Module 12

Antiseptic application

A disposable sterile fenstrated reape is the type of drape most commonly used. it has an opening that is placed directly over the operative site. A fenestrated drape covers a wide area of skin around the operative area, leaving only the operative sire exposed. this provides a sterile area.

Puncture

A tetnus booster may be administed with this type of wound b/c the tetanus bacteria grow best in a warm anaerobic environment such as one in a puncture.

Mole removal

An individual may be born with moles, which are know as congenital nevi

melanoma characteristics

Asymmetric, irregular border, color varies from one area of the mole to another, various shades of tan, brown, and black, diameter is larger and t/1 inch which is about the diameter of a pencil eraser. Painful or tender, itches, bleeds, oozes, or has scaly appearance.

Ingrown toenail

Can occur in bother the nails of hands and feet however is most app to occur in the toenails. external pressure such as from tight shoes or from trauma, improper nail trimming, or infection.

Pouring a sterile solution

Check the expiration date on the solution, no not use outdated solution. Place the palm of your hand over the label. Remove the cap by touching only the outside, and place the cap on a flat surface with the open end up. Palming the label prevents the solution from dripping on the label and obscuring it. Handling the cap by the outside prevents contamination of the inside. Rinse the lip of the bottle by pouring a small amount of solution into a separate container

Serosanguineous exudate

Consists of clear and blood-tinged drainage and is commonly seen in surgical incisions.

Purulent exudate

Contins pus

Guidlines for application of a bandage

Do not apply bandage directly over an open wound, ensure that joints and prominent parts of bones are padded to prevent the bandage from rubbing the skin and causing irritation, apply the bandage from the distal to the proximal part of the body to aid the venous return of blood to the heart. as you apple the bandage, ask the patient whether it feels comfortable, The bandage should fit snugly enough that it does not fall off but not so tightly that it impedes circulation.

postoperative instructions for ingrown toenail

Elevate the foot for 24 hrs following the procedure, keep the area clean and dry, apply an antibiotic ointment daily, wear loss fitting shoes for 2 weeks following the procedure, avoid strenuous exercise for 2 weeks following the procedure, contact the medical office if any signs of infection occur.

Tissue forceps

Have teeth which are used to grasp tissue and prevent it from slipping

Wound care

Keep dressing clean and dry, if it becomes wet contact the medical office to schedule a sterile dressing change. Apply ice bag for swelling, report immediately any signs that the wound is infected, give patient written instructions on wound care to refer to at home

Four local signs of inflammation

Redness,swelling,pain, and warmth.

Most common type of moles

Skin tages, flat moles, and raised moles.

Suture removal

Some areas of the body such as the head, face, and neck are removed 3 to 5 days, and sutures inserted in other areas such as the skin of the chest, arms, legs, hands, feet, are removed in 7 to 14 days.

Surgical skin staples

Stapling is the fastest method of closure of long skin incisions. in addition trauma to the tissue is reduced because the tissue does not have to be handled.

Changing a sterile dressing

Tell the patient to keep the wound clean and dry and to contact the office if signs of infection occur such as excessive swelling, pain, or discharge. also remind patient to return to office as directed by the physician.

Procedure: colposcopy

The patient is assisted into a lithotomy position and is prepared as for a pelvic exam. the cervix is swabbed with acetic acid, using a long button-tipped applicator. The acetic acid dissolved cervical muscus and other secretions. it also causes abnormal tissue to turn white which allows easier visualization of abnormal areas of the cervix

Wound healing

The skin is a protective barrier for the body and is considered its first line of defense. The body has a natural healing process that works to destroy invading microorganisms and to restore the structure and function of damaged tissues.

Care of surgical instruments

To prolong the proper functioning of the ratchet, keep instruments with a ratchet in an open position when not in use

Cervical cryosurgery

also know as cryotherapy, uses freezing temperature to treat certain gynecologic conditions. most often performed as a treatment for cervical dysplasia to destroy abnormal cervical cells that show changes that may lead to cancer.

