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Surgical fundamental skills

We need to know: ?Iind year, medicine

- anatomy

- phisiology

- microbiology

goal:practical activity in clinic (oncalls)

Sef lucrari dr. Tama

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1. Preparing the surgeon for surgery

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2. Preparing the patient for surgery positioning

monitoring

decontamination

Isolating the operatory field

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3.Local anesthesia

preparing for the intradermal test

testing the patient’s reaction –intradermal injection

subcutaneous injection

testing the quality of local anesthesy

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4. Organising the table with sterile instruments

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5. Surgical knots !thicon plate

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VI.Skin suture

discontinuous"separate stiches#

simple continuous

continuous suture entrapment

intradermal

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VII. bandages and dressings

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medical specialties

SURGICAL SPECIALTIES

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SURGERY ( as proceeding# any technique/ proceeding on a patient, performed in a hospital , by asurgical team.


medical eld that treats diseasesby cutting and opening

SURGERY

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WHAT IS A WOUND ?SURGICAL WOUND

absence of skin/mucosacut wound

surgical wound

urn

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SU'ER(ICIAL WOUND


? TOPOGRAFIC ANATOMY → LAYERSSupercial

Middle

Deep

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supercial

skin,

celular issue ,

su!er"cial #ascia.

testing te cutane!us f!ld

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!r"!aring t#" surgical $"ld %or t#" &anag"&"nt o%a su!"r$cial wound

middle

deep fascia

muscle

"l!!d #essel

ner#e

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Deep

"!nes

deep #essels and ner#es

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ANATO)Y $ %e se!arai&n 'e(een %e su!er"cial an) )ee! issues DEEP $ASCIA

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*+CONTAMINATION

*ACTERIA

CONTA)INATION+ IN(ECTION

*+-INF+CTION

STERILI%ATI&'

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CONTA)INATION

)irec c&nac (i% an in#eci&n s&urce

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IN(ECTION,the entrance and developement of some pathogenic

agents ,in a living body, (parasites,bacteria orviruses ) and the tissues’s reactions to thisagression, meaning the inamation

tumor

rubor calor

dolor

functio laesa

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DESINFECTIN

proced!re "it# temporary res!lt ,"ic#

e$terminates%anni#ilatest#e &acteria and vir!ses

' "ors in inert environments , !sing p#ysical and

c#emical means

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STEI*IS+TIN: complete elimination%anni#ilation o any ind o micro'organism , incl!ding

t#e &acterial spores

active and eicient on

t#e inert o&-ects

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!r"!aring t#" surgical $"ld %or t#" surgical&anag"&"nt o% a su!"r$cial wound

&!erai&n r&&/ %e !lace (%ere %e sur0ical ac )e1el&!s srucure Filer

Circuis$serile /aerials, unserile /aerials, /e)ical sa,!aien

Rules #&r /ainainin0 serili

Pr&&c&les #&r %e aci1i

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&!erai&n r&&/ %e !lace (%ere %e sur0ical

ac )e1el&!s

srucure

Filer

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O!erai&n r&&/ Filer

s!ecial !lace #&r scru''in0

s!ecial scru''in0 rules

'e#&re sur0er

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O!erai&n r&&/

c&ain0 serile sur0ical 0a(n

(

)

*

+

,

-

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c&ain0 serile sur0ical 0l&1es

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Circuis$ serile /aerials,unserile/aerials,/e)ical sa, !aien

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!les or maintaining t#e sterility

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rotocols or t#e activity

II. Preparing the patient for surgery positioning

monitoring

decontamination

Isolating the operatory field

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urgical fieldegion or segment to be operated

/cleaning /decontamination

/isolating

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sterile %an)lin0 %e /aerials an) sur0ical insru/ens

serile !r&eci&n e6ui!/en

serile #&rce!s #&r %an)lin0 %e /aerials

circuis #&r sur0ical r&&/

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!re!arin0 %e sur0e&n #&r sur0er

e6ui!a/en(costume for thesurgical room,masc,bonnet 7

sur0ical scru''in0(specialsolutions,technique,timing)

serile sur0ical 0a(n

serile 0l&1es

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!re!arin0 %e !aien #&r sur0er

outside the operation roominformed consent

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-cl"aning.s#ow"r/"li&inating t#"#air0-s!"cial "1ui!a&"nt .singl" us"0

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!re!arin0 %e !aien #&r sur0er

inside the operating room correct positioning on the surgical table

le# laeral !&sii&n

0nec&l&0ical !&sii&nin0!&sii&nin0 &n %e &r%&!e)ic a'le

inside the surgical room

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inside the surgical room

supercial venous acces (cannula) monitor(blood pressure,heart rate,!"

periphericlevel)

testing the patient’s reaction to local anesthesia

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preparing the surgical field

+ the correct use of a hemostatic band(tourniquet)= reduce the

bleeding ,better view

8. !r&eci&n0ause 2. !lacin0 %e 'an) !r&9i/al &

%e sur0ical "el)

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+ correct use of the hemostatic band = reduce the bleeding

3. :e9i&n %e "n0ers 4. elasic 'an) a!!licai&n#r&/ )isal & !r&9i/al

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+ correct use of the hemostatic band = reduce the bleeding

usin0 %e elasic 'an) ;re)uces %e 'l&&) 1&lu/e

#r&/ )isal se0/en %e li/'

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preparation

+decontamination (solutions,limits,technique)

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+limits( sterile drapes- unique or multiple use,technique)

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!r"!aration o% a surgical $"ld %or t#"surgical &anag"&"nt o% a su!"r$cial

wound

!re!arin0 %e a'le (i% serile insru/ens

draping the table #ith sterile materials

correct ,sterile handling and manipulating for theinstruments

correct position of the instruments on the surgicaltable

preparing the materials for local anesthesia

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sterile draping of the surgical table

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handling and manipulating thesterile instruments

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sterile handling of the surgicalinstruments

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correct position of the instruments onthe table

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correct position of the instruments onthe table

incisi&n

scal!el

s issue /ani!ulai&n

sur0ical #&rce!s

)iseci&n

sciss&rs

sur0ical %ae/&s%asis

%ae/&s%asis #&rce!s

suure

needle!lder

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preparing and testing the solutionsfor local anesthesia

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T%ank

&u===

abiliti

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