail grove and penetrates surrounding skin.

DYSPLASTIC NEVI

Precancerous mole

What are local signs of inflammation?

Redness, Swelling, Pain, Warmth

BIOPSY

Removal and examination of tissue from the living body.

What information is found on the label of a swaged suture packet?

Specify the gauge, type, and length of suture material, the type of needle point, and the needle shape

MINOR OFFICE SURGERY

Surgical procedure that is restricted to management of minor conditions. *Does not require the use of minor conditions

SWAGED NEEDLE

Suture and needle are one continuous unit

INFLAMMATION

The protective response of the body to trauma and entrance of foreign substances is called?

Purpose of a sterile fenestrated drape is to?

The purpose is to cover a wide area of skin around the operative area, leaving only the operative site exposed.

SEBACEOUS CYST

Thin, closed sac or capsule located just under the surface of the skin.

LACERATION

Tissues are torn apart, leaving ragged and irregular edges.

MELANOMA

Very serious type of skin cancer

COLOSCOPY

Visual examination of the vagina and cervix with a colposcope

SKIN

What is the first line of defense of the body?

OPEN WOUND

What is the term for a break in skin surface or mucous membrane that exposes underlying tissue?

PUROSANGUINEOUS

What type of exudate contains both serum and blood?

PURULENT

What type of exudate contains pus?

RETRACTORS

Which instrument is used to hold tissue aside to improve exposure of the operative area?

NONABSORBABLE

Which suture has the smallest diameter?

PUNTURE

Wound made by sharp pointed object piercing skin layers

WHY 1 INCH BORDER

a 1 inch border around sterile field is considered contaminated or unsterile

PRECANCEROUS

abnormal cells that have the potential to develop into cancer in the future.

WHERE DO YOU HOLD STERILE ARTICLES

above the waistline- anything out of sight might become contaminated-sterile articles should be held in front of you and not touch uniform

What is the purpose of reversing the spiral during a spiral-reverse turn?

allows for a smoother fit & prevents gaping caused by variation in the contour of the limb

WHY FACE STERILE FIELD

always face the sterile field so to not contaminate. if you must turn your back or leave place sterile towel over it

CERVICAL DYSPLASIA

an abnormal growth of cells on the surface of the cervix that are precancerous.

FLAT MOLE

any dark spot or irregularity in the skin

PROCEDURE OF SEBACEOUS CYST REMOVAL

apply anesthetic incision down center or both sides removes cyst sutures area sterile dressing

HOW LONG DOES LIDOCAINE WORK?

begins working in 5 to 15 minutes and lasts 1-3 hours

NONCUTTING NEEDLE

blunt needle-penetrate tissues that offer small resistance-internal organs-sc tissue-muscle

B/B

both blade tips are blunt

S/S

both blade tips are sharp

SUTURES ARE MEASURED ?

by their gauge sizes range from numbers below o(aught) to numbers above 0-the diameter increases with number above 0 and decreases with number below 0

WHAT TYPE OF BANDAGE TURN IS USED TO ANCHOR A BANDAGE?

circular

What occurs during the maturation phase of a wound healing?

collagen continues to be synethsized and scar tissue forms-begins as soon as granulationtissue forms and lasts up to 2 years

What is the difference between congential nevi and acquired nevi?

congential are born with moles and acquired are developed over time

SEROSANGUINEOUS EXUDATE

consists of clear & blood tinged drainage

PUROSANGUINEOUS EXUDATE

consists of pus & blood

SEROUS EDUDATE

consists of serum

PURULENT EXUDATE

contains pus (WBC, dead tissue)

What is the purpose of a fenestrated drape?

covers a wide amount of skin around the operative site, this provides a sterile area

SKIN LESIONS

cryosurgery used-benign skin lesions -warts skin tags liquid nitrogen

CURVED NEEDLE

dip in and out of tissue -must use needle holder

The purpose of swabbing the cervix with acetic acid during colposcopy is to?

dissolve cervical mucus and other secretions

List two advantages of surgical skin staples to approximate a wound.

fastest method and reduced trauma

What occurs during the inflammatory phase of wound healing?

fibrin network forms causing blood clot to plug up the opening of the wound and stop blood flow-lasts 3 to 4 days

What occurs during the granulation phase of wound healing?

fibroblasts migrate to the wound and begin to synethsize collagen, growth of new capillaries

WHY USE INCISION AND DRAINAGE?

for localized infections like abscesses-furuncles and infected sebaceous cysts that do not rupture and drain easily

MOLE SHAVE EXCISION

for protruding moles- do not use on dysplastic nevi because tissue cells underneath may grow back