Surgical asepsis

also known as sterile technique, refers to practices that keep objects and areas sterile, or free from all living microorganisms and spores. protects the patient from pathogenic microorganisms that may enter the body and cause disease. It is always employed under the following circumstances; when caring for broken skin, such as open wounds and suture punctures, when skin surface is being penetrated, as by a surgical incisions for a mole removal or the administration of an injection; and when a body cavity is entered that is normally sterile, such as during the insertion of a urinary catheter. A sterile object that touches any unsterile object is automatically contaminated and must not be used. If the medical assistant is in doubt or has a question concerning there sterility of an article, he or she should consider it contaminated and replace it with a sterile article.

Phase 3 of wound healing

also known as the maturation phase, begins as soon as granulation tissue forms and can last for 2 years, during this phase, collagen continues to be synthesized, and the granulation tissue eventually hardens to white scar tissue.

Guidelines for surgical asepsis

always face the sterile field, if you must turn you back to it or leave the room, a sterile towel must be placed over the sterile field. Hold a sterile article above waist level. anything out of sight might become contaminated. the sterile article should be held infront of you and should not touch uniform. To avoid contamination place all sterile items in the center not around the edges of the sterile field. Do not reach over the sterile field. dust or lint from your clothing may fall onto it, or your unsterile clothing may accidentally touch it.

Bandage

apply pressure to control bleeding, to protect a wound from contamination, to hold a dressing in place, or to protect support, or immobilize an injured part of the body.

skin tags

are small painless benign growths that project from the skin from a small narrow stalk know as a peduncle.

abscess

collection of pus in a cavity surrounded by inflamed tissue

postoperative for cervical punch bipsy

do not douche, use tampons, or have intercourse for 1 week following the procedure to allow proper healing of the cervix to take place.

Procedure; incision and drainage

either gauze packing or rubber penrose drain is inserted in the wound to keep the edges of the tissue apart, this facilitates drainage of the exudate.

advantages of adhesive skin closures

eliminate the need for sutures and a local anesthetic, they are easy to apply and remove, they have a lower incidence of wound infection compared with sutures, and they result in less scarring than sutures.

Colposcopy

examine the vagina and cervix to detect areas of abnormal tissue growth that may not be visible with the naked eye. Performed following abnormal pap test results and to evaluate a vaginal or cervical lesion observed during a pelvic exam.

Signs a wound is infected

fever, persistent or increased pain, swelling or drainage, red streaks, radiating away from the wound, increased redness of warmth.

Figure eight turn

generally is used to hold a dressing in place or to support and immobilize and injured joint such as the ankle , knee, elbow, or wrist.

Hemostatic forceps

have serrated blades, ratchets, rind handles, and box locks and are available with straight or curved blades. Hemostats are used to clamp off blood vessels and to establish hemostasis.

Open wounds

involve a break in the skin surface or mucous membrane that exposes the underlying tissues; include incisions, lacerations, punctures, and abrasions

Epinephrine

is a vasoconstrictor that prolongs the local effect of the anesthetic and decreases the rate of systemic absorption of the local anesthetic.

furuncle

known as a boil, is localized staphylococcal infection that originates deep within a hair follicle.

Swaged suture packets

labeled to specific gauge, type, and length of suture material. The type of need point, and the needle shape.

Phase 1 of wound healing

lasts approximately 3 to 4 days, during this phase a barbarian network forms, resulting in a blood clot that plugs up the opening of the wound and stops the flow of blood. The blood clot eventually becomes a scab.

Absorbable sutures

made of a material gradually digested and absorbed by the body in a relatively short period of time.

Sutures

may be required to close a surgical incision or to repair an accidental wound. They approximate or bring together the edges of the wound with surgical stitches and hold them in place until enough healing has taken place so that the wound can withstand ordinary stress and no linger needs support from the sutures.

Swaged

means that the suture and needle are continuous unit. The needle is permanently attached to the ned of the suture

Suture size and packaging

measured by their gauge, which refers to the diameter of the suturing material. The sizes range from numbers below 0 to numbers above 0. The diameter of the suture material increases with each number above 0 and decreases with each number below 0.

Shave excision

most commonly used to remove protruding moles. can also be used to remove skin tags

Biopsies

most often performed to determine whether a tumor is malignant or benign.

Cutting needle

needle with a sharp point

post operative instrutions : cervical cryosurgery

normal activités can be resumed the day following the procedure, on the first postoperative day a clear watery vaginal discharge occurs, which lasts for 2 to 4 weeks. The discharge is caused by the shedding of the dead cervical tissue and gradually diminishes as the healing progresses. Use sanitary pads (rather than tampons) to absorb the watery discharge, do not douche, use tampons or have intercourse for 2 to 3 weeks following the procedure to allow proper healing of the cervix to take place

Non absorbable sutures

not absorbed by the body and may remain permanently in the body tissues and become encapsulated by fibrous tissue or may be removed. They are made from materials that are not affected by tissue enzymes Silk, nylon, polyester, polypropylene,polybutester, stainless steel, and surgical skin staples.

noncutting needle

one with a round point

examples of minor office surgery

performed in an ambulatory health care facility, can be performed in a short period of time, usually in less than 1 hour, require a local anesthetic, a topical anesthetic, or no anesthetic. can be performed safety with a minimum of discomfort of the patient. Do not under normal circumstances pose a major risk to life, or function of an organ or body parts.

Cervical punch biopsy

performed in combination with colposcopy to remove a cervical tissue specimen for examination by a pathologist. The purpose of the biopsy is to detect the presece of cervical dysplasia or cancer of the cervix.

curved needle

permits the physician to dip in and out of tissue. A needle holder must be used with a curved needle.

dysplastic nevi

precancerous moles, usually larger in size and irregular coloration and shape. The center of dysplastic nevi may be raised and darkened.

infiltration

produce a loss of sensation in that area and prevent the patient from feeling pain, during surgery. when first injected into the tissues, lidocaine causes the patient to experience a brief burning or stinging sensation at the injection site. The local anesthetic begins working in 5 to 15 minutes and has a duration of action of 1 to 3 hrs depending on the type of anesthetic.

Inflammation

protective response of the body to trauma, such as cuts and abrasions, and to the entrance of foreign matter, such as microorganisms.The purpose of inflammation is to destroy invading microorganisms and to remove damaged tissue debris from the area so that proper hearing can occur.

Minor office surgery

refers to a surgical procedure that is restricted to the management of minor condition

Scalpel

small straight surgical knife consisting of a handle and thin sharp steel blade. A scalpel is used to make surgical incisions and can divide tissue with the least possible trauma to surrounding structures.

Sebaceous cyst

thin closed sac or capsule located just under the surface of the skin. Forms when the outlet of a sebaceous oil gland becomes obstructed. This type of case can occur anywhere on the body except on the palms of the hands and the soles of the feet. usually slow-growing, painless and contender and may disappear on its own.

Two circular turns

used to anchor a bandage at the beginning and end of a spiral

Retractors

used to hold tissues aside to improve the exposure of the operative area

Laser surgery

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

Straight needle

used when the tissue can be displaced sufficiently to permit the needle to be pushed and pulled through tissue.

Spiral-reverse-turn

useful for bandaging a part that varies in width, such as the forearm or lower leg, reversing each spiral turn allows for a smoother fit and prevents gaping caused by variation in the contour of the limb.

benign mole characteristics

usually range in color from brown in nearly black in color but can be pinnkish flesh color to dark blue of even black. Shape is usually round or oval and may be smooth or rough. Size is usually smaller than a pencil eraser but can range from barely visible to quite large area. may form a raised are on the skin or may be flat.

laceration

would in which the tissues are torn apart, rather than cut, leaving ragged and irregular edges,