WHAT IS THE PURPOSE OF SERRATIONS FOUND ON SOME INSTRAMENTS?

grasp tissue & prevent it from slippin gout of the jaws of the instrument

Why are sutures inserted in the head and neck generally removed sooner than other sutures?

head and neck have a good blood suply and heals quickly

HOW ARE SUTURES PACKAGED

in a box of individually packed sutures that are stamped with an expiration date

Explain how an instrument should be handed to the physican during minor office surgery.

in a firm, confident manner in its functional manner

LUGOIS IODINE

is used on cervical epithelium. it contains glycogen which absorbs iodine and turns abnormal tissue dark brown

What is the purpose of using gauze packing or a rubber Penrose drain after incising a localized infection?

keep edges of tissue apart; facilitates drainage.

What is the name of the local anesthetic most frequentl used in the med office during minor office surgery?

lidocaine hydrochloride (xylocaine)

PROCEDURE COLPOSCOPY

lithotomy position vaginal speculum wipe cervix with saline colposcope used to observe cervix acetic is swabbed on surface and caused abnormal tissue to turn white

PROCEDURE FOR INCISION AND DRAINAGE

local anesthetic scalpel incision pus drains out using gauze to absorb gauze packing or Penrose drain inserted in would to keep tissue apart apply sterile dressing of several thicknesses

EXUDATE

material that has escaped from blood vessels during the inflammatory process

CONGENITAL NEVI

moles that an individual is born with

ACQUIRED NEVI

moles that develop over time

What is an ingrown toenail?

occurs when the edge of the toenail grows deply into the nail groove & penetrates the surrounding tissue

B/S

one tip is blunt and the other is sharp

SEBACEOUS CYST REMOVAL

only when infected and irritating is drained first

WHAT IS THE FUNCTION OF THE SPECULUM

open or distend a body orifice/cavity to permit visual inspection

WHAT IS INFILTRATION?

physician injects local anesthetic to tissue

MELANOCYTES

produces the pigment melanin

WHAT IS THE PURPOSE OF INFLAMMATION?

protective response of the body to trauma destroys invading microorganisms and to remove damaged tissue debris

SANGUINEOUS EXUDATE

red & consists of RBC

LIST 4 LOCAL SIGNS THAT OCCUR DURING INFLAMMATION?

redness, swelling, pain & warmth

EXPLAIN STERILITY OF HANDS

sanitizing hands to make them medically aseptic must be performed before and after surgical procedure using proper technique

SERRATIONS

saw like teeth that grasp tissue and prevent it from slipping out of the jaws of the instrument.

ABSORBABLE SUTURES ARE USED FOR?

sc tissue-fascia-intestines- bladder and to ligate or tie off vessels

RECURRENT TURN

series of back and forth turns used to bandage tips of fingers toes amputee or head

CUTTING NEEDLE

sharp point-used for firm tissue like skin-

PROTRUDING MOLES

shave excision is often used to remove?

What are the most common methods used to remove moles?

shave excision, surgical excision, & laser surgery

WHAT ARE NON-ABSORBABLE SUTURES MADE OF?

silk-nylon-plyester

What are skin tags? Where are they most frequently found on the body?

small painless benign growths that project from the skin from a small narrow stalk; eyelids, neck, armpits, groin, and upper chest

WHAT ARE ABSORBABLE SUTURES MADE OF?

surgical gut-surgigut- or synthetic materials-polyglycolic acid

WHY DOES A PUNCTURE WOUND ENCOURAGE GROWTH OF TETANUS BACTERIA?

the pierced hole provides a warm anaerobic environment

What is a sebaceous cyst and what causes it to form?

thin, closed sac or capsule located under the surfaceof the skkin; when a sebaceous gland is obstructed

CONTUSION

tissue under skin injured

STRAIGHT NEEDLE

tisue permits needle to be pushed and pulled through tissue no needle holder

What is the purpose of performing a cervical punch biopsy?

to detect the presence of cervical dysplasia or cancer of cervix

SPIRAL TURN

used for fingers arms legs chest abdomen upward at a slight angle and overlap previous turn by one-half to two thirds the width of the bandage

LASER MOLE SURGERY

used to remove small or flat moles that are black or brown in color use laser beam of light which evaporates mole tissue seals of blood vessels no local anesthetic

What is the appearance of dysplastic nevi?

usually larger than normal moles, have irregular color & shape, center is raised & darkened

EPINEPHRINE

vasoconstrictor that prolongs the local effect of anesthetic by constricting blood vessles exampl forearm

COLLEGEN

white protein that provides strength to wound